Asthma Health Outcomes Project
Overviews of Surveyed Asthma ProgramsSeptember 2005
Domestic Programs: New York (cont’d)
Creating a Medical Home for Asthma
New York, NY
David Evans, PhD
In 1991, Columbia University implemented the "Creating a Medical Home for Asthma" project in New York City. The project trained staff of New York City Bureau of Child Health (BCH) pediatric clinics to provide continuing, preventive care for asthma among the low-income children they serve. Training was based on NAEPP guidelines and included screening to identify new cases and health education to improve family management. Training consisted of five 3-hour group in-service sessions over a five-month period, tutorial observations of Columbia physicians treating asthma, and ongoing clinic support from a nurse-educator to resolve problems and continue staff education as needed. The intervention included strong administrative support by the BCH to promote staff behavior change.
The project was evaluated over a 2-year period in a controlled study of 22 BCH clinics. Control clinics were provided with current NAEPP guidelines but received no staff training. In both the first and second follow-up years, the intervention clinics had greater positive changes than control clinics on measures of access, continuity, and quality of care. The intervention substantially increased the BCH staff's ability to identify children with asthma, involve them in continuing care, and provide them with state-of-the-art care for asthma.
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