South Bronx Asthma Partnership/Bronx-Lebanon Hospital
"I'm really grateful to NACI for being the heart of this entire initiative and bringing together so many important experts towards improving asthma outcomes, and this collaborative venue here is what's actually going to make the real dent that we need in the asthma world.”
Mamta Reddy, MD, Director, South Bronx Asthma Partnership (Bronx, NY)
Dr. Mamta Reddy discusses the Asthma Passport, a self-management education tool designed for use with patients and their health care providers.
Mamta Reddy, M.D., (right) discusses SOBRAP's Asthma Passport with Michael Cabana. M.D., at a NACI meeting in Baltimore, MD
The South Bronx Asthma Partnership (SOBRAP) designed its Asthma Passport project to bridge disparity gaps in asthma care and control by empowering both health care providers and parents of children who have asthma with specific knowledge, skills, and confidence for effectively navigating the components of the written asthma action plan. A provider curriculum and a parent curriculum, both based on the Asthma Passport, helped to align patient and provider communication and their goals for asthma control.
The palm-sized, wire-bound Asthma Passport that SOBRAP developed and piloted serves as a guide for promoting skill-based, literacy-sensitive asthma self-management education. Parents can track their progress on each page of the Asthma Passport as they tackle key topics over the course of several facilitated structured education sessions.
The project recruited parents of children with asthma enrolled in Bronx-based childcare centers, where 0 to 4-year-olds had more asthma-related emergency department visits than any other age group. In addition to educating the children’s parents, the project also conducted asthma workshops for the children’s health care providers, structured to reinforce each element of the Asthma Passport.
To recruit parents of children who have asthma to receive structured education using the Asthma Passport.
To recruit and engage the health care providers of those children who have asthma.
Challenges & Solutions
Dr. Reddy (right) shares the Asthma Passport with a colleague.
Challenge: Delivering culturally sensitive and literacy-friendly asthma messages. SOBRAP worked with childcare and literacy experts and conducted role-playing sessions to design an Asthma Passport curriculum and accompanying moderator script to convey evidence-informed educational messages and skill-based asthma self-management techniques to parents using clear, plain, non-medical language. As it began to conduct pilot sessions in the field, however, SOBRAP discovered some inconsistencies and discontinuities in the delivery of its messages that could impede parents’ understanding of them.
Solution: Evolve the Asthma Passport to fit the audience. Using detailed notes of the reactions, responses, and general flow of the pilot sessions, SOBRAP detected similarities in the problems encountered across many of these sessions. It then made targeted changes to the messages and the layout of each Asthma Passport session. These revisions allowed SOBRAP to convey its messages in a more conversational manner, allowing more room for parents to get their questions answered. It also enabled the project to reach and educate more parents in less time.
SOBRAP’s Asthma Passport project received more inquiries from childcare centers, schools, and health care providers outside of its original target sites that were interested in participating in the Asthma Passport project, suggesting future opportunities to expand the program.
SOBRAP developed a script to guide moderators in delivering the Asthma Passport.
SOBRAP translated its Asthma Passport materials from English into Spanish.
SOBRAP shared and collaborated with additional NACI-funded projects to advance asthma care best practices. For example:
At a NACI meeting, SOBRAP shared and discussed its Asthma Passport with other project participants. This exchange allowed SOBRAP to obtain useful feedback, which it incorporated into the final Asthma Passport version. It also received ideas for modifying other SOBRAP tools.
To meet its project goals, SOBRAP used asthma education and empowerment and systems integration in its work with patients and their families, health care providers, and community programs.
Other NACI-funded projects that used SOBRAP-type approaches are: