1. Tribal Asthma Home Visit Programs Marci Getz, MPH Asthma Disparities Project Coordinator Washington State Department of Health June15, 2011

2. Presentation Outline Health disparities data Goals of project PGST Asthma Home Visit Program Evaluation Successes & barriers Starting an asthma home visit program

3. Health Disparities

4. Asthma Among WA AI/ANs Non-Hispanic AI/AN adults highest asthma rate in WA (16.9%) AI/AN adults have very poorly controlled asthma Native Americans were 3.1 times more likely to die from asthma as non-Hispanic whites

5. More Data

6. Risk Factors AI/AN Non-Hisp. White Annual household income less than $25,00037%16% Prevalence of current asthma among smokers17%11% % of individuals who smoke33%16% Someone had smoked in home in the last week28%11%

7. Project Goals 1.Reduce asthma-related health disparities in tribal communities 2.Build skills and capacity within Washington tribes to address asthma 3.Develop model for a tribal asthma home visit program

8. Selection Process Competitive process Diverse selection committee Clear eligibility criteria

9. Port Gamble S’Klallam Tribe

10. Asthma Home Visits Home environmental assessments Trigger reduction Self-management education

11. Major Tasks Engage community Develop culturally appropriate program materials & protocols

12. Major Tasks Deliver home visit services Develop tribal program implementation guidebook

13. Evaluation Asthma Control Test BRFSS questions King Co. questions Quality of life, knowledge, & behavior change Process evaluation for first 15 families

14. Successes & Barriers Motivation & commitment Participants are reporting positive health outcomes: clearer understanding of preventative vs. rescue medications Multiple demands on the Community Health Representatives (CHR’s) time

15. Thinking of Starting a Program? Tribe with health clinic Project coordinator & home visitor(s) based in clinic, have access to medical records Home visit staff that are known in their community Transportation

16. Questions/Comments?