Tribal Asthma Home Visit ProgramsMarci Getz, MPH

Asthma Disparities Project Coordinator Washington State Department of Health

June15, 2011

Presentation Outline• Health disparities data• Goals of project• PGST Asthma Home Visit Program• Evaluation• Successes & barriers• Starting an asthma home visit program

Health Disparities

Asthma Among WA AI/ANs• Non-Hispanic AI/AN adults highest asthma rate

in WA (16.9%)

• AI/AN adults have very poorly controlled asthma

• Native Americans were 3.1 times more likely to die from asthma as non-Hispanic whites

More Data

Risk Factors

AI/AN Non-Hisp. White

Annual household income less than $25,000 37% 16%

Prevalence of current asthma among smokers 17% 11%

% of individuals who smoke 33% 16%

Someone had smoked in home in the last week 28% 11%

Project Goals

1. Reduce asthma-related health disparities in tribal communities

2. Build skills and capacity within Washington tribes to address asthma

3. Develop model for a tribal asthma home visit program

Selection Process• Competitive process• Diverse selection committee• Clear eligibility criteria

Port Gamble S’Klallam Tribe

Asthma Home Visits

• Home environmental assessments

• Trigger reduction• Self-management

education

Major Tasks

• Engage community• Develop culturally

appropriate program materials & protocols

Major Tasks• Deliver home visit

services

• Develop tribal program implementation guidebook

Evaluation

•Asthma Control Test

•BRFSS questions

•King Co. questions

•Quality of life, knowledge, & behavior change

•Process evaluation for first 15 families

Successes & Barriers• Motivation & commitment • Participants are reporting positive health

outcomes: clearer understanding of preventative vs. rescue medications

• Multiple demands on the Community Health Representatives (CHR’s) time

Thinking of Starting a Program?• Tribe with health clinic

• Project coordinator & home visitor(s) based in clinic, have access to medical records

• Home visit staff that are known in their community

• Transportation

Questions/Comments?