Reducing childhood asthma through community-based service delivery—New York City, 2001-2004

Morbidity and Mortality Weekly Report, Jan 14, 2005 by S.W. Nicholas, V.E. Hutchinson, B. Ortiz, S. Klihr-Beall, B. Shoemaker Jean-Louis, K., C. Singleton, J. Credell, R. Swaner, R.D. Vaughan, M.E. Northridge, L.F. Cushman, E. Polley, C. Golembeski

Based on findings from a qualitative evaluation involving parents/guardians of children enrolled in HCZAI and the pediatric asthma team, at least three limitations were documented. First, some families did not believe their child's diagnosis of asthma was correct, or they believed that it was outdated. Thus, they were unwilling to enroll their children in HCZAI. Second, other nonparticipants cited problems with scheduling of home visits or reported that socioeconomic needs and lack of housing precluded enrollment in HCZAI. Third, monitoring effectiveness proved burdensome for some staff and clients and failed to capture the full extent of client needs and service provision.

To be more effective in reducing asthma morbidity among children in Central Harlem, additional activities will be implemented in HCZAI. These include 1) building closer working alliances with other community organizations and agencies, particularly the NYC Department of Education and the NYC Department of Health and Mental Hygiene; 2) developing protocols for situations in which family and mental health problems preclude participation in HCZAI; and 3) expanding community education regarding asthma to enhance health literacy through existing Harlem Children's Zone, Inc., programs (2).

Previous research has indicated that an individualized, home-based, comprehensive environmental intervention decreased exposure to indoor allergens, resulting in reduced asthma-related morbidity (9). By incorporating HCZAI into an ongoing, community-building initiative and linking it to programs targeted to meet children's medical, educational, environmental, social, and legal needs, positive outcomes will be sustained throughout their lifetimes. Additional information about HCZAI is available at http://www.hcz.org.