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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Matthew J. Carlson, PhD1, Patti McIntire2, David Mosen, MPH, PhD1, Doreen Kiss, MD3, David Labby, MD1, and Cindy L Fessler, BS2. (1) Department of Public Health and Preventive Medicine, CareOregon and Oregon Health & Science University, 522 SW Fifth Ave, Suite 200, Portland, OR 97204, (503) 416-1482, carlsonm@careoregon.org, (2) CareOregon, 522 SW Fifth Ave, Suite 200, Portland, OR 97204, (3) Department of Pediatrics, Legacy Emanuel Children's Hospital, 2801 N Gantenbein, Portland, OR 97227
In order to reduce the burden of pediatric asthma, CareOregon, Oregon’s largest Medicaid managed care plan, implemented the National Cooperative Inner-City Asthma Study (NCICAS) intervention in its largest urban county. Based on the highly successful clinical trials, the NCICAS is a family intervention conducted by a master’s level social worker focusing on education and problem solving. Evidence from the 6-month evaluation identified several challenges in program implementation. One of the most important challenges was enrolling eligible participants. In the original NCICAS II, 86% of eligible participants completed baseline interviews, and 95% completed two-month follow-up interviews. In the health plan intervention, 39% of the eligible participants (n=23) completed baseline assessments. The high rate of participation in the NCICAS clinical trial compared to the health plan intervention may be explained in part by the use of monetary incentives in the former, and the lack thereof in the latter. Following the 6-month evaluation, a $20 cash incentive was instituted by the health plan to improve participation. Early evidence suggests that group session attendance has increased from under 50% one month prior to incentives, to nearly 100% one month after. Baseline data from completed assessments suggest that the program is recruiting a high need population in which 17% had at least one asthma-related ER or hospital visit in the prior 2 months, 56% reported symptom days in the past 2 weeks (mean days=7.5, SD=14.5) and 30% reported missed social/family activities. Evidence from this 6-month evaluation highlights important principles about the gap between efficacy and effectiveness.
Learning Objectives: At the conclusion of this session, the participants will be able to
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.