METHODS: MAP participants include children aged 0-17 years with uncontrolled asthma and their parent or guardian. Between June, 2011 and December, 2014, participants enrolled on an ongoing basis. Participants reported data on asthma symptoms, asthma control, and asthma self-management skills at baseline, 1 month, 6 month, and 12 month contacts. In July 2015, they were analyzed to assess changes in asthma control and quality of life over time among participants completing all six home visit contacts.
RESULTS: Since June 2011, 79 children completed all six contacts outlined in the program (46%). The median number of hours of asthma education that participants received was 5.7 hours. Demographics of participants include 22% non-white, wide range of ages, and 43% of participants having Medicaid as their primary insurer. Participants who completed the program reported significant improvements between baseline and 12 months in Asthma Control Test scores (28% vs. 86%), good inhaler technique (30% vs. 73%), having no emergency department visits in the last 6 months (38% vs. 72%) and self-efficacy related to asthma management, like having an asthma action plan (30% vs. 90%). Measurements taken at each contact indicate that improvements continue to occur through the year long program.
CONCLUSIONS: These findings suggest that it is feasible to translate an adapted home visiting program into public health practice in a rural area. Asthma home visiting can achieve dramatic improvements in asthma control and self-management skills for children with uncontrolled asthma. Improvement in asthma control takes several months to achieve emphasizing the need for reinforcement of education at every visit.