1. Update on CDC efforts in asthma control
Stephen C. Redd, M.D. Chief, Air Pollution and Respiratory Health Branch

2. Asthma issues Rising prevalence
Rising measures of burden (stabilizing?)
Disparity in outcomes
4 year old CDC program
HP2010 goals

3. Aim of CDC asthma program
Reduce the burden of asthma through better application of current knowledge of medical and environmental management
Reduce death rate, hospitalization rate, ED visit rate, missed school and work days, activity limitation
Improve adherence to NAEPP guidelines
Improve tracking capability (
Not sure how to end, this could go at the beginning, alternatively could summarize HP2010 goals very briefly here

4. Who works on asthma at CDC
National Center for Environmental Health
NCCDPHP / Division of Adolescent and School Health
National Institute for Occupational Safety and Health
National Center for Health Statistics
Agency for Toxic Substances and Disease Registry

5. CDC’s asthma program Surveillance
Implement scientifically proven interventions
Partnership / Training

6. Components of asthma surveillance system
Assist states in evaluating existing data
Mortality data / Hospitalization data
Develop and implement telephone surveys
Behavioral Risk Factor Surveillance System
National Asthma Survey (AL, CA, IL, NY, TX)
Develop new tools for tracking
Surveillance for incident cases
ED department surveillance

7. Identify and implement science-based asthma interventions
Translate into programs
Fund
Inner City Asthma Intervention
(based on NIAID funded research)
Open Airways
Asthma Care Training

8. From Research To Practice
Evaluation
Translation
This simple diagram demonstrates the steps that emanate from intervention research.
First comes translation which I will describe in detail in a few minutes using NCICSA as an example.
Once translated and made widely available, the intervention can be implemented, and, of course, all interventions should have an evaluation which feeds information back into the intervention activity and also helps define additional research needs.
Let me emphasize, the program evaluation is not a repetition of the research. We already know that the research model is effective if implemented appropriately.
Implementation

9. Controlling Asthma in American Cities Project
7 city-based collaborative groups funded to plan a broad-based, multi-sector asthma intervention
Develop collaborative group / Define interventions / Determine evaluation
Entering 2nd year of planning period
Planning 5 yr intervention beginning October 2003

10. Work through partnership / Training
Federal partners: Federal Liaison Working Group on Asthma
State and local public health agencies
Cooperative agreements to 29 states and DC for planning and surveillance
Training—National Asthma Training Curriculum
Providers and purchasers of health care
NAEPP project on essential elements of asthma care
Non-profit and professional organizations
ALA, AAFA, AAN/MA, AAAAI, ATS
Looks a little bit to much like alphabet soup. This slide should take a while to go through and should concentrate on brief number of specific projects

11. For information on CDC State Asthma Programs:
Go to:
Select “State Asthma Contacts and Programs”
Click on any state to get contact information for partnership, surveillance and intervention grant activities

13. CDC funded State Asthma Programs, 2002
1999
2000
2001
2002
Hawaii

14. CDC approach to support state health departments
Hired of epidemiologist in Program Section
Assigned an epidemiologist to each grantee
Standard approach to surveillance
Handbook for epi support
National Asthma Training Curriculum
Standards proposed
Advice on data sources
Case definition
Age groupings
Data suppression

15. Program Elements Guidebook for state health department asthma programs
Intended for grant applicants and newly funded programs
Identifies elements of successful programs
Examples of overcoming barriers to successful implementation

16. Future priorities for CDC asthma program
Increase support for state asthma programs
Implement National Asthma Survey
Implement tracking for incident cases of asthma
Implement Controlling Asthma in American Cities Project