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

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.

Implications for Impact Statement

We conducted a theoretically based, community-engaged needs assessment to inform the development of an intervention program to address pediatric asthma health disparities in Rhode Island. Our findings suggest the need for the program to facilitate care coordination across different sectors, and systematically screen and provide tailored care based on levels of asthma control/risk. Our needs assessment procedures and findings may serve as a roadmap for similar efforts to intervene with pediatric asthma and other chronic health conditions in communities across the U.S.