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The Baltimore City Health Department’s Childhood Asthma Program. Presented to: the NACCHO MCH Emerging Issues Conference January 22,2004. Components of the Childhood Asthma Program. Four aspects Baltimore Asthma Surveillance System Home Visiting Program Community Outreach and Education
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The Baltimore City Health Department’s Childhood Asthma Program Presented to: the NACCHO MCH Emerging Issues Conference January 22,2004 MJ Harris/BCHD/NACCHO presentation/January 2004
Components of the Childhood Asthma Program Four aspects • Baltimore Asthma Surveillance System • Home Visiting Program • Community Outreach and Education • Coalition building MJ Harris/BCHD/NACCHO presentation/January 2004
Baltimore Asthma Surveillance System (BASS) Started in 2000 Analyzed data from 1993-1998 Databases used: Maryland HSCRC/collaboration with community partners(eg.academic institutions) Home Visiting Program Model developed and implemented in 2001 Referral base established Methods used to promote ‘By- in’ of new community partners Establishment of enrollment policies procedures including Open ended enrollment Two Components to be discussed Today MJ Harris/BCHD/NACCHO presentation/January 2004
The BASS/History • The original data compiled from existing data sources • Indicators included: hospitalization rates, emergency department rates, demographics • Spanned period from 1993-98 • Compiled by BCHD in conjunction with NASA, U Maryland, Johns Hopkins and others MJ Harris/BCHD/NACCHO presentation/January 2004
Elements Guiding Decision for Characteristics of Dataset • Feasibility:How “do-able” is it? • Uniformity • Validity • Non-duplication • Economy • How retrievable is the data? • Can it be collected on an ongoing basis MJ Harris/BCHD/NACCHO presentation/January 2004
Goals/Concerns/Focus of the Surveillance System • Prevalence • Incidence • Etiologic factors • Measurement of disease severity: disease burden MJ Harris/BCHD/NACCHO presentation/January 2004
What is our ultimate goal for the BASS? • To discern factors affecting in order to make an impact • To guide population and individual interventions • To diminish disease burden MJ Harris/BCHD/NACCHO presentation/January 2004
Home Visiting Program • Under Bureau of Child Health and Immunization/Division Maternal Child Health • Funded since FY 2000 by Title V block grant • One of four components of overall program • No overlap with other components MJ Harris/BCHD/NACCHO presentation/January 2004
Home Visiting Program • Key aspects: • Individual assessments and interventions • Three separate assessment instruments utilized, Household Asthma Screening Survey, Nursing Assessment, and Quality of life Survey • Partnering with community collaborators • Education, follow up MJ Harris/BCHD/NACCHO presentation/January 2004
Home Visiting Program • This is a service to the community • Referral focuses on the child and the entire family unit and includes all factors affecting the child’s disease process/holistic approach! • Follow up is key • Links to other existing community partners are of primary importance MJ Harris/BCHD/NACCHO presentation/January 2004
Childhood Asthma Home Visiting Program Client Focus • · Symptom control • · Medication compliance • · Recognition of triggers • · Trigger control • · Use of spacers and inhalers MJ Harris/BCHD/NACCHO presentation/January 2004
Home Visiting Program Issues for Outcomes Measurement • Severity of disease, baseline and ongoing • Symptom days and medication usage • Nature of emergency department visits • Scores on Quality of life instrument MJ Harris/BCHD/NACCHO presentation/January 2004
Home Visiting Program/other considerations for success • Buy in’ of primary caregivers • Contact with medical providers • Higher ‘maintenance’ families need higher level of intensity, very individualized approach • Children not dropped from program until over age, move from city, or unable to maintain contact MJ Harris/BCHD/NACCHO presentation/January 2004
Contact Information • Mary Jo Harris, RN, MS Coordinator Childhood Asthma Program, Baltimore City Health Department Maryjo.harris@baltimorecity.gov 410.361.9645 MJ Harris/BCHD/NACCHO presentation/January 2004