A60-14 Implementation of a Community Health Worker to Improve Asthma Outcomes

Abstract Rationale Asthma is the most common chronic lung disease in children, affecting about 4.6 million children in the United States with children living in urban populations disproportionately impacted. Community health workers (CHWs) have proven to be a pertinent asset in improving health outcomes by helping underserved pediatric patients and families navigate the healthcare system and access appropriate resources. However, there is limited data on the impact of CHWs in an urban, underserved inpatient pediatric setting. We conducted a pilot study enrolling all patients admitted to the hospital aged 2-18 years old with a primary diagnosis of asthma. A CHW screened for social determinants of health (SDOH) while admitted and served as a patient navigator for both PCP and pulmonary follow up appointments after asthma hospitalization. Methods A retrospective chart review comparing asthma outcomes 1 year prior to and 1 year after enrollment into a CHW lead pediatric asthma program was completed from May-October 2024. The mean number of hospitalizations, emergency department (ED) visits, and oral steroid courses one year prior to and one year after enrollment in the program were compared using paired t-tests. Descriptive analyses were utilized for demographic data. Results Data was collected from 76 patients ranging from 2-17 years old. Twenty-nine (38%) were female, 47 (62%) were male. SDOH screening demonstrated 48 (63%) patients screened positive for transportation concerns, 39 (51%) reported housing insecurity, and 40 (52%) had food insecurity. Only 15 (19%) screened negative for SDOH. Thirty-four (45%) were classified as mild persistent asthma, 32 (42%) as moderate persistent asthma, and 10 (13%) as severe persistent. Mean number of hospitalizations 1 year prior to enrollment in the asthma program was 0.75±0 and 1 year post enrollment was 0.29±0.56, p.0001. The mean ED visits 1 year prior to enrollment was 1.21±1.53 and 1 year post enrollment was 1.09±1.53, p = 0.5. The number of oral steroid courses 1 year prior to enrollment was 1.56±1.59 and 1 year post enrollment was 1.25±1.62, p = 0.07. There was a 61% decrease in hospitalizations, 9.75% decrease in ED visits, and 19.8% decrease in steroid courses although the latter two were not considered significant. Conclusions Utilization of a community health worker in an inpatient pediatric setting to serve as a patient navigator and screen for social determinants of health may help to improve asthma outcomes in underserved pediatric patients. This abstract is funded by: none