ACCELERATING IMPACT PROJECT:

IMPLEMENTING AN EBI IN COMMUNITY

SETTINGS

WOMEN BREATHE FREE

AN EVIDENCE BASED SOLUTION FOR IMPROVING ASTHMA IN

WOMEN

WOMEN BREATHE FREE INTERVENTION

Women Breathe Free is the first asthma management program specifically designed for women.

It has been designed to focus on female gender-specific issues that may impact women’s asthma

WHY WOMEN: ASTHMA AND GENDER

More symptoms, diminished QOL Baseline pulmonary function: Male=Female Female sex hormones play key role in asthma development and severity for women

30% to 40% of women during menses Coughing and breathlessness are more severe in women with menstruation-linked asthma

Increase in health care utilization in women with menses-linked asthma

1/3 of pregnant women experience a worsening of asthma Potential for exaggerated inflammatory response during menstruation, pregnancy, the onset of menopause, and with the use of hormonal birth control

SELF-REGULATION

Women Breathe Free is based on the theory of Self-Regulation. The theory asserts that people more likely to make long-term behavior change with personal control and investment over their own health behavior decision making.

Observation Judgements Reactions/Change Strategies for Improved Management Response and Reflection

P R I D E

Problem identification Research and observation Identify a goal Develop a plan Evaluate progress, establish a reward

CORE PROGRAM ELEMENTS

• 4 Telephonic/In Home or Hybrid sessions led by trained Health Educator

• Introduces a step-by-step self-regulation approach to help manage asthma effectively (PRIDE)

• Teaches observation skills to monitor asthma symptoms and triggers, asthma management routine, and asthma issues potentially associated with hormonal shifts and social role impact

• Assists patients with the development of skill sets to assimilate insight from observations into strategies for behavioral change

• Build patient capacity for self advocacy and increased effectiveness when communicating with clinicians and family members

ADAPTING FOR AFRICAN AMERICAN WOMEN

Results from Women Breathe Free showed African-American women were:

Experiencing greater difficulty balancing asthma management with other life responsibilities

Less likely to use asthma medicines/attend physician visits as recommended (time and cost factors)

Reporting lower levels of family and/or social support than other women in the study

Experiencing higher rates of hospitalizations and emergency room visits than their non-African American female counterparts – largely due to inadequate access to healthcare

ADAPTING WOMEN BREATHE FREE FOR AFRICAN AMERICAN WOMEN WITH ASTHMA

Program Element Culture Specific Element

Counseling Session Content

• The role of obesity in worsening asthma symptoms (BMI data – higher in AA women)

• Impact of family responsibilities – lack of social support

• Importance of community/family connections and influence on asthma management beliefs

• Inclusion of discussions surrounding spirituality and/or alternative remedies that may be culturally specific

Participant Visuals • All images used in workbook represent broad spectrum of African American women

Workbook Content • Culturally relevant activities discussed as potential triggers

• Culturally relevant examples in list of potential asthma-management problems

THE ACCELERATING IMPACT PROJECT (AIP)

Due to a significant gap in moving proven chronic disease research findings and interventions into practice, the overarching goal of this project is to move evidence based interventions out into communities reaching the largest number of people possible; specifically, low-income families, minority groups, children, older adults, and women.

AIP KEY PARTNERSHIPS Planned Parenthood Mon Marte (PPMM) Telephonic RN’s

Boston Public Health Commission (BPHC) Hybrid Community Health Worker Healthy Homes

Partners Asthma Center – Brigham Women’s Hospital (PAC) Hybrid Patient Asthma Center Coordinator (MPH/MEd) Healthy Homes

Asthma and Allergy Network (AAN) Telephonic Respiratory Therapists/Admin Staff/Outreach Coordinators

Asthma Network of Western Michigan (ANWM) Adapted for pediatric population Home Based Social workers/RN’s/Respiratory Therapist