Putting on AIRS*
*Asthma Indoor Risk Strategies
The Putting on AIRS (AIRS) Program was originally developed in 2001 by the Asthma Shoreline Action Partnership, a project of the Ledgelight Health District and the New London Department of Health & Social Services funded by the Connecticut Department of Public Health. The goal of the program is to reduce acute asthma episodes and improve asthma control through recognition and elimination/reduction of environmental and other asthma triggers. The Program has since grown statewide and is currently available in six Connecticut regions. The AIRS Program provides in home asthma education to the client/family/caregiver focusing on patient education and asthma management. An asthma education specialist conducts the education session with the client/family/caregiver by reviewing prescribed medications and its usage, and instruction on proper medication administration as well as education on asthma signs and symptoms. The environmental specialist conducts an environmental assessment of the home to identify asthma triggers and provide low cost remediation techniques. Referrals to the program can be made by a variety of sources such as emergency department, health care providers, or school health services.
On May 27, 2016 the Connecticut Department of Public Health asthma staff presented to POA coordinators and to their Local Health Directors proposed changes to the current Putting on AIRS home-based asthma intervention. After the meeting, the DPH staff drafted changes to the current POA protocol based on the recommendations from this meeting. On July 26, 2016, once again the CT DPH asthma staffs meet with the POA coordinators and their staff to discuss the draft proposal, to discuss data collection and provide training on cultural competency and motivational interviewing. In addition to these two in-person meetings, emails were sent back and forth delineating recommendations and changes to the current POA protocol.
The revisions to the CT Home-based asthma program are aligned with CDC requirements and recommendations, are evidenced-based, and are aligned with the CDC community guidelines.
The proposed changes to the CT home-based asthma program were as follows:
1) enrollment criteria: focus on “poorly controlled asthma, school absenteeism,”.
2) Age: Keep 75% children and 25% adult
3) Focus on asthma control
4)Require Asthma Action Plan of all participants
5) Measure: Require ACT scores at each visit
6) High risk: Target High risk patients
7) Face-to face Interactions: Settings for asthma education
8) Home Visits: Required to have three
9) Phone calls: Made during visits
10) Duration of home visit: average time 1-1.5hours
11) Assessing ability to correctly administer asthma medication: Use of a Self-Administration of Medication Checklist @ each visit
12) Culturally and Linguistically Appropriate services: LHD must provide interpreter services: In-person or by phone
13) Strategies to reduce attrition should be provided: Incentives
14) Linkages with health providers and/or school nurses should be made
The current POA protocol offers (3) three face to face visits and follow-up phone calls in between visits. The enrollment criteria are:
- Asthma Control Score < 19 (indicative of poorly controlled asthma)
- > 1 ED visit or hospitalization or unscheduled medical visit in the last 6 months due to asthma
- Non-adherence to inhaled corticosteroids
- Self-administered 3 rescue inhaler canisters in 6 months
- Activity limitations due to asthma
- School absences: missed > 2 school days in the last year due to asthma
- School nurse’s office visits > 2 / week due to asthma
- Work absences: missed > 2 work days in the last year due to asthma