James W. Krieger, MD, MPH Principle Investigator Miriam Philby, MA Program Manager

1. King County Asthma Program James W. Krieger, MD, MPH Principle Investigator Miriam Philby, MA Program Manager Karen Artz, RN, MN Clinical Manager

2. Agenda • Introductions • Project Updates • Success & Challenges • Group Feedback • Policy & MAP funding • Next Steps

3. Introductions • What is your connection to the King County Asthma Program?

4. HomeBASE Overview Five year study to determine how to improve asthma control in adults Participants are followed for one year Each participant receives 3 in home education visits by a highly trained Community Health Worker An enrollment visit which includes extensive medical and behavior questionnaire, review of living environment for asthma triggers, and spirometry. Allergy test at the University of WA

5. Services INTERVENTION GROUP 3 CHW educational visits and home environmental assessment in participant’s home. Phone survey at 6 and 12 months Gift cards for participating CONTROL GROUP Usual care, Phone survey at 6 and 12 months; may receive one home education visit and all supplies and resources at the conclusion of the study

6. Project Update MAP • Medicaid Asthma Home Visit Project (MAP) • Funding discontinued 12/31/08 • Enrollment discontinued 1/2/09 • Providing education visits to currently enrolled participants only no 12 month data collection • Looking for funding to complete services and complete analysis

7. Recruitment Status N=331

9. Enrolled by ClinicN=100

10. GENDER Male 18.8% Female 81.3% LANGUAGE English 72.9% Spanish 27.1% HOME OWNERSHIP Renting 85.4% Own 14.6% RACE/ETHNICITY White 39.6% African American 15.6% Hispanic 39.6% Other 5.2% EDUCATION LEVEL < high school 22.9% High school grad 28.1% Some College 32.3% College grad 16.7% DemographicsN=96

11. Participants by AgeN=96

12. EmploymentN=96

13. Health InsuranceN=96

14. Weight StatusN=96

15. Symptoms During the Past 14 DaysN=96

16. Asthma TriggersN=96

17. Problem taking medicinesN=96

18. Success • 100 enrolled and randomized participants • Fully staffed • Stories from the field

19. Challenges • Recruitment • Retention of enrolled participants • Very poorly controlled asthma • Multiple chronic diseases • Mental health concerns • Substandard housing & fear of landlord

20. Group Participation Large Group: • How can we support participant so they can fully participate? Small Group: • How can we increase recruitment? • How can we retain current participants? • Should we address special topics such as BMI and asthma?

21. Clinic & Participant Feedback Small Group • Clinic: • Is the fax referral giving providers the information they need? • Is the process working? • How can we better integrate with providers? Large group report out session

22. Policy & MAP Funding Large Group • How can we continue to fund home visits?

23. Next Steps • When should we meet next? • What should we discuss? • Would progress reports at clinic level be helpful? • Minutes and form modifications will be sent out to committee members within two weeks.

24. King County Asthma Programthank you for coming