Improving Asthma-Related Outcomes Among Children Participating in the Head-Off Environmental Asthma in Louisiana (HEAL), Phase II Study.

PURPOSE: Pediatric asthma disproportionately affects low-income and minority children. The HEAL (Head-Off Environmental Asthma in Louisiana), Phase II Project was a collaborative effort with a primary focus to improve pediatric asthma management in New Orleans, Louisiana. The purpose of this article is to report clinical outcomes captured at baseline and 12-month follow-up. METHOD: HEAL (Head-off Environmental Asthma in Louisiana), Phase II was a pre-post intervention study that enrolled children ages 2 to 18 years of age with a diagnosis of asthma to receive asthma education within the clinic setting. Enrollees received an asthma education intervention, an environmental evaluation, and a 12-month follow-up session. Endpoints included symptom days, level of asthma control, asthma exacerbations, emergency room visits, hospitalizations, and missed school days. RESULTS: The majority of participants were aged 5 years and older, male, Black, and persistent asthmatics. Emergency room visits decreased from 41% to 20% ( p < .001). Improvements in coughing (83% to 62%, p < .001), wheezing (50% to 26%, p < .001), and chest tightness (29% to 18%, p < .001) were also seen. CONCLUSION: The novel intervention was associated with improved asthma outcomes among pediatric patients receiving care at the clinical sites in the Greater New Orleans area.

The alliance to reduce disparities in diabetes: infusing policy and system change with local experience.

This supplement provides a comprehensive and in-depth examination of proven clinical-community health strategies employed by the Alliance to Reduce Disparities in Diabetes, across five sites located in diverse geographic regions of the United States, including a tribal community. Alliance projects in these communities focused on African Americans, Hispanics/Latinos, and American Indians as priority populations. Each project was implemented with an understanding that there are cultural norms, community characteristics, and health care system challenges that require sustained multicomponent approaches to ameliorate factors that exacerbate poor disease management and health outcomes. The articles increase understanding of what is required to implement evidence-based approaches shaped by local experiences in order to meet the needs of diverse communities affected by diabetes. Lessons learned have generic elements that can be used in other priority populations and settings.