2. Asthma in Harlem Prevalence rate in Harlem is among the highest in the U.S.: – #1 Reason kids miss school and are hospitalized! As high as 30% compared to 8% in NYC, 4% in the rest of the country African American and Hispanics, most affected Poverty, particularly poor housing conditions, main factor

3. Context Started in 2001 as a collaboration among Harlem Children’s Zone Inc., Harlem Hospital Center, Columbia University Funded by Robin Hood Foundation Columbia University, Mailman School of Public Health, Biostatistics Department Key partners: NYC Department of Health, Volunteers of Legal Services, Lawyers Alliance, Single Stop, Fund for the City of New York

4. Care Coordination Home visiting conducted by Community Health Workers (culturally, linguistically competent) Partnerships with schools, CBOS, Daycares, hospital Education (medication, home environment) Link to primary and specialty care providers Referrals to: – Legal services – Integrated Pest Management – Social Services

5. Scope Families of children (ages 0-18) who live in or attend school in Harlem Original catchment area 24 blocks, one charter school network Now over 900 kids, more than 600 families and 282 schools

6. Results Percentage of kids admitted to the ER decreased by more than half Percentage of kids admitted to the hospital overnight decreased by 79% The proportion of kids who reported missing school within the last 14 days decreased from 21% to 11% Smoking inside the home-known to cause asthma in children—decreased from 7% to 1%

7. Asthma Symptoms

8. Environmental Triggers

9. Data: Problems No internal data capacity before 2011 – Didn’t know how many families – No link between outreach and enrollment Paper-based/Scantron system; one person could enter data Third-party warehousing Dependent on researchers for analysis Last publication: 2005

11. Data: Solutions Built custom database with new reporting Decentralized entry Netbooks with 3g connection Paperless Shortened visit time Built capacity for our own statistical analysis, now ready again to work toward publication of lessons learned