Project Abstract Summary
New Hampshire (NH) has consistently reported some of the highest rates of asthma in the nation, with BRFSS data estimating that 12.7% of adults and 7.2% of children in the “Granite State” have the condition. Within this high-burden state, specific populations experience especially high rates of asthma; adult women, multiracial individuals, people with less than a high school education, and people with less than $15,000 annual income all have higher asthma prevalence. Hospital Discharge Data lends insight into geographic areas with higher rates of Emergency Department (ED) visits for asthma in both children and adults, specifically the cities of Manchester and Nashua, as well as the Belknap, Northern Grafton, and Coos counties. Building on existing infrastructure and partnerships, the New Hampshire Asthma Control Program (NHACP) aims to reduce the burden of asthma in these high burden areas by improving access to complete and interdisciplinary asthma services for the families that need them most. Through strengthening coordinated care, supporting asthma home visiting programs (AHVPs), promoting guidelines-based medical management, and introducing environmental policies that reduce indoor and outdoor asthma triggers, the NHACP hopes to dramatically improve asthma care and reduce the number of asthma ED visits in the state.
Throughout the proposed five-year grant period, the NHACP will work toward this goal through the maintenance of current infrastructure, embodied in state leadership and a statewide asthma collaborative, and through the implementation of EXHALE strategies in NH’s high burden communities. To increase access to asthma self-management education (AS-ME), the NHACP will conduct educational sessions with providers, caregivers, and school personnel, as well as promote culturally appropriate asthma education tools and trainings for partners. The NHACP will also partner with the state Tobacco Prevention and Cessation Program (TPCP) to connect families to tobacco cessation services and educate providers on asthma and tobacco. The program will increase access to and availability of AHVPs in the state by continuing to support and expand successful programming in Manchester, work to strengthen a growing program in Nashua, and build two new programs in the identified high burden areas through partnerships with social service agencies. Referral protocols for these programs, along with targeted provider outreach, will serve to increase linkages and the coordination of care of children and families navigating asthma. Additionally, Quality Improvement (QI) projects with clinical partners and educational events for providers and pharmacists will allow the NHACP to make progress toward wider adoption of guidelines-based medical management. Finally, with working groups on school and occupational health, as well as projects building the evidence base for smoke-free multi-unit housing, the NHACP will promote environmental policies that reduce indoor and outdoor triggers for individuals with asthma. All these initiatives will be complemented by work to achieve Medicaid reimbursement for AHVP and AS-ME, supporting NHACP partners toward sustainable financing. With such coordinated efforts of key stakeholders implementing evidence-based interventions throughout the high burden areas, communit
ies will experience reduced hospitalizations and stronger health outcomes.