Community-Engaged, Multi-Method Needs Assessment to Improve Asthma Care Implementation: The Rhode Island Asthma Integrated Response (RI-AIR) Program

社区参与式多方法需求评估以改善哮喘护理实施:罗德岛哮喘综合应对(RI-AIR)项目

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Abstract

OBJECTIVE: Asthma disproportionately afflicts U.S. urban children, particularly those of Black and Latino backgrounds, and is highly prevalent in Rhode Island (RI). We collaborated with community partners to conduct a multi-level, theoretically supported needs assessment and used its findings to inform the development of the Rhode Island Asthma Integrated Response (RI-AIR) Program. METHODS: To elucidate social, epidemiological, behavioral, environmental, educational, administrative, and policy-related factors contributing to gaps in asthma care in RI, we established the RI-AIR Collaborative with community partners; examined state- and hospital-level health care data; conducted in-depth interviews and focus groups with community partners; used geospatial mapping to identify high burden areas; and interpreted outcomes of our existing school- and home-based programs. RESULTS: The Collaborative reviewed quantitative and qualitative data from multiple sources and identified gaps to address, and resources and strengths to utilize in the RI-AIR program. Findings highlighted the need to provide tailored interventions based on asthma control, and improve communication between families, schools, and health care providers to promote integrated care. Existing strengths included our guidelines-based school and home interventions, longstanding community collaborations, and technological resources. CONCLUSIONS: We developed RI-AIR, a coordinated system of asthma assessment and intervention, that provides school- and/or home-based interventions tailored to risk levels and facilitate communication across sectors of care. Our multi-method needs assessment and RI-AIR represent an innovative, community-engaged approach to building a program to address asthma disparities.

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