Childhood Asthma Scan


Asthma is the most common chronic health condition affecting children in the United States: In 2007, 9.1 percent of children (6.7 million) had a current asthma diagnosis. Children from low-income families are disproportionately burdened, as they are more likely to have asthma, are less likely to be able to control the symptoms, and are more likely to visit the emergency department and be admitted to the hospital because of an uncontrolled episode. Despite large funding initiatives and numerous, multi-faceted interventions, the situation for children with asthma from low-income families has not improved over the past two decades.

In response, MDRC performed a review of the existing evidence on the effectiveness of childhood asthma interventions with support from the JPB Foundation. The Childhood Asthma Scan (CAS) includes a meta-analysis, which draws from about 30 independent studies and earlier published reviews and systematically compares findings across a range of outcomes and a spectrum of different approaches to addressing childhood asthma. By highlighting intervention models that have proven to be successful at improving health outcomes for low-income children and families, the CAS also seeks to inform the direction of future efforts. In addition, the paper includes case studies of various local programs and state-level policy initiatives, which were conducted in partnership with the National Academy of State Health Policy, to illuminate current efforts to address childhood asthma in low-income communities. These case studies highlight both local innovations and barriers faced in sustaining asthma programs.

Agenda, Scope, and Goals

The Childhood Asthma Scan (CAS) seeks to identify evidence-based approaches to tackling the burden of childhood asthma among low-income children and families. The main elements of the scan include:

  • A comprehensive literature review of pediatric asthma interventions evaluated within the past 10 years, and a comparative analysis of their impacts on health and health care use. The review culls the most current data on outcomes of pediatric asthma programs in order to assess the impacts of various interventions on health care use and quality of life indicators, and to identify gaps in the existing research as well as case studies of promising pediatric asthma programs that target low-income children.

  • Interviews with asthma experts to learn more about what works, and to identify current gaps in knowledge in the field of pediatric asthma.

  • Reviews of state-funded asthma interventions, in conjunction with the National Academy for State Health Policy, highlighting some of the most promising state-level initiatives to treat childhood asthma.

  • Site visits to a handful of programs identified through expert interviews and literature reviews as potentially promising or proven approaches to improve health outcomes for low-income children with asthma. These visits will be used to qualitatively synthesize the different challenges and successes of cutting-edge asthma interventions.

Design, Sites, and Data Sources

The Childhood Asthma Scan (CAS) relies on the existing literature of asthma interventions and primary data collection.

  • Studies for the CAS literature review were identified through several asthma, public health, medical, and social research databases. The literature review focuses on programs that have employed both experimental designs and pre- and post-experiment comparisons.

  • Qualitative methods, including structured interviews, fieldwork visits, and document reviews, were used to identify various program models and their key components.