PURPOSE: Over 200 asthma coalitions in the U.S. and many more internationally are working to change systems and policies to enhance the health of children with asthma. Little empirical evidence is available regarding these efforts. This study describes the effect of coalitions’ efforts in seven American cities on local policies and on the health of low income minority children in the Allies Against Asthma (Allies) communities.
METHODS: Data were collected through documents and reports concerning the policy focused actions of the seven coalitions. In each locale surveys were also conducted with a total of 224 parents of children with asthma and 318 parents of children in comparison groups to test the effect of programs offered as part of coalitions’ efforts to enhance family management of disease. Qualitative and quantitative data analyses were conducted.
RESULTS: Preliminary qualitative analyses identified 32 changes in institutional and public policies resulting from efforts of the coalitions related to coordination and integration of care and services and linkages among institutions. Quantitative analyses of differences between children participating in coalition programs and comparison groups illustrated that at the one year follow-up measurement children and families exposed to the work of the Allies coalitions reported a decrease in daytime asthma symptoms within the past 14 days (p<0.01) and a decrease in nighttime symptoms within the past 14 days (p<0.01) and a decrease in nighttime symptoms during the past year (p < 0.01) compared with families not exposed to the Allies interventions.
CONCLUSION: Asthma coalitions can have significant impact on local policies and health care systems bringing about sustainable changes that improve health services delivery and the community environment, especially, for children with asthma. Children and families participating in coalition programs exhibit improved outcomes related to both daytime and nighttime asthma symptoms.
CLINICAL IMPLICATIONS: Coalitions involving a broad range of clinical and non clinical stakeholders and community based groups can be valuable vehicles for changing asthma related health and health care in low income communities.
DISCLOSURE: Noreen Clark, None.