The Massachusetts Comprehensive Asthma Control Project is an integrated strategy that builds on existing public health infrastructure and supports implementation of population-wide and priority population approaches to improve asthma management and control. Massachusetts has a solid foundation and extensive capacity for comprehensive asthma control work. With CDC-RFA-EH09-901 (901) and CDC-RFA-EH14-1404 (1404) grant funds, Massachusetts has developed statewide capacity and infrastructure to build on the state’s asthma prevention and control work to address health equity and to reduce asthma morbidity, mortality, and disparities in poor asthma outcomes. The Asthma Prevention and Control Program (APCP), which resides within the Division of Health Protection and Promotion at the Massachusetts Department of Public Health, will oversee the project.
The purpose of the project is to implement population-wide and priority population approaches to prevent and control asthma and reduce health disparities among children and adults living with asthma in the Commonwealth. Our integrated strategy strengthens current approaches to asthma management by strategically targeting the unequal burden of chronic disease borne by the state’s most vulnerable residents and communities. These strategies use existing infrastructure and collaborative partnerships, to enhance community-clinical linkages by employing CHWs. The work will be done in two categories – Category A: Enhance Program Infrastructure and Category B: Leverage Partnerships to Expand EXHALE. The proposed strategies are designed to achieve all short term and intermediate outcomes, and make progress on achieving long term outcomes, as outlined in the logic model on page 4 of the NOFO.
Work in Category A will build upon the previous CDC-funded asthma grants, including leveraging successes and lessons learned, building on existing infrastructure and partnerships, and coordinating evaluation efforts. Collaborations are central to advancing the proposed work. The APCP will build upon its previous asthma partnerships, including with the Massachusetts Asthma Action Partnership, to both strengthen existing efforts and broaden to new ones. Similarly, the strategies employed under Category B will all build upon the comprehensive statewide work conducted under 1404 and enhanced by coordinated implementation. The APCP has sought to build on the strength of existing work by identifying areas for additional collaboration. The APCP will operate at three levels of implementation that will complement each other: statewide, with the designated EXHALE clinical partners, and with the Comprehensive School Health Services (CSHS) Programs.
Many of these strategies and activities will benefit a broad range of Massachusetts residents with asthma. Priority populations include those that are affected disproportionately by uncontrolled asthma or those at risk for poor asthma outcomes, including emergency department visits and hospitalizations for asthma. These health outcomes are largely due to racial, ethnic, socioeconomic or other inequities, including inadequate access to care, poor quality of care, or low income. This is reflected in the demographics of patients served by our EXHALE clinical sites, many of whom identify as non-white. Our choice of target populations reflects an analysis of data on disparities, both in the burden of asthma and on associated risk factors. We are committed to applying a racial justice framework to inform our activities, in order to create a lasting impact and achieve health equity.