Improving outcomes for children with asthma through community-based programs

Published June 9, 2014

According to the Asthma and Allergy Foundation of America, 36,000 kids miss school and 27,000 adults miss work due to asthma every day.  That’s a sizable impact on American families, as well as educational and business operations.  Worse, asthma sends 4,700 people to the emergency room and results in 1,200 hospital admissions and 9 deaths every day.

More than a chronic cough or shortness of breath, asthma is an incurable, lifelong condition that affects more than 18.7 million adults and 6.8 million children in the U.S. This disease makes it harder for sufferers to move air in and out of their lungs due to inflammation and subsequent narrowing of air passages. It is potentially fatal, but can be managed effectively to allow people to live normal lives.

In addition to working with a doctor and understanding the necessary medication, one of the most important keys to managing asthma is to be aware of potential triggers for the condition.  These can include allergies and common bugs like the cold or flu, as well as smoke, pet dander, mold and vigorous exercise. Because asthma is common in children, it is very important for parents and caregivers to understand how to avoid triggers and manage the disease to prevent flare ups.

With this in mind, Health Care Service Corporation (HCSC) - which includes Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of New Mexico, Blue Cross Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas - formed a partnership with the American Lung Association of the Upper Midwest (ALAUM) to implement community-based interventions to improve the health outcomes of children with asthma.

The three-year collaboration, that’s part of HCSC’s Healthy Kids, Healthy Families® initiative, was formed in 2012 and engages 60 health centers that serve high-risk populations with the goal of improving pediatric asthma care to an estimated 480,000 children.  The program aims to directly impact children with asthma and their caregivers, community leaders and educators, resulting in improved long-term care outcomes.

Through this project, five health centers will be recruited every year in four of HCSC’s states – Illinois, New Mexico, Oklahoma and Texas - to form a cohort.  The health centers in the cohort then meet monthly, focusing each month on improving one element of guidelines-based asthma care at their facilities.  Technical assistance, mentoring and training are provided by ALAUM. By the end of each one-year cohort, all levels of health center staff and all stages of clinic care – from intake to outpatient – will have been addressed.

“The key to the success of this initiative is not requiring clinics to achieve a particular outcome.  Rather, we partner with clinics to achieve high-quality, guidelines-based asthma care by providing technical assistance, tools, and assistance every step of the way,” said Jill Heins Nesvold of ALAUM, who oversees the Enhancing Care for Children with Asthma Project. 

Results from the first round of cohorts, which included 23 clinics, found statistically significant improvements.  For example, from baseline to 12 months post-intervention, the percentage of patients completing a self-assessment of asthma symptoms (asthma control score) increased 27 percent.  Likewise, there was a 35 percent increase in the number of children with asthma receiving asthma education in the clinic. 

It’s just one example of the many ways Blue Cross Blue Shield companies are acting on our commitment to create healthier communities. To learn more about this and other Blue Cross Blue Shield community investments, download the full Investing in America’s Health report.