La Red de Asma Infantil de Merck de Puerto Rico Puerto Rico Merck Childhood Asthma Network Program

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La Red de Asma Infantil de Merck de Puerto Rico
Puerto Rico Merck Childhood Asthma Network
Program
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Outline

• Background
• Program goals
• Puerto Rico MCAN program partners and staff
• Needs of our target population
• Overview of our interventions
• Plans for 2006
• Successes and challenges to date

La Red de Asma Infantil de Puerto Rico
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The History of the Alianza

• Founded in 2000 with funding from the RWJ Allies
  Against Asthma National Program
• From the onset the voice and presence of the
  community has been central
• A highly-committed and socially conscious
  leadership core
• Starting in 2006, sustaining and amplifying reach
  of interventions thanks to MCAN funding

La Red de Asma Infantil de Puerto Rico
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Overall Goals of the Puerto Rico MCAN Program
(La Red)

• Improve realized access to and quality of asthma
  health care services for children
• Make schools more asthma-friendly
• Promote asthma-safe home environments
• Promote linkages of key stakeholders and
  integration of services in the community
• Be sustainable beyond Merck Funding

La Red de Asma Infantil de Puerto Rico
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PR MCAN Program Partners Staff
RAND / UPR FILIUS

• Carmen Arabía Rojas, MPH(Program Coordinator)
• Beatriz Morales, BA (RA)

• Marielena Lara, MD, MPH (PI)
• Nicolás Linares Orama, PhD (Co-PI)
• Carlos Vázquez Rivera, PhD (Implementation
  Director)
• Gilberto Ramos Valencia, PhD (Associate
  Evaluation Director)
• Jesús González Gavillán, PhD (Associate
  Environmental Director)
• Wanda Pacheco Bou, PhD (Associate Community
  Director)
• Associate Clinical Director (TBN)

Other Partners/Consultants

• APNI
• Local clinics
• Medical Card Systems
• PR American Lung Association
• PR Department of Health
• San Juan Department of Health
• Herman Mitchell, PhD (ICAS)
• Vicki Legion, MPH, Yes We Can

La Red de Asma Infantil de Puerto Rico
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Assessment of Target Communities and Coalition
Interventions to Date

• Baseline population-based survey comparable to
  Mainland prevalence, morbidity, and risk factors
• Analysis of medical claims data hospitalization
  and ED use
• Qualitative and quantitative evaluation of
  coalition structure, function, and reach as part
  of the national Allies Against Asthma evaluation

La Red de Asma Infantil de Puerto Rico
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Residencial Luis Lloréns Torres, San Juan,
Puerto Rico (Housing Project 1)
La Red de Asma Infantil de Puerto Rico
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Residencial Manual A. PérezSan Juan, Puerto
RicoHousing Project 2
La Red de Asma Infantil de Puerto Rico
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Baseline Assessment of Target Communities
Manuel A Pérez (Housing Project 2)
Luis Lloréns Torres (Housing Project 1)
Households approached 2573 2023 Households
reached 1222 1030 Number of children in household
1324 1057 Number of children with
asthma 548 519 Asthma study sample 324 305 Respon
se Rate 96 98
Among those reached
La Red de Asma Infantil de Puerto Rico
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Baseline Assessment Access and Quality of Care
La Red de Asma Infantil de Puerto Rico
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Baseline Assessment Home Environment
Luis Lloréns Torres (Housing Project 1)(n324)
Manuel A. Pérez (Housing Project 2 (n305)
Smoker in the household () 30 33Have furry
pets () 32 30 Report cockroaches
() 30 38 Report mold () 20 24 Report problems
with pigeons () 39 32
La Red de Asma Infantil de Puerto Rico
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Overview of La Reds Interventions

• Based on language and cultural adaptation of
  evidence-based models
• Yes We Can
• Inner-City Asthma Study
• Open Airways
• Community Asthma Team (CAT) serves as integration
  and coordination focus
• Targets children with moderate and severe asthma
  in two housing projects in San Juan, Puerto Rico
• Builds on 4 years of experience with the target
  communities

La Red de Asma Infantil de Puerto Rico
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Schematic Diagram of Puerto RicoMCAN
interventions
La Red de Asma Infantil de Puerto Rico
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Successes to Date

• Established relationships with local health care
  providers and insurers
• Coalition partners who are galvanized by a shared
  sense of urgency to help meet extraordinary need
• Empirical prevalence and risk factor assessment
• Well-attended and publicized kick-off press
  conference

La Red de Asma Infantil de Puerto Rico
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Encuentros Familiares (Family Gatherings)
La Red de Asma Infantil de Puerto Rico
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Challenges to Date

• Successfully engagingand motivating high-risk
  populations
• Limited community-based capacities
• Lack of institutionalized outreach and
  community-based health services coordination
• Sustaining interventions in the long term

La Red de Asma Infantil de Puerto Rico
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Plans for 2006

• Review and adapt evidence-based model
  interventions
• Develop, pilot, and start implementing Community
  Asthma Team (CAT) intervention in Housing
  Project 1
• Continue analysis and publication of baseline
  data
• Convene Advisory Board and Community Advisory
  Group for Housing Project 1
• Establish Sustainability TaskForce

La Red de Asma Infantil de Puerto Rico
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Our Goal To Improve the Quality of Life of Every
Child with Asthma and his or her family in our
Communities
La Red de Asma Infantil de Puerto Rico