physicians roundtable
Building Community Asthma Coalitions
Battling Asthma on Your Home Turf
By Sharlene Sephton
California’s San Joaquin Valley, tucked under the skirts of the Sierra Mountains, was put on the map in 1990 as having the third highest asthma mortality rate in the United States. Despite breakthroughs in therapy and guidelines for the diagnosis and management of asthma, incidence of the disease continued to escalate.
The San Joaquin Health Consortium invited health professionals, asthma pa-tients, school personnel, managed care organizations and others to assess the situation. After taking a long, hard look in the mirror, they came up with an answer:
To win the war against asthma, they needed to fight the battle on their home turf.
Out of this meeting, the first community asthma coalition–the Central California Asthma Project (CCAP)–was born, says Joy Grado, program manager for the consortium. Currently, about 50 coalitions exist nationwide. Most are in their infancy, powered by small corps of volunteers.
The National Asthma Education and Prevention Program (NAEPP) defines a community asthma coalition as “a broad-based, multiorganizational, community partnership that brings together the public, private or nonprofit sectors for a prolonged period in an effort to reduce asthma morbidity and mortality and improve quality of life for asthma patients.”
To assist these worthy pursuits, The American College of Chest Physicians (ACCP) and NAEPP co-sponsored a special day-and-a-half session, “Community Asthma Coalitions,” during the 65th annual CHEST conference in November. Grado was among more than 35 presenters who discussed strategies and successes.
Currently, the ACCP is surveying existing coalitions to find out about their organizational structures, goals, activities, interventions, services and accomplishments, says Sydney Parker, PhD, the college’s vice president for health and science policy.
When the interviews are completed, she will publish a “lessons learned” manual for community asthma coalitions. Parker expects to release it at the CHEST 2000 annual conference being held in San Francisco this October.
“To improve asthma management, one must educate patients, health professionals, communities and policy makers,” Parker says. “Local coalitions can do this and change the health care system.”
COALITION COMPONENTS
From her research so far, Parker has found that “asthma coalitions come in all shapes and sizes.” But they share many common features.
“Most began with a group of health professionals who saw a need for better coordination of services and education,” Parker says. Then, they gathered relevant stakeholders, such as representatives from the public health department, school districts, community-based organizations and hospitals, along with patients and families, to set goals and objectives.
Most coalitions targeted three audiences: health care professionals, patients and the community.
For example, a physicians subcommittee resulted from CCAP’s groundbreaking meeting. The subcommittee planned a half-day medical conference to familiarize area doctors with the NAEPP guidelines and provide hands-on education for asthma tools. A subcommittee of respiratory therapists did the same.
To educate patients, the coalition trained volunteers to teach patient self-management classes. And, to raise community awareness, they promoted their efforts with a countywide information campaign that included announcements on local radio stations.
ACCOMPLISHMENTS
As word spread about the San Joaquin Valley’s efforts, CCAP helped nearby counties to form their own branches. They elected chairpersons, set objectives, and decided what activities they would need to accomplish their goals.
“One of the keys to our success is CCAP acts as a home base,” Grado says. “I think it’s important that the new coalition officers have someone to assist them.”
CCAP recently evaluated the coalitions’ accomplishments from 1996 to 1998. Among the highlights: 1,028 children participated in asthma education at their schools; 12 asthma medical conferences and workshops were held with 1,354 people in attendance, including 530 doctors, respiratory therapists, nurses, physician assistants and nurse practitioners; and 246 health professionals in rural clinics, medical practices and other health agencies received on-site education.
RESOURCES
An important objective of CCAP is to provide “consistency and quality of care,” Grado adds. In order to ensure that the information they provide is timely and accurate, CCAP partnered with the NAEPP. By using NAEPP’s educational materials and media connections, they have boosted CCAP’s credibility.
But a coalition’s best resources can be found by tapping each member’s expertise, Grado stresses. “The community itself knows best how to address the problem… When you get buy-in from the community, your empower them to handle their own issues.”
Sharlene Sephton is editor of ADVANCE.
Physicians Roundtable is a joint venture of ADVANCE and the American College of Chest Physicians. For information on ACCP activities and offerings, contact David Eubanks at (847) 498-1400. For membership information, call Lynne Marcus at the same number, or write to ACCP, 3300 Dundee Road, Northbrook, IL 60062-2348. You also can reach the ACCP online at their Web site, http//www.chestnet.org or by E-mail, [email protected].
