Mid-Atlantic Regional Asthma Initiative (MARAI) Newsletter: October 2007
In This Issue
by Erin McCarville, Asthma Project Manager, Health Promotion Council
The Philadelphia Merck Childhood Asthma Network (MCAN) has spent the last year addressing gaps in pediatric asthma care across the Philadelphia region. Through family and community asthma education, home environmental assessments, healthcare provider education, and coordination of asthma services, the Philadelphia MCAN project has expanded asthma treatment and management services to more than 269,000 children in Philadelphia.
The Philadelphia MCAN project was established through a grant from the Merck Company Foundation’s Merck Childhood Asthma Network . In November 2005, the Philadelphia Allies Against Asthma (PAAA) Coalition was one of five sites nation-wide to be awarded this four-year, $2 million grant to combat pediatric asthma. The Health Promotion Council, the lead agency on this project, has managed the Philadelphia MCAN project on behalf of the PAAA Coalition.
Other key partners for this initiative include: the Children’s Hospital of Philadelphia’s Community Asthma Prevention Program (CAPP) , Thomas Jefferson University, the School District of Philadelphia, the Philadelphia Department of Public Health, the National Nursing Centers Consortium, and the Philadelphia Health Management Corporation.
Over the four-year grant period the Philadelphia MCAN project will provide services in four geographic regions of Philadelphia—West, South, Northwest, and Northeast. The long-term goals of these services include:
- Improving access to and quality of pediatric asthma health care services
- Educating children and families about asthma
- Making communities and schools more asthma-friendly
- Promoting asthma-safe home environments
In order to achieve these goals, the Philadelphia MCAN Project has developed three programs—asthma screening, asthma care coordination, and asthma education—and targeted three groups—communities, schools, and primary care providers.
Asthma Screening: It is currently estimated that 30 percent of children 5-13 years old in Philadelphia have asthma, but there is very little concrete data on asthma prevalence. Through community and school asthma screening, the Philadelphia MCAN project aims to identify Philadelphia children with asthma. This screening allows the project to target asthmatic children for asthma care services. In addition, screening will provide valuable data on asthma prevalence that can be used by policy-makers, researchers, and community groups.
Care Coordination: In the past patients, health care providers, and service providers have found it difficult to manage asthma care and services across agencies, health management organizations, and providers. In response to these concerns, the Philadelphia Allies Against Asthma Coalition developed the Child Asthma Link Line—a telephonic care coordination hub for Philadelphia residents with asthma. The Link Line’s Asthma Care Coordinators work with families with asthma to ensure that all of their social, health, and educational needs are being addressed. The Link Line is now a key partner in the Philadelphia MCAN project, accepting referrals from schools, communities, and healthcare providers.
Asthma Education: It is imperative that families of children with asthma, schools, and primary care providers understand how to manage the disease of asthma. Therefore, the Philadelphia MCAN project—in conjunction with the Community Asthma Prevention Program, the Philadelphia Department of Public Health, and the School District of Philadelphia—has developed a number of community asthma education programs. These programs are offered at community sites and Philadelphia community health centers throughout the target region. In addition, the MCAN project offers school education programs that target students, teachers, and school staff in order to ensure that schools remain a healthy environment for children with asthma. Finally, asthma education is also offered to primary care providers to ensure that providers are up-to-date on the latest asthma research and guidelines.
In its first year of implementation, the Philadelphia MCAN project has made great strides to address pediatric asthma in Philadelphia. Hundreds of children have been screened for asthma and referred to asthma care coordination and asthma education services. The program looks forward to three more years of providing integrated pediatric asthma services to the Philadelphia community.
For more information on the Philadelphia MCAN project, the Philadelphia Allies Against Asthma, or the Asthma Link Line, please contact Erin McCarville (email@example.com, 215-731-6195).
This online Network is designed for community-based asthma programs and organizations that sponsor them-including representatives of health plans and providers, government health and environmental agencies, nonprofits, coalitions, schools and more. The Network is supported by EPA in partnership with Allies Against Asthma, a program of the Robert Wood Johnson Foundation.
Community-based asthma programs in this national Network are helping each other to achieve remarkable health and quality of life improvements for people with asthma. This interactive Network will introduce you to effective strategies that are key to achieving positive health outcomes.
Partners in this Network have real-time access to other registered programs and their best practices; cutting-edge Internet tools to facilitate collaboration, problem solving, and learning between leaders of asthma programs; and the most current strategies for making your program a thriving and comprehensive asthma management resource.
