How Cadmus helped EPA develop a campaign that empowered communities to reduce the harmful impact of asthma
Working with the U.S. Environmental Protection Agency (EPA) to address high asthma prevalence and the role of the environment in asthma, Cadmus discovered that bringing the most difficult and highest-cost asthma cases under control demanded both environmental and medical management in the clinic, at home, at school, and in the community. In 2006, Cadmus launched the Asthma Change Campaign for EPA to promote management of environmental asthma triggers as standard medical practice and to support the emergence of comprehensive community-based asthma care systems.
Challenge: Comprehensive asthma care can achieve population-level health improvements and cost savings. However, it requires the existence of coordinated, community-level asthma care systems to fulfill critical functions, such as identifying high-risk patients; ensuring communication across clinical and in-home care teams; tracking health outcomes; addressing social, structural, and environmental issues that contribute to asthma severity; and more.
The development of integrated community-based systems for asthma care faces many barriers:
- The disproportionate impact of in-home environmental exposures on low-income communities
- Cultural, policy, and economic barriers to home-based environmental interventions
- Scarce technical knowledge and resources for remediating homes to reduce asthma triggers
- The challenges of facilitating communication between clinical, public health, public housing, community health worker, and school-based care teams
Solution: To overcome these barriers and change standard practice, Cadmus designed a long-range strategic process to:
- Raise awareness about the need for better asthma care and the environment’s contributing role in asthma
- Promote the scientific evidence base of improved health outcomes that result from comprehensive asthma care
- Design a model framework of a community-wide system
- Establish, grow, and sustain community-based asthma care systems in communities nationwide
After two years of preparation, in 2006 we launched the Asthma Change Campaign and introduced the technical and management tools to help communities deliver and pay for integrated medical and environmental asthma care across a coordinated community system.
The next year, we debuted AsthmaCommunityNetwork.org, a national network and online platform where dedicated practitioners could meet; share and learn from others; identify how to improve their community’s system of care; and find tools, mentors, and partners to aid in their efforts to reduce racial, ethnic, and income disparities in asthma in their communities.
Throughout the Asthma Change Campaign, Cadmus has tracked the process and measured progress against interim and long-term outcomes.
Result: The Campaign’s results have been impressive. Though an initial campaign goal was to enlist 1,000 communities in the quality improvement initiative within five years to build comprehensive asthma care systems, by 2010 the campaign had enrolled more than 1,400 community programs. These communities had assessed their approach and health outcomes against best-in-class programs and adopted our recommended practices for building, evaluating, and sustaining community-based asthma care systems.
Community programs enrolled in the Campaign are reporting:
- Reductions in asthma-related emergency room visits, hospitalizations, and school absences
- Improvements in patient knowledge and self-management efficacy
- Reductions in exposures to environmental triggers
Results vary, but one clinic-based program that uses a simple registry to coordinate school-, home- and clinic-based care for more than 3,000 children with asthma projected:
- 50 percent reduction in asthma-related ER visits
- 80 percent reductions in hospitalizations
- $850,000 in healthcare cost savings in just one year
“Cadmus understands how to build capacity starting in the local community to eventually engage a system that can effect sustainable change. They have mastered how to articulate the system such that others can see themselves in it, and they know how to engage the right decision makers to move the dial forward. Working with Cadmus, in conjunction with national partners such as the U.S. EPA, our organization has made great strides towards improving our community’s health.”
—Karen Meyerson, MSN, RN, FNP-C, AE-C
Manager, Asthma Network of West Michigan
Learn more about our web development support for AsthmaCommunityNetwork.org.