For children with asthma and their families its WIN-WIN
by Sherry Mazzocchi Celia Veloz knows the suffering asthma causes. Her two children, Josue, 8, and Hannah, 4, both have asthma. Severe attacks caused them to miss school. Their regular visits to a pulmonologist’s office were often preceded by trips to the emergency room. Asthma attacks are the number one reason children end up in emergency rooms in the U.S. Because approximately one quarter of children in Northern Manhattan have asthma – nearly four times the national average – Morgan Stanley Children’s Hospital of NewYork-Presbyterian established the Washington Heights-Inwood Network (WIN) for Asthma Program. Families whose children require frequent emergency room care for asthma were invited to participate. In March, 35 families, including the Veloz family, completed a one-year program. “Our goal is to improve asthma management at large in the community,” said Dr. Adriana Matiz, medical director of WIN for Asthma. Now in its fourth year, the program works with families, local pediatricians, community organizations as well as schools and daycare centers in providing asthma education. Funded by Merck Childhood Asthma Network, it is working with 230 area families and so far 60 families have completed the entire program. WIN for Asthma teams up with Alianza Dominicana, Community League of the Heights, Fort George Community Enrichment Center and Northern Manhattan Improvement Corporation to work with families. A community health worker from each organization was trained in asthma education and partners with families for a year. Gricel Hernandez from NMIC recently saw eight of the 33 families she works with graduate from the program. By going into their homes, she helps families identify the triggers that cause asthma attacks – mold, dust mites and bug infestations that are common in pre-war Northern Manhattan apartments. She also instructs parents on the proper use of medications. But Hernandez’s role extends far beyond asthma education. “Every family dealing with asthma has other issues that arise when they start talking to you,” she said. Families need help with insurance, housing and landlord problems. She made mental health referrals and provided information about domestic violence issues, General Education Degrees and English as a Second Language classes. “Most of the families also have immigration issues. They think they can’t get help because they don’t have legal documents,” she said. “We help them with everything.” The vast range of public health and social problems that plague families in Northern Manhattan was an eye-opener for Matiz and her staff. As they began developing the asthma program for the community, they quickly realized how many other problems compete with a family’s ability to care for its children. “It’s not just teaching a family about asthma,” Matiz said. “It’s about empowering them to take control of other aspects of their lives as well.” WIN for Asthma also provided guidelines for classifying the severity of patient’s asthma to 110 private practitioners and pediatricians in Northern Manhattan. “We found that a lot of physicians were not classifying the children,” said Matiz. “We are working with the kids through our peer educators and the parents and at the same time we are working with the providers.” It seems to be working. Of the 60 families that completed the program, 83 percent have seen a reduction in emergency room visits and 73 percent have reduced the frequency of hospitalization. Eighty-three percent of the families have fewer asthma-related school absences. Veloz said she would recommend the program to other families who have children with asthma. Hannah and Josue now have far fewer asthma attacks – only two incidents each in the past year. Instead of the usual 10 minutes in a pediatrician’s office, Veloz had many opportunities to talk at length with Matiz and other asthma specialists for a better understanding of the disease and its triggers. She makes sure her children dress appropriately for the weather. Her children also get a flu shot each year. “That’s not something I did before,” Veloz said, “but I do now.” She also appreciated support group events like the Christmas and graduation parties that directly involve the children. There, families could meet, exchange ideas and support each other. “We are all in a similar situation,” she said. “And we can learn from each other.” The Manhattan Times is the bilingual newspaper of Washington Heights and Inwood.
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