MJ Harris/BCHD/NACCHO presentation/January 2004 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 Two Components to be discussed Today Baltimore Asthma Surveillance System (BASS) Started in 2000 Analyzed data from 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
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 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