The Network hosts various online seminars. Archives of previous seminars include:
- "Investing in Best Practices for Asthma: Health Plans Tackle Asthma Control" (August 16, 2007)
- "Investing in Best Practices for Asthma: A Business Case for Education and Environmental Interventions" (June 19, 2007)
- "Leveraging Asthma Awareness Month: Communities Making a Difference" (May 3, 2007)
Also located on the Network is the archive of all sessions from the Second Annual National Asthma Forum that was held on May 31 – June 1, 2007. So if you missed any of these events and want to know what was presented please view them on the Asthma Community Network and if you have not yet joined the Network consider joining to gain updates regularly on new seminars and be able to find local organizations to partner with and gain new ideas from.
U.S. EPA Headquarters and the U.S. Department of Health and Human Services (HHS) signed a Memorandum of Understanding (MOU) to improve the quality of life for Head Start and Early Head Start families nationwide. The MOU establishes a framework between EPA's Indoor Environments Division (IED) and the HHS' Office of Head Start (OHS). The agencies intend to work together to conduct nationwide outreach to nearly a million families in an effort to deliver health risk reduction messages related to secondhand smoke and other environmental asthma triggers.
Numerous studies have documented the significant health risks to young children from exposure to secondhand tobacco smoke and other indoor asthma triggers. These risks include upper respiratory tract infections and more frequent and more severe asthma attacks among children with asthma. Other indoor asthma triggers include dust mite and cockroach allergen, animal dander, and mold. The National Academy of Sciences has concluded that exposure to secondhand smoke and exposure to house dust mite allergen are also risk factors for the onset of new asthma. Data gathered through the 2004 EPA National Survey on Environmental Management of Asthma and Childhood Exposure to Environmental Tobacco Smoke (PDF, 2pp, 88k, about PDF) indicates that Environmental Tobacco Smoke (ETS) exposure and asthma rates are higher in households at or below poverty level and in those with lower levels of education. These findings suggest a critical need to better educate low-income and low-literacy populations about exposure to ETS and for children with asthma, other indoor asthma triggers as well. Particular focus should be given to the families of the approximately 20 percent of children with asthma who are exposed to ETS in their homes.
According to information contained in the HHS “Action Against Asthma: A Strategic Plan for HHS,” asthma is a growing problem for Head Start, as well as the nation as a whole. It is one of the most common chronic disease of childhood and places a disproportionate burden on minority groups and the poor, the population that Head Start serves. The HHS Office of Inspector General issued the 2002 “Head Start Services for Children with Asthma” report, which found that asthma is the top chronic disease among Head Start children and is one of many health conditions affecting Head Start children and their families.
In June 2006, HHS released "The Health Consequences of Involuntary Exposure to Tobacco Smoke, A Report of the Surgeon General" (PDF, 727pp, 19.83 MB, about PDF). This report summarizes an extensive body of literature that documents the very serious negative health effects of exposure to secondhand smoke for adults and children; among its conclusions are that there is no risk-free level of exposure to second hand smoke.
The mission of HHS is to protect the health of all Americans and provide essential human services, especially for those who are least able to help themselves. Programs funded under the Head Start Act provide comprehensive child development services to low-income children from birth to age five, pregnant women, and their families. They are child-focused programs and have the overall goal of increasing the school readiness of young children in low-income families. Currently, over 950,000 low-income children from birth to age five, including American Indian, Alaska Native and migrant populations, are enrolled in the program.
Head Start health services focus on prevention and early intervention. Head Start and Early Head Start programs work closely with parents to ensure that children are up-to-date on a schedule of age appropriate preventive and primary health care, as well as help parents obtain the necessary medical services for children who have reoccurring health conditions. A review of the 2002-2005 Head Start Program Information Report (PIR) shows asthma as the most frequently reported chronic health condition by Head Start programs nationwide.
The mission of EPA is to protect human health and the environment. Two of the goals of EPA's Office of Radiation and Indoor Air are to reduce the health risks from childhood exposure to secondhand smoke, as well as to reduce the health risks for people with asthma through comprehensive asthma management practices, including reducing exposure to environmental asthma triggers. EPA has developed a number of effective outreach and communication strategies and programs to encourage voluntary behavior change among parents and other caregivers of children with asthma and those exposed to secondhand smoke.
In partnership, EPA and HHS can make significant progress in fulfilling their respective and complementary missions through a joint and concerted effort to educate staff and parents of Head Start and Early Head Start programs on the importance of reducing children’s exposure to environmental asthma triggers and the harmful effects of secondhand smoke. Increasing awareness of secondhand smoke’s health effects will also benefit nonsmoking parents and other adults in the household who are at significant risk for heart disease and lung cancer from secondhand smoke exposure. Education of Head Start staff and parents is will be accomplished through the promotion and distribution of EPA’s Asthma and Smoke-Free Homes Program messages and educational materials to Head Start and Early Head Start programs.
MOU Key Activities
EPA, Office of Radiation and Indoor Air:
- Intends to work with the Office of Head Start to identify and develop cooperative activities to promote awareness of the health effects of secondhand smoke and other asthma trigger exposures on young children and effective strategies for motivating families to take effective exposure reduction actions.
