WIN for Asthma program improves outcomes for children with poorly controlled asthma

With childhood asthma rates in Northern Manhattan four times the national average, the Ambulatory Care Network at NewYork-Presbyterian Hospital partnered with the community of Washington Heights/Inwood to initiate the Washington-Heights Inwood Network (WIN) for Asthma program. The program began in May 2006 to improve outcomes for children with poorly controlled asthma by providing culturally relevant asthma education. To date, Community Health Workers have enrolled 400 families. Families who completed the one-year program reported a greater than 50 percent drop in emergency room visits, a greater than 50 percent drop in hospitalization and a 30 percent drop in school absenteeism. Caregivers also reported that they were significantly more confident in caring and controlling their child's asthma after participating in the program.

Initially funded through a grant from the Merck Childhood Asthma Network (MCAN), WIN for Asthma was established to strengthen the existing community-wide network of care. The program targets caregivers of children from birth to 18 years with high-risk asthma in Washington Heights, Inwood and West Harlem and lasts one year.

The program utilizes community-based, bilingual, heath workers who act as a single point of contact for the families to educate them on the best ways to control their child's asthma. All families of children admitted to NewYork-Presbyterian/Morgan Stanley Children's Hospital with a diagnosis of asthma are automatically referred to the WIN for Asthma program and receive basic asthma education. Since 2007, the program has provided asthma education and support to nearly 400 families living within the target area. Referrals to the program come through the hospital, community groups, schools, daycares and community physicians.

"Our Community Health Workers are key to the program's success," says Dr. Adriana Matiz, medical director of the WIN for Asthma program and pediatrician at NewYork-Presbyterian/Morgan Stanley Children's Hospital. "Their intensive work and their understanding of myriad of obstacles the families face really create the vital links that support the families in the long term."

The first three months of the program are filled with educational opportunities for the family. Families learn about asthma and the treatments necessary for their child's optimal care. The family can also receive a home environmental assessment to identify asthma triggers, such as dust and tobacco smoke, and to educate families on ways to rectify these issues. At the conclusion of the visit, the family receives a copy of the assessment, along with a plan of action.

Ongoing support is an important part of the WIN for Asthma program. The program hosts monthly educational workshops with the program's medical director and the Community Health Workers make themselves available by phone or in person to answer questions, make referrals for clinical and social services, or to serve as a sounding board when issues arrive -- and this support extends beyond program graduation. WIN for Asthma connects families to community resources to support their health today and into the future. Community partners are an integral part of the program's success, as they provide the services that help local families address issues such as immigration, domestic violence, sub-optimal housing, and unemployment. "Without access to these services, our families would be unable to address the obstacles that stand in the way of managing their child's asthma", says Patricia Peretz, Program Manager.