Asthma Outcome Evaluation

Home-based interventions are recommended by the Community Preventive Services Task Force for children and teens with asthma. According to a review of 23 studies, there is strong evidence indicating that such programming has been associated with reductions in symptom days and school absenteeism as well as improved quality of life (Crocker, et al., 2011).  


In the absence of an evidence-based, self-management education program for adults with current asthma, the Asthma Program coordinated the development, implementation and evaluation of the Maine In-Home Asthma Education Program (the Program). The Program was designed to educate people with asthma and their direct family members. It was primarily aimed at adults and children with uncontrolled asthma; however, the eligibility of each client was determined by the educator. The Program was delivered in multiple languages, including English, Arabic, Somali, and French. Written educational materials/handouts were limited due to the many languages in which the Program was delivered. Public Health Nurses, Community Health Workers, and Community Paramedics from the following agencies implemented the Program between 2017 and 2019: 


  • Bangor Public Health and Community Service 
  • Maine Access Immigrant network 
  • United Ambulance Community Paramedicine Program 
  • Portland Community Health Center 
  • St. George Volunteer Firefighters and Ambulance Association 
  • NorthStar Ambulance 
  • Northern Light Health Community Paramedicine Program 
  • Mayo Regional Hospital Emergency Medical Services  

Evaluation  

 

A fixed mixed-method with quantitative priority using a convergent parallel design was implemented. The evaluation focused on assessing the efficacy of the HAEP and was guided by the following evaluation questions:  


  1. To what extent have participants changed their asthma-related behaviors as a result of participating in the Program? 
  2. To what extent is there an impact on knowledge and attitudes among participants? 
  3. To what extent have participants’ skills in properly using medication devices increased?  

Highlights of the findings   


  • 163 children and adults with asthma completed the Program. 
  • 98.5% of adults and 91.1% of children increased their asthma control immediately after completing the Program. 
  • 55.0% of adults and 19.8% of children improved their medication adherence. 
  • For adults, there was an 81.6% decrease in use of Emergency Room care and 76.4% decrease in hospitalizations. 
  • For children, there was an 87.6% decrease in use of Emergency Room care and 65.0% decrease in hospitalizations. 
  • Adults missed 62 fewer workdays and children missed 117 fewer school days.