- Plans to work with the Office of Head Start to identify EPA outreach materials that are appropriate for Head Start families and facilitate appropriate dissemination mechanisms, including use of various electronic and print media, as well as EPA-sponsored toll-free telephone hotlines.
- Intends to provide technical assistance to the Office of Head Start in the development and implementation of activities under this MOU.
- Intends to share with the Office of Head Start information on knowledge and asthma management actions taken by caregivers of children with asthma, obtained through the National Survey on Environmental Management of Asthma (NSEMA).
- Plans to help promote the partnership initiative at national, State, and local conferences and support recognition opportunities for Head Start and Early Head Start programs, as appropriate.
U.S. Department of Health and Human Services, Office of Head Start:
- Intends to work with the Office of Radiation and Indoor Air to identify and develop activities to increase awareness of effective interventions to reduce children’s exposure to environmental asthma triggers, including but not limited to secondhand smoke, and encourage parents to take action to reduce exposures.
- Intends to facilitate outreach to Head Start and Early Head Start families by promoting and distributing messages and materials through its network and infrastructure.
- Intends to support EPA's Office of Radiation and Indoor Air’s efforts in creating, developing, and evaluating outreach materials and products for use in Head Start and Early Head Start programs.
- Plans to inform and train the Head Start community about the partnership and opportunities for developing comprehensive asthma management and secondhand smoke programs and activities at the State and local program levels by working with the Head Start State Collaboration Offices.
- Plans to promote the partnership initiative at national, State, and local conferences and support recognition opportunities for Head Start and Early Head Start programs, as appropriate.
To learn more about Head Start Asthma and Second-hand smoke outreach check out "Care for Their Air: Promoting Smoke-free Homes for Head Start Families."
by Melissa Linden, AmeriCorps VISTA, EPA Region 3
As an AmeriCorps VISTA (Volunteer in Service to America) I would like to take the time to tell you what has been accomplished so far in my year of service. I started my year with EPA in Region 3 in November of 2006. Things I have been able to help out with are developing more outreach contacts through participating in various health fairs and festivals. During these events I am also able to distribute materials to educate individuals on various EPA programs. Another part of my service has been developing and presenting an Asthma and Secondhand Smoke presentation to Head Start students, parents and teachers. As a VISTA my ultimate goal is to create and develop plans and lasting relations with supporting organizations that can be continued once I am gone. Being a VISTA we are not involved in direct service as other AmeriCorps programs are, but rather do indirect service that will build and strengthen an organization and allow it to be sustainable once the year of service is completed. Many of the other AmeriCorps VISTA volunteers work to do grant writing to secure funding for their organizations to be sustainable as well. The main focus of all AmeriCorps VISTA positions is to aid disadvantaged areas throughout all 50 states; it was created in the vision of a domestic peace corps. When a program applies for the grant to pay for an AmeriCorps VISTA, they must submit a work plan identifying the need and what specific areas they want the VISTA to focus upon. Most programs are approved for receiving a volunteer position for three years funded by the Corporation for National and Community Service (CNCS).
If your organization is in need of a volunteer to do direct service, you can also apply to the CNCS under a grant for an AmeriCorps volunteer. Some examples of direct service done by the AmeriCorps volunteers are tutoring children and adults, building homes for low-income families, working in national parks to protect the environment, building computer learning centers for low-income communities, developing education programs to help families transition from welfare to work, helping families affected by domestic violence, and rebuilding communities effected by natural disasters.
Requirements of an AmeriCorps volunteer are they must be at least 17 years of age, but each organization can set specifics for age and experience depending on the position they wish to fill. Another organization specific requirement is whether the position to be filled will be part-time or full time and whether it will be for a full year or just half a year. If you wish to apply for an AmeriCorps VISTA, these positions are not as flexible and require that it be a full-time position for one year.
Applying for an AmeriCorps volunteer or VISTA can be done online at the AmeriCorps web site under the section for "Organizations."
This publication, seventh in an annual series, highlights EPA's work to protect children from environmental risks.
This year makes the tenth year of explicit attention to the health of children following the Executive Order of 1997, Protection of Children from Environmental Health Risks and Safety Risks (PDF, 4 pp, 114KB). EPA has funded research on how the environment affects children's health, promoted the education of health care providers, assembled data to quantify the extent of the issues, and been an international leader of children's health issues. The 2007 report captures all this and more.
Asthma In The News:
- Low vitamin E intake during pregnancy can lead to childhood asthma
- Fish Oil Reduces Airway Inflammation Caused by Exercise-Induced Asthma
- Back-to-school Season Can be Tough on Kids with Asthma, University of Michigan expert says
- New Campaign Has Asthma Patients Asking — What’s My IgE?
- Vitamin C -- a Nutritional Approach to Managing Exercise-induced Asthma
- Atlanta Named Top Asthma Capital for 2007