PURPOSE:Asthma is the leading cause of hospitalization and absenteeism among children 0–14 years in New York City(NYC). In parts of the city asthma rates are double the national average. To address the high prevalence of asthma in pre-school children, the NYC Department of Health & Mental Hygiene (NYC-DOHMH) launched a city-wide Asthma Initiative to facilitate earlier diagnosis and interventions in this population.
METHODS:In May, 2005 The Long Island College Hospital Asthma Center (LICH-AC) entered into a contract with the NYC-DOHMH to participate in the Asthma Initiative. The LICH-AC implemented asthma screening and asthma educational sessions at daycare centers selected by zip code in central Brooklyn. Health Tracking software (HTS) from NYC-DOHMH which includes asthma educational messages, was installed in the centers. Asthma screening was accomplished using a validated Brief Respiratory Questionnaire (BRQ) composed of 8 questions. The educational sessions were provided to caregivers and daycare center staff via a Health Educator. Caregivers of children with BRQ data consistent with a diagnosis of asthma received letters to present to the children’s physicians.
RESULTS:Thirty-eight daycare centers have been recruited through March, 2008. Asthma screening has been completed in 4632 children and 907 (19.5%) were consistent with a diagnosis of asthma. Physicians concurred with the diagnosis in 606 (67%) of the children screening positive, and provided an Asthma Action Plan (AAP) to 513 (85%). Eight-five (16%) of children given AAP’s were deemed to have persistent asthma by their physicians and 80 (94%) of these received inhaled corticosteroids. Asthma education was provided to 625 caregivers and 429 school staff. Training in the use of HTS was provided to 241 school staffers.
CONCLUSION:With modest resources, asthma screening for pre-school children attending daycare, and asthma education for caregivers and daycare center staff is feasible.
CLINICAL IMPLICATIONS:This program has broad potential application in similar populations.
DISCLOSURE:Kathy Garrett-Szymanski, Other Supported by contract # 08CR147301R0X00 from New York City Department of Health & Mental Hygiene; No Product/Research Disclosure Information