Asthma control is a serious public health issue in Houston, Texas. An estimated 315,551 adults 18 years and older in the Houston area (6.7% of the population) currently have asthma. In 2016, there were 1,956 hospital discharges due to asthma, of which 44% were children.
A multitude of factors contribute to exacerbations of asthma in both adults and children in Houston including: higher poverty levels, older housing stock (56.3% built pre-1980), mold, flooding, extreme heat waves, and proximity to industrial sites and their byproducts. The Houston Health Department (HHD) research indicates pervasive outdoor air pollution, partly stemming from the largest petrochemical complex in the U.S., triggers asthma attacks. Houston is the only city in the U.S. to alert residents when high levels of ozone and nitrogen oxides, extending for multiple days, have historically posed an increased risk of an asthma attack.
The purpose of the Houston Asthma Control through Evidence-based Intervention Project (HACEIP, or “the Project”) is to enhance program infrastructure to decrease the morbidity and mortality due to asthma, increase quality of life, and eliminate disparities among high burden populations with asthma, including children, ethnic minorities, and low socioeconomic status individuals in the Houston region. Using a Participatory Action Research (PAR) approach, HACEIP will mobilize a multi-sectoral collaborative to create and implement a strategic plan to expand the reach, quality, effectiveness, and sustainability of asthma control services in Houston in a coordinated manner across a large, complex health structure. The Project will be data-driven and implement evidence-based interventions through CDC’s EXHALE strategies.
A key objective of the HACEIP will be to use a data-driven process to strengthen and expand the programmatic infrastructure of Houston’s health system in order to optimize services and reduce asthma disparities. The Project will work with its strategic partners to analyze all core and additional data sets in order to monitor trends for children and adults, guiding program planning and evaluation activities. Local health systems data (e.g., MCOs, hospitals, and clinics), including quality measures and health outcomes data, will be collected and analyzed to identify key populations that are disproportionately affected by asthma; further prioritize services to areas of high need; optimize referrals and coordination of services; and identify opportunities for training and other quality improvement activities.
Using both CDC’s Evaluation Framework for Public Health as well as Learning and Growing Through Evaluation: State Asthma Program Evaluation Guide, the HACEIP will work with the Project’s strategic partners and the Texas Gulf Coast Asthma Coalition to develop, implement and continually update the Project’s evaluation and performance measurement plan which will guide the Project’s evaluation activities while keeping them grounded in the four overarching questions set forth in CDC’s National Asthma Control Program (NACP) logic model and aligned with the National Asthma Education and Prevention Program (NAEPP) guidelines, evidence-based interventions set forth by CDC’s 6/18 initiative and the Controlling Childhood Asthma Reducing Emergencies (CCARE) initiative to improve asthma outcomes in children.
All information regarding project activities, outcomes, and performance measures will be reported to CDC annually, and as requested.