Sinai Urban Health Institute
Since 2000, SUHI and Sinai Children’s Hospital have implemented a series of six comprehensive interventions aimed to decrease asthma-related morbidity and improve the quality of life of inner-city children with asthma and their families. At the heart of each program is the Community Health Worker (CHW) Model. Interventions vary in length from 6 months to 1 year and consist of 3-6 home visits conducted by a trained CHW. CHWs are recruited from the specific communities targeted by the interventions and provide one-on-one individualized home-based asthma education to children and their families. “Hands-on” in their approach, they not only teach but demonstrate skills; for example, proper medication techniques or how to remove asthma triggers from the home environment. The CHW also serves as a liaison between the family and the medical system, encouraging regular primary care physician (PCP) visits, providing referrals to those without a PCP, and working with the PCP and the family in the development of an Asthma Action Plan.
To date, four interventions have been completed, and three are in process. Process and Outcome evaluation is a main priority and strength of the Sinai Asthma Program. Each of the four completed interventions is associated with significant decreases in asthma-related morbidity. Specifically, symptom frequency was reduced on average of 53% and emergency department visits were reduced on average of 64%. Interventions have also documented significant increases in Quality of Life and asthma knowledge and reductions in asthma triggers. The Sinai Asthma Program is also cost-effective, resulting in a cost-savings of $4 - $13 saved per dollar spent on the intervention. In conclusion, our findings suggest that individualized, one-on-one asthma education provided by a trained, culturally competent CHW in the home environment is an effective means of improving asthma.
To learn more please visit: http://www.sinai.org/content/suhi-projects.