CDC-RFA-EH-24-0016, Advancing Health Equity in Asthma Control through EXHALE Strategies - Over 450,000 children ages 0-17 and 1.8 million adults ages 18 and older in Texas are currently living with asthma. In Texas, asthma disproportionately impacts specific demographic groups, including females and non-Hispanic Black children and adults. When uncontrolled, asthma can impact quality of life by potentially limiting involvement in physical activities and causing decreased academic performance due to missed school days among children. Asthma can result in frequent emergency department (ED) visits and hospitalizations. In 2022, there were over 103,000 asthma ED visits in Texas with 45.2% of those belonging to children. Amongst those individuals with ED visits, non-Hispanic Black children had an age-adjusted ED visit rate (162.2 per 10,000 visits) that was 3.5 times higher than the non-Hispanic White rate (46.1 per 10,000 visits). Asthma also has a large economic burden to the state with over $1 billion in asthma-related hospitalizations and ED visits charged to payers in 2022. Among ED charges for children, the majority of charges (60.1%) were billed to Texas Medicaid as the primary payment source (over $202 million). The Texas Department of State Health Services (DSHS) will address systems-level, environmental, and social drivers of asthma health disparities through strengthening strategic partnerships across Texas to implement all six EXHALE strategies through the Texas Asthma Control Program (TACP). Through this funding opportunity, TACP will: • Strengthen existing organizational infrastructure in areas such as leadership, program management, strategic partnerships, surveillance, communication, and evaluation. • Collaborate with diverse partners like coalitions, community organizations, schools, housing, healthcare systems, and nongovernmental organizations. • Implement EXHALE strategies, working with the Texas Asthma Control Collaborative and other community members to expand the reach and sustainability of asthma control services. Asthma control activities will be data-driven and evidence based. Activities will be directed to areas of the state with high asthma burden, targeting asthma health disparities identified by surveillance data. Populations of focus include children with asthma, non-Hispanic Black Children, and children covered by Texas Medicaid and Children’s Health Insurance Plan (CHIP) services. Strategic partnerships with Texas Medicaid, San Antonio Metropolitan Health District, University of North Texas Health Science Center, and the American Lung Association will help TACP implement EXHALE strategies in the school, healthcare, home, and community settings. Activities will aim to address asthma health disparities and non-medical drivers of health as well as build sustainability of the asthma program by developing the asthma workforce and creating business cases for asthma strategies. TACP will achieve the following outcomes by the end of the cooperative agreement: • Increased implementation of selected EXHALE strategies in school, healthcare, home, and community settings and increased access to EXHALE interventions for people with uncontrolled asthma in those settings. • Increased linkages to community resources to address drivers of health disparities. • Increased use of surveillance and evaluation data to drive TACP improvement. • Enhanced partnerships, including development of new strategic partnerships representing focus populations. • Reduced impact of drivers of health disparities for asthma control among populations with highest risk.
