A Novel Framework to Facilitate Multisector Activities to Improve Population-Level Asthma Control: The EXHALE Technical Package
Saturday, March 3, 2018: 3:00 PM
S230AB (Convention Center)
Joy Hsu, MD
RATIONALE: Determinants of asthma control include biological, environmental, behavioral, and social factors. Multisector collaboration could reduce asthma morbidity and mortality; this collaboration could be facilitated by a framework. A technical package (TP) is a selected group of related interventions that can help states, communities, and other sectors address a public health problem. A TP for asthma does not exist yet.

METHODS: From July 2015 to August 2017, CDC staff reviewed more than 2,700 articles, abstracted data, and characterized strength of evidence to identify priority, population-level strategies for improving asthma control. Abstracted data included adherence, health care utilization, and economic outcomes. Using these identified strategies, we created a TP for asthma. During the development of this TP, we sought input from multiple federal agencies, state asthma control programs, non-governmental organizations, and health care organizations.

RESULTS: This TP included six strategies, summarized by the acronym “EXHALE”:

Education on asthma self-management;

X-tinguishing smoking and secondhand smoke;

Home visits for trigger reduction and asthma self-management education;

Achievement of guidelines-based medical management;

Linkages and coordination of care across settings;

Environmental policies or best practices to reduce asthma triggers from indoor, outdoor, and occupational sources.

Our literature review indicated these strategies were complementary and reinforced each other.

CONCLUSIONS: The EXHALE TP is a novel framework to facilitate asthma control activities in various sectors, as well as multisector collaboration (e.g., public health and health care) to address asthma. This integrated approach could achieve a substantial impact on asthma control, including fewer asthma-related emergency department visits and hospitalizations.