Background: In spite of declining hospitalization rates, East Harlem has one of the highest pediatric asthma morbidity rates in New York City. Low socio economic status, poor living conditions and low literacy levels contribute to consistently high morbidity rates over the years. Low referral rates to one of the reputed family asthma programs in the community, makes one wonder if there has been an actual decline in pediatric asthma rates in recent times or could there be unidentified gaps in referrals across providers that need to be addressed.
Methods: Semi structured in depth interviews of the key providers in the major hospitals and community based organizations in East Harlem.
Results: A total of 19 pediatric asthma providers were interviewed from early July to late October of 2012. Majority of them were physicians (including pediatric allergists and pulmonologists). Others were either social workers or registered nurses. After codifying the interview transcripts, some major themes were identified based on common codes. Lack of awareness among certain providers, preference of asthma counselor model over the visiting nurse service; establishment of a Department of Health funded asthma center which has failed to integrate into the community are some of the reasons for reduced referrals.
Conclusion: Strategies need to be devised to improve intra agency referrals. This would avoid duplication of services in the community and better allocation of resources. Expansion of the program to neighborhoods with high morbidity rates would help. Asthma is a chronic problem and can be kept under check only by the full-fledged support and cooperation amongst the various players in the community.
|Advisor:||Garland, Elizabeth J.|
|School:||Mount Sinai School of Medicine|
|School Location:||United States -- New York|
|Source:||MAI 50/06M, Masters Abstracts International|
|Subjects:||Public Health Education, Public health|
|Keywords:||Asthma, Asthma counselors, Community providers, Harlem, Outreach, Pediatrics|
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