Improving childhood asthma outcomes in East Harlem: the East Harlem Asthma Center of Excellence’s Asthma Counselor Program

Abstract

Objectives

To evaluate the effectiveness of the Asthma Counselor Program, a program of the New York City Department of Health and Mental Hygiene, designed to improve asthma outcomes among children.

Methods

We used a pre-post study design among children who enrolled in the program. We included self-reported outcome measures by comparing the previous 12 months (captured at intake) to the 12 months following program enrollment. To calculate the 12 months after enrollment, we added the number of outcome events reported at each follow-up session, which are conducted approximately three months apart, to compute 12-month (or “year-end”) post-enrollment outcomes.

Results

We enrolled 136 children during the study period (2018); 85 children remained in the program for 12 months and 51 became lost-to-follow-up. Among those who remained in the program, at the “year-end” session, there were statistically significant reductions in the mean number of asthma-related unscheduled healthcare appointments or urgent-care visits (73%), uses of prednisone (65%), asthma-related school absences (60%), asthma-related ED visits (57%), and asthma-related hospitalizations (50%).

Conclusions

Twelve months after children enrolled in the program, they had significantly improved asthma outcomes. Our findings, along with results from similar studies, support multicomponent interventions, especially those led by masters-level social workers.

Keywords:

• Health equity
• program evaluation
• social workers
• asthma control
• children
• intervention

Acknowledgements

We wish to thank the many staff and partners who have been a part of this program, including the asthma counselors and the partner hospital staff at Mt Sinai and Metropolitan.

Declaration of interest

The authors report no conflict of interest.

Additional information

Funding

This work is supported by both New York State and City tax levy dollars.