Coalitions: A tool for coordination and integration of community asthma control strategies

摘要: Background: Control of asthma is a complex process involving people with asthma, families, schools, childcare sites, worksites, health providers, and communities. Often, these agents do not coordinate. The seven Allies Against Asthma coalitions have used the unique capacities of coalitions to develop more integrated systems for asthma control. Coalition strategies: Each coalition developed a vision of an asthma control system that integrates family, school/childcare, clinic, and community strategies. These may include (a) cross-program coordinating mechanisms such as joint recruiting and cross-referral of families,(b) community health workers and nurse coordinators to link families with providers, schools and childcare sites; promote communication; and encourage the use of shared asthma action plans among providers,(c) home visits to link environmental and clinical issues (d) adoption of a single action plan by health plans, providers and schools to promote consistency of care,(e) centralized referral centers that link families to appropriate resources such as education, home visits, insurance, social services and case management,(f) tracking systems to monitor referrals and make asthma management data available across providers,(g) quality improvement activities to link primary care to other sectors, and (h) policy initiatives to promote the use of consistent asthma messages, adoption of uniform asthma management guidelines, and asthma-friendly policies in community sites. Conclusions: The early experience of Allies Against Asthma demonstrates that integrating multi-level asthma control strategies is feasible and yields synergistic …