Inner City Asthma

Implemented in El Rio Santa Cruz Community Health Center, Tucson, Arizona by MAS Consultants Inc., P.O. Box 5130 Aiken, South Carolina 29804.

This case study was prepared for CDC by Dr. LaMar Palmer of MAS Consultants. The purpose of the case study is to share the experience of one community as they attempt to address the problem of asthma. It does not represent an endorsement of this approach by CDC.

Inner City Asthma: Program Modifications

The education, counseling, and environmental interventions are being implemented in accordance with the prescribed NCICAS/ICAI format and content. A few modifications have been added to the El Rio implementation. These additions are examples of creative teaching and inventiveness that supplement the protocol without changing the overall objectives or the expected outcomes.

• The addition of one follow-up meeting has been instituted to provide another opportunity for the staff to become better acquainted with the families and allow the families to feel more comfortable with the AC and the RT. This change was considered important to increase families’ willingness to express themselves more openly and be more candid with the staff, which are necessary for effective follow-up telephone communications and home visits that flow from the core program.
• Home visits, not part of NCICAS, were instituted with the ICAI because families were expected to respond better to environmental recommendations from the AC if she/he actually visited the home. This option further personalizes the intervention and adds convenience for families who otherwise need child care or need to transport siblings to the clinic for meetings with the AC – especially true for reservation families who live many miles away. The El Rio ICAI staff are use home visits liberally as an alternative for improving follow-up visits. When follow-up visits are held at the ICAI office in the El Rio Clinic, some families do not follow through with their appointments. Home visits may successfully fill this gap.
• A notebook in the form of a three-ring binder is provided to every family at the second counseling session. It contains numerous asthma-care resources.
• Use of a live "asthma kid" in the children’s group session sparks added interest among the children as they explain asthma and its symptoms and triggers. Also, the use of the “miniature bedroom,” used to reinforce learning about asthma triggers in the home, is an added innovation that builds on one of the children’s group activities used to teach the importance of eliminating dust in the room where the child sleeps.