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Mission Hospital/Mission Healthcare Foundation

"[Our project uses] a traditional clinical approach in a nontraditional setting such as the home, school, or other care facility site.”

Melinda Shuler, Regional Clinical Coordinator, Mission Hospital (Asheville, NC)

Melinda Shuler discusses how Mission works in home and childcare settings to address asthma disparities in rural Western North Carolina.

Project Snapshot

Mission Hospital’s Asthma Disease Management Program and Mission Healthcare Foundation (“Mission”) designed an asthma disease management and education program to address health disparities among minority children who have asthma in rural Western North Carolina. Many residents in this area have limited access to health care due to economic and transportation barriers. Through this multifaceted approach, children and families received asthma care and education at home and in local community settings.

Project activities included:

Asthma disease management, conducted under the direction of the patient’s primary care provider. A predominant focus of the program was outreach to Native American, African American, and Hispanic children at or below 12 years of age who lack regular asthma care.

Educational workshops targeting childcare administrators, teachers, and parents—focused on asthma and environmental irritants that trigger asthma.

Environmental assessments in homes and childcare centers to identify and reduce specific irritants found in these settings.

Project Goals

  1. Help children 12 years of age and younger to manage their asthma.
  2. Reduce environmental irritants in homes and childcare settings.

Melinda Shuler, Mission Healthcare Foundation, (right) and Charlotte Collins, Asthma and Allergy Foundation of America, discuss strategies at a NACI meeting in Baltimore, MD.

Challenges & Solutions

Challenge: Collaborating with new communities. Mission sought to establish new partnerships in rural counties and Indian reservations not previously served by its asthma disease management program.

Solution:  Leveraging existing partnerships. Mission forged partnerships in these newly initiated communities by making connections through its existing community, regional and state partners.


Mission provided asthma disease management and environmental home assessments to 50 children, resulting in overall improvements in their quality of life, school absences, emergency department and hospital utilization, and lung function.

Mission staff completed an extensive series of educational workshops and environmental assessments for childcare centers serving rural and Cherokee Indian populations throughout Western North Carolina.

Mission was the winner of the Environmental Protection Agency's National Environmental Leadership Award in Asthma Management in 2012.

Melinda Shuler compares notes with Amy Trees, also of Mission, during a NACI meeting in Baltimore, MD.


Mission shared and collaborated with additional NACI-funded projects to advance asthma care best practices. For example:

Mission collaborated with two other Demonstration Projects that had similar target audiences, goals, and activities—Asthma Allies in Albuquerque, NM and the Los Angeles United School District—to help identify useful tools, educational materials, and implementation strategies.

Medical Society of Virginia Foundation, another NACI Demonstration Project, provided guidance to Mission on working with primary care provider and family practice offices to address disparities in the implementation of the asthma guidelines.

To meet its project goals, Mission used asthma disease management, home-visit interventions, and environmental strategies in home and childcare settings and focused on communities affected by asthma disparities.

Other NACI-funded projects that used Mission-type approaches are:

Mission Healthcare Foundationexternal disclaimer
890 Hendersonville Road, Suite 300
Asheville, NC 28803

Last Updated February 2015