State Asthma Plans Rebecca Giles MPH CHES Manager Asthma

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State Asthma Plans Rebecca Giles MPH CHES Manager Asthma Powered By Docstoc
					State Asthma Plans
 Rebecca Giles, MPH, CHES
    Manager, Asthma Program
    Utah Department of Health
         rgiles@utah.gov
          State Asthma Plans
• Overview
  – Describe CDC’s vision for comprehensive state
    asthma plans
     • Highlight a few examples
  – Utah’s experience
     • Process of development
     • Results: Utah’s Asthma Plan
         CDC’s Vision for A Comprehensive
                State Asthma Plan
• Background                 • Science-based interventions

• Asthma priorities          • Legislation and policies

• Process of creating the plan • Communication/plan
                                 dissemination
• Goals/objectives/activities
                               • Evaluation plan
• Collaboration
                               • Sustainability plan
• Surveillance Plan
               Background

• Defines current condition of asthma in your
  state
• Describes why asthma is a public health
  priority
              Asthma Priorities

• Outlines the results of your asthma
  surveillance activities
• How your data drives your plan’s approach
  to address the disease
           Goals and Objectives

• Process and outcome   • Method of
  objectives              evaluation

• Time-phased           • Prioritized

• Measurable
                 Collaboration

• Broad, statewide collaborative linkages

• Diverse partnerships


• Decision makers
               Surveillance Plan


• Surveillance - the continuous monitoring or
  routine collection of data on various factors
  over a regular interval of time
          Surveillance Questions

• How much asthma is there?
• How severe is asthma?
• How successful are we in managing
  asthma?
• What is the cost of asthma?
              Core Elements of a
              Surveillance System
• Prevalence data using core asthma questions on
  Behavioral Risk Factor Surveillance System
  (BRFSS)
• Hospitalization data
• Mortality data
• Explore by age, sex, race, over time and
  geography
             Examples of Data Sources for a
              More Comprehensive System
• BRFSS Child Asthma Prevalence module
• Youth Risk Behavior Survey
• State and local agencies have also run asthma-specific
  surveys in schools
• BRFSS Optional Adult Asthma module
• Emergency department data
• Health insurance plan measures: HEDIS
• Medicaid program
• Utah specific: Health Status Survey
         Surveillance is Complicated

• Asthma is episodic in nature and its clinical
  expression can vary greatly.
• No confirmed case definition for surveillance
  purposes.
• Severity and control of the disease are
  intertwined.
                 Interventions
• Interventions should be science-based whenever
  possible
• Surveillance data should drive intervention
  decisions
• Interventions should support plan goals and
  objectives in a measurable manner
• Each intervention must include an evaluation
  component
                      Interventions

•   Schools
•   Child care facilities
•   Professional education
•   Work-related asthma
•   Indoor and outdoor environmental factors
•   Asthma in the elderly
•   Coordination with other public health interventions
             Legislation and Policy

• Legislation and policies are key intervention
  areas for many chronic diseases
• Know what asthma-related legislation exists
  in your state
• Know State Medicaid issues related to
  asthma
                Communication and
                Plan Dissemination

• Effective and continuous communication
  between those implementing and those
  affected by the planned activities.
• Wide release and publication of plan
                 Evaluation Plan

• Are we doing the right things?
• Is it working?
• Ongoing from planning to implementation
               Sustainability Plan

• How will the coalition and partners
  sustain the plan’s activities over time?
                  Some Examples
•   Connecticut
•   Idaho
•   Vermont
•   Oregon
Utah’s Asthma Plan
Strategic Plan Development
                      Utah Asthma Task Force
                         Kick-off Meeting
                            March 2002

Five Workgroups Formed:
♦ Education
♦ Health Systems
♦ Patient Issues
♦ Risk Factor
♦ Data & Monitoring
                     Task Force Vision
                         Statement


   Utah communities work together to
improve the quality of life for people with
 chronic asthma symptoms by increasing
    awareness, access and education
                      Workgroup Mission
                          Statement



                Education

Promote unified, accurate, consistent, and
appropriate asthma education materials and
messages that are delivered to patients,
providers and the public.
                         Education Workgroup



Objective 1: Knowledge, Skills, & Follow-up
              for People with Asthma
Objective 2: Patient Resources
Objective 3: Provider Awareness of Resources
Objective 4: Education for Providers
Objective 5: Public Awareness
                       Workgroup Mission
                           Statement



              Health Systems

Promote a health care system that provides
access to high quality care for all Utahns with
asthma.
                             Health System
                              Workgroup


Objective 1: Access to Health Care & Barriers
              to Care
Objective 2: Innovative Approaches for
               Professional Development
Objective 3: Health Care Benefit Design
Objective 4: Resources for Under/Uninsured
                       Workgroup Mission
                           Statement



               Patient Issues

Provide the tools and resources necessary to
maximize and promote wellness and to
improve quality of life for people with chronic
asthma symptoms.
                             Patient Issues
                              Workgroup


Objective 1: Patient Management Skills to
               Function at Normal Level
Objective 2: Patient Transfer of Knowledge
               into Performance Behaviors
Objective 3: Patient Motivation
Objective 4: Guide to Resources for Patients
                with Difficult-to-Manage Asthma
Objective 5: State Laws and Policies
                       Workgroup Mission
                           Statement



                Risk Factor

Identify Utah-specific risk factors for asthma
and facilitate the implementation of effective
strategies to reduce those risks.
                                   Risk Factor
                                   Workgroup
Objective 1: Community Cooperation in Promoting
               Indoor Air Risk Factor Awareness &
               Reducing Risks
Objective 2: Outdoor Air Risk Factor Awareness to
               Reduce Risks
Objective 3: Occupational Health Nurses and Safety
               Professional Awareness
Objective 4: Information & Resources to OSH to Develop
               Industry-Specific Surveillance & Monitoring
Objective 5: Recommendations for Employee
               Management Plans
Objective 6: Genetics as Predictor of Asthma Risk
                      Workgroup Mission
                          Statement



           Data & Monitoring

Assure availability of high quality data to
guide interventions that prevent asthma and
improve the quality of life for people with
asthma.
                           Data & Monitoring
                              Workgroup

Objective 1: Identify Data Needs
Objective 2: Quality of Existing Data Sources
Objective 3: New Data Sources
Objective 4: Produce & Disseminate Data
Objective 5: Develop Infrastructure to
              Support Surveillance Needs
Objective 6: Evaluate Implementation of
              Utah’s Asthma Plan
Plan Implementation:
    Asthma Summit
    Action Groups
                          Public Awareness
                            Action Group

Activities:
  • Media Events
     • Asthma Inhaler Law
     • Air Quality Guidance
  • Submission to newsletters
                         School Resource
                           Action Group

Activities:
  • Asthma School Resource Manual
     •Development
     • Pilot Testing
     • Training
  • Emergency Protocol
                        Provider Action Group


Activities:
  • Partnership with Medical Home website
      development
  • Identifying resources for module
                           Risk Factor
                           Action Group

Activities:
  • Guidance for School
  • Tools for Schools Grant
  • Occupational asthma data collection
  • Occupational asthma needs assessment
                         Data & Monitoring
                           Action Group

Activities:
  • Asthma in Utah Report
  • Data Presentations
  • Data Needs Assessment
     • School Pilot Project
Questions?