Asthma Health Outcomes Project
Overviews of Surveyed Asthma ProgramsSeptember 2005
Domestic Programs: Massachusetts (cont'd)
CHAMP: The Chelsea Asthma Program
Massachusetts General Hospital/ Partners HealthCare Institute for Health Policy
Timothy G. Ferris, MD, MPH
The Chelsea Asthma Program (CHAMP) was initiated in 1997 in Chelsea, MA by Massachusetts General Hospital/ Partners HealthCare Institute for Health Policy.
CHAMP is a community-based intervention that was designed to improve asthma care for inner-city minorities through home visits, physician-directed care management plans, and community collaborations. The program was developed to: 1) identify patients with asthma, 2) conduct home visits, 3) systematically assess personal, social, and environmental risk, 4) assess and apply optimal medication plans, 5) provide asthma education to patients and their families, 6) conduct individual follow-up, 7) provide public education campaigns, 8) provide assistance with home and workplace environmental remediation, and 9) provide feedback to practitioners on patient use of emergent healthcare services, medication compliance, and whether pharmacological treatment conformed to the National Heart, Lung, and Blood Institute Guidelines for Clinical Treatment of Asthma. The program also encourages regular interaction between physicians and school nurses, and performs occupational exposure inspections of local industrial sites. The program targets both adults and children in a primarily low-income, urban, Hispanic population. CHAMP is low-cost and is staffed by a bilingual lay asthma care coordinator and two consulting physicians (0.1 MD FTE total).
Three methods were used to test the hypothesis that the intervention improved care for residents with asthma including a case-control design to assess the impact of the intervention on enrolled subjects, community level asthma hospitalization rates to assess impact at the community level, and a pre/post design to assess changes in care processes, asthma symptoms, and quality of life. There were significant improvements in clinical management of asthma and reductions in hospitalizations among the study cohort. Community level effects could not be determined.
Based on this evaluation, investigators concluded that inexpensive, low-intensity community-based programs can improve asthma outcomes, though effectiveness on a population basis may require additional resources.
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