The CDC has just released a 50-page report called the YES WE CAN Children’s Asthma Program: the San Francisco Experience. The case study documents an effective medical/social asthma management program in journalistic detail. The case study was written to promote national replication and sharing of lessons learned, and is only the sixth such case study presented by the CDC. The multi-pronged intervention was developed for use in public health and community clinics, and then demonstrated in three San Francisco clinics.
A distinguishing feature of the program is its integration of community health workers who provide home environmental remediation, culturally competent health education, and patient navigation. The program resulted in large reductions in symptom days, emergency department visits, and hospitalizations. Replication materials are written up in a three-volume Toolkit.
To mount the demonstration, seventeen organizations combined in the YES WE CAN Urban Asthma Partnership. They developed a care model shaped by best practices from founding partners. San Francisco State University and City College of San Francisco coordinated the effort from their Community Health Works project office. They contributed a team model of care. Kaiser Permanente Northern California contributed methods in chronic conditions management developed since 1996, including risk stratification and close case management. The Pediatric Asthma Clinic at San Francisco General Hospital developed an electronic data base embedding National Institutes of Health Clinical Guidelines, and many innovations to insure the model would work under resource-scarce real-world conditions. The National Initiative on Children’s Healthcare Quality contributed expertise in clinical quality improvement and team care. The California Endowment was the lead funding source of the demonstration project and the Toolkit, together with Kaiser Permanente, First Five, and the U.S. Department of Education’s Fund for the Improvement of Post Secondary Education.
The case study report is available to view and download as a free copy from the following website:
http://www.cdc.gov/asthma/interventions/yes_we_can.htm
Additional information on the YES WE CAN demonstration and Toolkit is available at:
http://www.communityhealthworks.org/yeswecan/
Related to this story, CAFA has summarized scientific information on in-home environmental interventions in easy-to-understand language. Please go to http://www.calasthma.org (click on “resources” and then sort by “environmental” and “evaluation” and “homes”), or, for example, go directly to:
1.) http://www.calasthma.org/resources/show_resource/428/ (Morgan et al, NEJM, from “Innter City Asthma Study”
2.) http://www.calasthma.org/resources/show_resource/609/ (Gruchella et al, JACI, from “Inner City Asthma Study”
3.) http://www.calasthma.org/resources/show_resource/485/ (Breysee et al, EHP, a summary report on what we know and what we still need to learn about the relationship between housing and children’s health, from a federally sponsored workshop 11/2002)
We also encourage you to re-visit our CAFA Briefing Kit’s fact sheet “Asthma and Indoor Air Quality in the Home,” available at:
http://www.calasthma.org/resources/show_resource/444/
The Briefing Kit is available in its entirety (with complete lists of references) at: http://www.calasthma.org/home/briefing_kit/
In addition, if you have trouble accessing the article, you can contact Community Health Works by e-mail (chw@sfsu.edu) to request an electronic version be sent (Adobe PDF file or Microsoft Word document, to be determined). Please write “YES WE CAN! CDC Case Study” as subject line and your name and preferred e-mail address as message.
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