Engaging, Involving

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Engaging, Involving Linking Key Stakeholders
in Community Coalitions The Allies Against
Asthma Experience

• Noreen M. Clark, PhD
• Linda Jo Doctor, MPH
• Laurie Lachance, PhD
• Xin Geng, MS
• Amy R. Friedman, MPH
• Christy Houle, MPH
• National Program Office
• University of Michigan School of Public Health

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Asthma Continues as a Major Public Health Problem

• In 2001, 31.3 million people reported at some
  time of their life being diagnosed with asthma.
• Asthma affects 5 to 8 of children under 18
  years of age is most common reason for childhood
  hospitalizations.
• Asthma-associated work absence days have
  increased by 50 since 1980 to 14 million in
  1996.
• In 2000, estimated direct and indirect cost of
  illness related to asthma was 14 billion,
  (direct medical costs 9.4 billion).

(NCHS,2002) (Mannino et al, 2002) (NHLBI, Chart
book, 2002)
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• Asthma control requires putting patients at the
  center of efforts

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Management by Patient
Family Involvement
Clinical Expertise
Work/School Support
Community Awareness, Support Action
Community-Wide Environmental Control Measures
Conducive Policies
Clark, 2001
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• Coalition A group of individuals representing
  diverse organizations, factions, or
  constituencies within the community who agree to
  work together to achieve a common goal.
• (adapted from Feighery, Rogers, 1990)

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Goals of AAA

• Assist coalitions to develop and prosper creating
  sustainable community-wide asthma control and
  prevention systems.
• Describe processes/relationships congenial to
  success of coalitions.
• Assess outcomes of coalition activities.
• Learn as much as possible about coalitions as a
  means to improve asthma control.

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Allies Against Asthma Coalitions
Alianza Contra el Asma Long Beach Alliance
Pediátrica en Puerto Rico for Children with
Asthma San Juan, Puerto Rico Long Beach,
California Marielena Lara, MD Elisa Nicholas,
MD, MSPH Consortium of Infant and Fight
Asthma Milwaukee Allies Child Health Asthma
Workgroup Milwaukee, Wisconsin Hampton Roads,
Virginia John Meurer, MD, MBA Cynthia Kelly,
MD Fran Butterfoss, PhD King County
Asthma Forum Philadelphia Allies Against
Asthma Seattle/King County, Washington
Philadelphia, Pennsylvania Jane Peterson, PhD
Robert Groves, MA, MPH James Krieger, MD,
MPH DC Asthma Coalition Washington,
D.C. Lisa Gilmore, MBA, MPH
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Measuring Coalition Impact
coalition development structure planning/ass
essment programs and policy development collab
oration
self-management skills institutional
arrangements organization of care
quality of life health status healthcare use
Processes and Products
Intermediate Outcomes
Health Outcomes
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Methods

• Coalition self-assessment survey (CSAS) to 7
  sites in 2002 to a total of 294 coalition members
• Interviews and reports from each coalition
  provided qualitative data

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Coalition Self-Assessment Survey Methods

• View of community members described
• Indices were constructed based on factor analysis
  of individual items
• Chi-square analysis performed to compare
  different groups with the membership on both
  indices and individual items
• Perception of health care providers and other
  members
• Perceptions of community members and other
  members
• Data is being analyzed by site and overall

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Allies Against Asthma Stakeholders Survey N 294
Community 22 (8-48)
Health Care Provider 38 (32-45)
School 11 (2-21)
Other 13 (6-21)
HMO 7 (3-12)
Health Department 15 (3-34)
CSAS, 2002
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Indices

• Decision Making
• Conflict
• Leadership
• Vision
• Benefits to Participation
• Support
• Problems with Participation
• Trust

• Butterfoss, F in Emerging Theories in Health
  Promotion Practice and Research Strategies for
  Improving Public Health, 2002
• Israel B, Schulz AJ, Parker EA, and Becker AB.
  Annu Rev Public Health 1998. 19173-202
• Kegler M, Steckler A, McLeroy K Malek S. Health
  Education and Behavior 1998. 25338-353
• Kenney E and Sofaer S. School of Public Affairs,
  Baruch College City University of New York

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Vision
CSAS, 2002
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Benefits
CSAS, 2002
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Trust
Extended Relationships
Comfortable requesting assistance
Talk openly honestly
Comfortable expressing point of view
Comfortable sharing new ideas
Respect for Viewpoints
Opinion Considered
84
86
88
90
92
94
96
CSAS, 2002
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Presentations

• Engaging the Stakeholders
• John Meurer, MD, MBA Fight Asthma
  Milwaukee Medical College of Wisconsin
• Elisa Nicolas, MD, MPH Long Beach Alliance for
  Children With Asthma
• The Childrens Clinic
• Barbara Cooper, BA King County Asthma Coalition
• Seattle School District
• Decision Making
• Michael Rosenthal, MD Philadelphia Allies
  Against Asthma
• Thomas Jefferson Hospital
• Fran Butterfoss, PhD CINCH
• Center for Pediatric Research
• Coalitions as a Tool For Coordination and
  Integration
• James Krieger, MD, MPH King County Asthma Forum
• Seattle/King County Public Health Department