Community Case Study | American Lung Association

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Community Case Study

In response to emergency medical care utilization rates soaring two-thirds higher than the national average, Long Beach, California city health officials sought to ease the burden of asthma among its residents most in need. Their research led them to discover the American Lung Association's Breathe Well, Live Well curriculum.

See Judeth Lagrimas Luong, MPH, REHS, Grant Program Manager for Department of Health and Human Services Bureau of Environmental Health explain why Breathe Well, Live Well was the right program resource for the residents of Long Beach.

Tailoring Breathe Well, Live Well to Fit the Needs of Long Beach

Concerned it may be difficult to reach residents most in need using an in person session model, the Long Beach public health officials adapted the Breathe Well, Live Well program to be delivered directly in the homes of residents with asthma. The outreach initiative became known as the Community Asthma and Air Quality Resource Education (CAARE) Program. The Breathe Well, Live Well workbook is used to help facilitate four visits to participants' homes where intensive one-on-one education is provided.

By learning to better understand their disease, avoid common triggers and develop an asthma action plan, CAARE Program participants enjoy a 61 percent decrease in overall reliance on emergency health care providers for asthma symptoms.

About the CAARE Program Participants

As of 2013, the city of Long Beach had 898 residents complete its adapted CAARE Program. Serving a predominately Hispanic/Latino community, program facilitators relied heavily on Breathe Well, Live Well's Spanish language materials.

Program participants ranged in age from 17 to 93-years-old. On average, most participants had been living with asthma for 19 years. The majority of participants were women (72%) and most were recruited to take part in the program through door-to-door outreach efforts conducted by the city's highly trained team community health workers.

Breathe Well, Live Well Helps Long Beach Residents Breathe Better

CAARE Program participants who used the Breathe Well, Live Well curriculum reported the following health outcomes as part of their three month follow-up assessment:

Access to Asthma Care

  • 89% reported having a primary asthma care provider.
  • 36% of those without a care provider began to utilize public clinics.
  • 51% decrease in those who reported using emergency departments as a primary care source.

Emergency Services Care Utilization

  • 56% said they no longer visited emergency departments for asthma care.
  • 63% were no longer hospitalized for treatment of asthma symptoms.
  • 49% discontinued making unscheduled doctor or clinic visits for treatment of acute symptoms.

Asthma Health Outcomes

  • 40% gained good control of daytime and nighttime asthma symptoms.
  • 28% reported a drop in excessive sleep patterns.
  • 49% fewer employed participants reported missing one or more workdays.
  • 71% fewer employed caregivers reported missing one or more days of work.
  • 41% fewer students reported missing one or more days of school.
  • 69% indicated improved quality of life with asthma.

Asthma Management Practices

  • 42% began attending asthma wellness visits with a physician.
  • 16% began taking an asthma controller medication for the first time.
  • 61% began using quick-relief medications in a controlled manner.
  • 50% started using a spacer most of or all of the time with inhaled medications.
  • 57% began using a peak flow meter.
  • 32% developed a written asthma management plan with a physician.
  • 26% reduced the number of behavior-based asthma triggers in their home.
  • 31% eliminated smoking triggers in their home.

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