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Reducing Quality-of-Care Disparities in Childhood Asthma: La Red de Asma Infantil Intervention in San Juan, Puerto Rico

2013; American Academy of Pediatrics; Volume: 131; Issue: Supplement_1 Linguagem: Inglês

10.1542/peds.2012-1427d

1098-4275

Marielena Lara, Gilberto Ramos-Valencia, Jesús A. González-Gavillán, Fernando López-Malpica, Beatriz Morales-Reyes, Heriberto Marín, Mario H. Rodríguez-Sánchez, Herman Mitchell,

Health, psychology, and well-being

BACKGROUND AND OBJECTIVE Although children living in Puerto Rico have the highest asthma prevalence of all US children, little is known regarding the quality-of-care disparities they experience nor the adaptability of existing asthma evidence-based interventions to reduce these disparities. The objective of this study was to describe our experience in reducing quality-of-care disparities among Puerto Rican children with asthma by adapting 2 existing evidence-based asthma interventions. METHODS: We describe our experience in adapting and implementing 2 previously tested asthma evidence-based interventions: the Yes We Can program and the Inner-City Asthma Study intervention. We assessed the feasibility of combining key components of the 2 interventions to reduce asthma symptoms and estimated the potential cost savings associated with reductions in asthma-related hospitalizations and emergency department visits. A total of 117 children with moderate and severe asthma participated in the 12-month intervention in 2 housing projects in San Juan, Puerto Rico. A community-academic team with the necessary technical and cultural competences adapted and implemented the intervention. RESULTS: Our case study revealed the feasibility of implementing the combined intervention, henceforth referred to as La Red intervention, in the selected Puerto Rican communities experiencing a disproportionately high level of asthma burden. After 1-year follow-up, La Red intervention significantly reduced asthma symptoms and exceeded reductions of the original interventions. Asthma-related hospitalizations and emergency department use, and their associated high costs, were also significantly reduced. CONCLUSIONS: Asthma evidence-based interventions can be adapted to improve quality of care for children with asthma in a different cultural community setting.