1. Are Asthma Programs Positioned for Impact? Factors associated with success Lachance L, PhD ; Friedman AR, MPH; Stoll S, MPH; Awad D, MA; Clark N, PhD CENTER FOR MANAGING CHRONIC DISEASE, UNIVERSITY OF MICHIGAN, ANN ARBOR, MICHIGAN Through a wide-reaching outreach campaign, AHOP identified 532 asthma programs worldwide, 223 of which met the inclusion criteria: (1) focused on asthma; (2) included an environmental component (e.g., education about triggers, policy action); (3) completed an evaluation that showed a positive impact on at least one health outcome. METHODS BACKGROUND Programs and services aimed at improving the health and quality of life for those with asthma have proliferated, and the complexity of asthma has shaped the variety of approaches designed to address the disease. The Asthma Health Outcomes Project (AHOP) collected data from national and international asthma programs to identify programmatic factors associated with successful health outcomes and describe how widely program practices are implemented across the field. Research funded by grant XA-83042901 from the Indoor Environments Division of the US Environmental Protection Agency Total Programs n=532 Eligible n=427 Evaluated* n=223 Published** n=111 Unpublished n=112 Not Evaluated n=194 Not Eligible n=105 ** Analysis of program factors and asthma health outcomes CONCLUSIONS 14 programmatic factors were found to be associated with one or more positive health outcomes. Descriptive categories of successful programs are: clinically connected, responsive to need, continuously collaborative, and community centered. Among the 14 factors significantly associated with positive health outcomes, ten were reported by 50% or more of the relevant programs for which data were available. Clinically Connected Quality of life for children and/or parents/caregivers and/or adults (p<0.01) Tailored intervention based on an assessment of trigger sensitivity (3) RESULTS Educated healthcare providers (including school nurses) School absences (p=0.02) (1) Component of a program took place in a doctor’s office or a clinic Emergency department visits (p=0.01) (2) (g) (h) (i) (j) (f) (d) (e) Program Factor Improved Outcome Correlated programmatic factors and reported positive health outcomes (n=111) How are these factors reflected in the field? Percent of programs reporting programmatic factors (n=223) Responsive to Need Collaborative Community Centered Quality of life for parents/caregivers (p=0.02) Asthma symptoms (p=0.03) and quality of life (p<0.01) Quality of life for adults (p=0.02) Collaborated with other agencies or institutions Collaborated with other agencies/orgs on policy action Collaborated with governmental agencies Hospitalizations (p=0.02) School absences (p=0.01) and medication use (p=0.04) Emergency department visits (p=0.04) Had an office located in the target community Hospitalizations (p=0.04), ED visits (p=0.04) , and health care utilization (p=0.01) Program Factor Improved Outcome Improved Outcome Improved Outcome Program Factor Program Factor Designed program to target a particular race or ethnic group Tailored content or delivery based on individual participants’ health or educational needs Assessed trigger exposure as an environmental strategy Conducted a needs and/or resource assessment School absences/ work loss (p=0.02) Collaborated with other agencies or organizations on technical assistance Health care utilization (p=0.04) Collaborated with community-based organizations Involved community-based organizations in planning the program Health care utilization (p=0.04) Health care utilization (p=0.03) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) ANALYSIS A focused analysis was conducted on programs with evaluation results reported in peer-reviewed publications (n=111). Relationships between programmatic factors and health outcomes were analyzed with chi-square statistics using Fisher's exact tests. (p < 0.05) Data from both published and unpublished programs were used to describe how widely these factors were implemented among the programs studied. * Frequencies to describe current practice