Columbia Study on Community-Based Disease Management

Initiative Finds Community Health Workers Are Critical to Program’s Success

In 2005, local leaders in New York City came together to address the burden of asthma in Northern Manhattan, where the rate of pediatric asthma-related emergency department visits was approximately four times the national average. Researchers at the Mailman School of Public Health and NewYork–Presbyterian Hospital/Columbia University Medical Center, with support by Merck, Inc., developed the Washington Heights/Inwood Network for Asthma Program where bilingual community health workers based in community organizations and the local hospital provided culturally appropriate education and support to families who needed help managing asthma. After 12 months, hospitalizations and emergency department visits decreased by more than 50%, and caregiver confidence in controlling the child’s asthma increased to nearly 100%. Study findings on the WIN for Asthma program are published online in the American Journal of Public Health.

Since 2006, 472 families have enrolled in the yearlong program where participating families received comprehensive asthma education, home environmental assessments, trigger reduction strategies, and clinical and social referrals. Key to the program’s success was the commitment and involvement of community partners from program inception to date, noted Sally Findley, PhD, Mailman School professor of clinical Population and Family Health and clinical Sociomedical Sciences and study author.

Here are the key findings:

--Community health workers who are based in local community-based organizations and have strong ties to the community that they serve are uniquely positioned to initiate and nurture partnerships with program participants. --Community health workers can move fluidly between the community and the health care settings, bridging gaps in care, providing culturally appropriate education and services, and connecting families to the clinical and social resources they need. --The strength and success of the Washington Heights/Inwood Network (WIN) for Asthma Program is based in large part on the commitment and active involvement of community partners from program inception to date as well as the frequent exchange of program information and ideas among all partners and staff. --Because of its customizable, culturally sensitive, and holistic approach to education and support, this model is applicable to other populations and disease areas

In 2010, WIN for Asthma received the 2010 National Environmental Leadership Award in Asthma Management from the U.S. Environmental Protection Agency. In terms of next steps, WIN for Asthma will be expanded to serve families affected by other chronic diseases, including adult asthma, diabetes, and congestive heart failure.

Read the paper.