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A Multicomponent, Multi-Trigger Intervention to Enhance Asthma Control in High-Risk African American Children
Mark H Ebell1,2, Stephanie Patrice Hall3, R Chris Rustin4
1College of Public Health, University of Georgia, Athens, Georgia.
Insights
A multicomponent, multi-trigger (MCMT) intervention improved asthma control in African American children. This public health approach reduced school absences and emergency visits, showing its effectiveness in high-risk populations.
Area of Science:
- Public Health
- Pediatric Asthma Management
- Environmental Health
Background:
- Poorly controlled asthma is prevalent in high-risk African American children.
- Existing interventions may not adequately address environmental triggers in this population.
Purpose of the Study:
- To evaluate the effectiveness and feasibility of a multicomponent, multi-trigger (MCMT) intervention for African American children with poorly controlled asthma.
- To assess the intervention's impact on asthma control, school absenteeism, and healthcare utilization.
Main Methods:
- Pragmatic quasi-experimental pretest-posttest study design.
- Intervention included 4 educational sessions and home asthma trigger reduction.
- Data collected from African American children enrolled in Medicaid and Children's Medical Services.
Main Results:
- Significant increase in asthma control (4 to 17 out of 20 children, P < .001).
- Reduced school days missed (6.4 to 4.2, P = .01) and emergency department visits (1.7 to 0.6, P = .02) at 12 months.
- Common interventions included dust mitigation, mattress/pillow protectors, and cockroach control.
Conclusions:
- The MCMT intervention, delivered via a health department, significantly improved asthma control in high-risk African American children.
- The findings support broader implementation of these asthma management strategies.
Introduction:
We evaluated the effectiveness and feasibility of implementation of a multicomponent, multi-trigger (MCMT) intervention through a public health department in a high risk population of African American children.
Methods:
This was a pragmatic quasi-experimental pretest-posttest study. The population consisted of African American children enrolled in Medicaid and Children's Medical Services who had poorly controlled asthma. The MCMT intervention included 4 educational sessions and home asthma trigger reduction. Parents reported outcomes at baseline and at 1 to 3 months, 6 months, and 12 months after the MCMT intervention. Analysis used the McNemar χ2 test and Student t test for paired observations. Data were collected during 2014 through 2016 in Augusta, Georgia.
Results:
The number of children with asthma that was assessed as well controlled increased from 4 to 17 out of 20 (P < .001). Compared with baseline, at 12 months parents reported fewer days of school missed (6.4 vs 4.2, P = .01), fewer emergency department visits (1.7 vs 0.6, P = .02) and fewer hospitalizations (0.59 vs 0.18, P = .05). The most common environmental interventions were dust mitigation, getting a mattress or pillow protector, and cockroach mitigation.
Conclusion:
An MCMT intervention in high risk African American children with poorly controlled asthma administered through the health department was associated with significant improvements in asthma control, days of school missed, and emergency department visits. Broader implementation of these strategies is warranted.
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