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DETROIT HEAD START ASTHMA PROJECT:

“An Intervention to Improve Asthma Morbidity and Asthma Health Care Use Among Low-Income Urban Preschool Children”. DETROIT HEAD START ASTHMA PROJECT:. Belinda Nelson, PhD Presenter/Project Director. Head Start 9 th National Research Conference June 23-25, 2008.

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DETROIT HEAD START ASTHMA PROJECT:

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  1. “An Intervention to Improve Asthma Morbidity and Asthma Health Care Use Among Low-Income Urban Preschool Children” DETROIT HEAD START ASTHMA PROJECT: Belinda Nelson, PhD Presenter/Project Director Head Start 9th National Research Conference June 23-25, 2008 This study was funded by the Center for Disease Control and Prevention: Community-Based Participatory Prevention Research. #R06/CCR521533-01

  2. Background: • Asthma is the most prevalent chronic condition of childhood • Children most affected by asthma are low-income minority children who live in large cities

  3. Prevalence of Asthma and Asthma AttacksAmong Children 0-4 Years (2001-2003) Source: National Surveillance for Asthma—US, 1980-2004, MMWR, October 2007/Vol.56/No.SS-8, DHHS, Centers for Disease Control and Prevention

  4. Health Care Utilization for Asthma Source: Morbidity and Mortality Weekly Report, October 2007/Vol.56/No.SS-8, DHHS, Centers for Disease Control and Prevention

  5. Why Focus on Head Start? • Based on demographic profile: Head Start children are at high risk • Few interventions focus on the youngest children with asthma

  6. COMMUNITY PARTNERS • Detroit Department of Human Services • Detroit Henry Ford Hospital • Six Detroit Head Start Agencies

  7. DETROIT HEADSTARTSTRUCTURE Grantee Delegate Agency Clerical Staff Content Area Coordinators Agency Director Family Service Workers Center Admin. Teachers Support Staff (cooks, etc.)

  8. PURPOSE The primary purpose of the project was to engage Head Start personnel and families in efforts to improve the management of asthma symptoms among children enrolled in Head Start and to develop a program that specifically addresses the needs of this population.

  9. OBJECTIVES • Identify Head Start children with asthma • Provide training for Head Start staff in asthma management • Provide educational information for Head Start families • Evaluation of the intervention and the collaboration • Dissemination of findings for community partners and Head Start families

  10. Screening and Recruitment Asthma Health Screening (n = 3254) Children identified with asthma symptoms (n = 888) Baseline Interviews (n = 675) Continued on Next Slide

  11. Intervention and Follow-Up Physician Led: Comprehensive Asthma Management Training Session Asthma Educators: Continued Training and Support Head Start Educators and Staffn=175 Parents receive assistance with asthma management (Educational handbooks, presentations, help from Head Start staff) Follow Up Interviews (n=487)

  12. Criteria Used to Identify Children with Active Asthma Symptoms Source: NAEPP Guidelines

  13. Asthma Prevalence Among Detroit Head Start Children

  14. Characteristics of Children and Caretakers in Detroit Head Start Asthma Project Continued on Next Slide

  15. Characteristics of Children and Caretakers in Detroit Head Start Asthma Project

  16. Asthma Severity Status

  17. Annual Symptom Days

  18. Asthma Attacks

  19. Asthma Health Care Utilization Continued on Next Slide

  20. Asthma Health Care Utilization

  21. Caretaker Level of Confidence in Head Start

  22. Summary: • Children in the intervention group experienced significant improvement on two measures of asthma morbidity: symptom days and visits to the doctor • Intervention caretakers showed an increase in help-seeking behavior by asking the doctor about asthma • Intervention caretakers demonstrated a significant improvement discussing their child’s asthma with Head Start personnel • Intervention caretakers were more likely to identify Head Start as a source of knowledge and support for asthma management

  23. Lessons Learned • Development of “buy-in” and community trust was a lengthy process • Teaching staff have many existing demands that competed with project goals • Establishing proficiency in screening for children with asthma prior to asthma management training is beneficial

  24. What Was Helpful? • Maintaining flexibility in setting time lines to assist Head Start achieved goals • Identification of Head Start personnel who were highly motivated • Working with Head Start on activities other than asthma (e.g. community health fair, Health Advisory Committee) • Encouraging the peer-relationship with Head Start staff in decision-making

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