Inhale Innovation and EXHALE Results
Missouri’s Measurable Approach to Improving Asthma Control of Children
The purpose of the Missouri Asthma Prevention and Control Program (MAPCP) is to maximize reach, impact, efficiency and sustainability of comprehensive asthma control services in Missouri and make substantial contributions toward health equity. Since its establishment in 2001, MAPCP’s reputation for innovation has grown substantially, while maintaining a clear, continued commitment to community-based programming. Surveillance data has continued focusing MAPCP on needs of low-income and/or African American children.
Supported by an alliance of long-standing strategic partners, MAPCP improves the capabilities of schools to provide self-management education and health systems to deliver high quality, guideline-based care. This work is supported by recent policy actions, including a Medicaid State Plan Amendment that covers home visit services for children enrolled in MO HealthNet. The proposed plans for EH19-1902 call for using big data and mobile applications to enhance decision-making of clinic teams with information from community-based providers, such as school nurses and home visitors. Additionally, MAPCP’s proposed strategies expand linkages between public health and health care through a central referral system for self-management education and home environmental assessments.
The MAPCP will implement, evaluate and improve activities across all six evidence-based strategies of the EXHALE framework: (1) self-management education, (2) smoking, (3) home environment assessments, (4) guidelines-based medical management, (5) care coordination and (6) environmental policy. By focusing multi-component strategies in selected communities (known as Childhood Asthma Linkages in Missouri communities), MAPCP will contribute to the CDC’s national CCARE goal of preventing hospitalizations and emergency department visits among children. The proposed workplan calls for delivering results by:
• coordinating EXHALE efforts in St. Louis, Kansas City, Springfield and rural counties,
• analyzing health plan claims data to support clinical quality improvement,
• leveraging health plan case management to support families and children,
• expanding access to home-based services to reduce environmental triggers, and
• supporting care coordination roles for school nurses and community health workers.
The MAPCP’s robust capacity for evaluation is made possible by many partners that contribute data and collaborate to prioritize activities. Consistent with utilization-focused theory, evaluation projects are designed to generate results are meaningful to real users and contribute directly to continuous quality improvement. Surveillance, partnerships, and communications are other organizational strengths that enable pursuit of excellence and achievement of long-term outcomes – better asthma care, lower costs, and improved health status. Past and future success is supported by a strong leadership team with expertise in asthma care improvement and public health program management, including eighteen consecutive years in service to MAPCP’s growth and development.