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Explore the exciting poster topics for our 2025 World Asthma Day session! Undergraduate and graduate students, along with community partners, will showcase works in progress, emerging research, innovative practices, and key challenges in the asthma landscape.
Click on the topics below to learn more about each presentation. If you haven’t registered for the Asthma Day Conference yet, be sure to secure your spot.
Register Today! Don’t miss this opportunity to engage with the hard work and insights of our poster presenters.
Poster Topics
Click on a topic to learn more
- Poster #1: Addressing Pediatric Asthma Inequities Through Community-Based Interventions
- Poster #2: Assessing Lung Function and Asthma Symptoms in Children in Little Village and Pilsen, Chicago
- Poster #3: Asthma in Healthy Homes: A Public Health Department Approach
- Poster #4: Barriers and Challenges to Asthma Management in the Community Setting After Disasters: A Systematic Review
- Poster #5: Chicago Asthma Consortium Community Engagement through Scholarship Funding
- Poster #6: Chicago Coordinated Asthma Care Program
- Poster #7: Evaluating the Impact of a Mobile Unit and Home Visiting Program on Asthma Outcomes
- Poster #8: High-Risk Asthma Clinic at Ann & Robert H. Lurie Children’s Hospital of Chicago
- Poster #9: Illinois Asthma Classification Trends in In-Patient and Emergency Department Settings
- Poster #10: Impact of an Asthma Quality Improvement Program on Primary Care in Illinois
- Poster #11: PM2.5
- Poster #12: RESCUE-IL: Statewide Stock Inhaler Programming Serves as an Implementation Model for School-Based Asthma Management Programs
- Poster #13: Rural Asthma Initiative
- Poster #14: SMART Therapy: Addressing Barriers to Implementation
- Poster #15: Thanks Neighbors! Updating Illinois County Hospital Discharge Rates
- Poster #16: The Illinois Asthma Partnership: Snapshot of Successes
- Poster #17: The Impact of Neighborhood Factors on Asthma Medication Adherence in Adults
Poster #1: Addressing Pediatric Asthma Inequities Through Community-Based Interventions
Author: Sydney Wilson, University of Chicago
Co-Authors: Sharmilee Nyenhuis, MD FAAAAI, University of Chicago Medicine, Elizabeth Hansen, MPH, The University of Chicago, Ernestina Perez, MPH, The University of Chicago, Lex Roach, MPH, The University of Chicago, Catina Latham, PhD, The University of Chicago
Project Objective
- To understand the impacts of the Community Health Worker program on patient engagement with the health care system.
Abstract
Background: Pediatric asthma disproportionately affects Black and Hispanic children in low-income urban communities, leading to increased hospitalizations and worse health outcomes. Community Health Workers (CHWs) offer a patient-centered intervention to bridge healthcare gaps through education, social support, and resource navigation.
Methods: A retrospective cohort study used data from the UChicago datamart and South Side Pediatric Asthma Center (SSPAC). Pediatric patients (ages 0-18) enrolled in the CHW program between 2023 and 2024 were analyzed. Key metrics—appointment adherence, MyChart enrollment, primary care provider (PCP) connection, and SDOH screenings—were compared six months pre- and post-CHW intervention. Data sources included electronic medical records (EMRs), CHW intervention logs, and UChicago Medicine’s datamart. Descriptive and dose-dependent analyses assessed the correlation between CHW engagement levels and patient outcomes.
Results: Preliminary findings suggest CHW interventions may increase healthcare engagement. While results are still pending, we expect patients receiving CHW support to demonstrate improved appointment attendance, MyChart enrollment, and PCP connections. Additionally, CHWs are anticipated to identify and address social needs, such as housing and food insecurity, contributing to better asthma management.
Conclusion: CHWs are vital in reducing pediatric asthma disparities by enhancing healthcare access and addressing SDOH. Findings support the expansion of CHW-led programs as an effective strategy for improving asthma outcomes in underserved communities.
Poster #2: Assessing Lung Function and Asthma Symptoms in Children in Little Village and Pilsen, Chicago
Author: Lori Gerstenfeld, Northwestern University
Co-Authors: Matt Siemer, Executive Director, Mobile Care Chicago, Kamari Thompson, Director of Programs, Mobile Care Chicago, Cameron Zielke, PhD Candidate in Epidemiology, University of Illinois at Chicago School of Public Health, Serap Erdal, PhD, Associate Professor at the Division of Environmental and Occupational Health Sciences of the University of Illinois Chicago School of Public Health, Andrea Pappalardo, MD, Associate Professor of Medicine and Pediatrics, University of Illinois at Chicago, Division of Pulmonary, Critical Care, Sleep and Allergy, Victoria Persky, PhD, Professor of Epidemiology and Biostatistics at the University of Illinois Chicago School of Public Health
Project Objective
- Evaluate trends in lung function and asthma symptoms over 4-week study period
- Understand environmental influences of changes in lung function and asthma symptoms in children with asthma
Abstract
Background: Asthma is one of the most common chronic childhood diseases that affects lung function and leads to respiratory symptoms including wheezing and shortness of breath. Childhood asthma rates in Chicago are above national and state averages and disproportionately affect children in low-income, racially minoritized neighborhoods. Numerous studies from urban areas in the United States and abroad have found an association between air pollution and asthma incidence and exacerbation. Fine particulate matter (PM 2.5) is one class of air pollution that has been associated with asthma and respiratory symptoms. The Lower West Side neighborhoods of Little Village and Pilsen are two predominantly lower-income, predominantly Latinx Chicago environmental justice communities due to their disproportionate exposure to poor air quality from industry and traffic emissions. These neighborhoods also face disproportionate asthma morbidity.
Methods: Researchers from University of Illinois, Chicago and Mobile Care Chicago, a nonprofit that runs mobile asthma clinics in the Little Village and Pilsen communities, collected air quality and lung function data for 22 children ages 6-19 residing in the Little Village and Pilsen communities for a 30 day period in fall 2024. Air quality data included indoor and outdoor PM 2.5 measurements from PurpleAir Flex sensors placed both inside and outside of participants residences. This analysis focuses only on the lung function data which included daily symptom diaries, daily peak expiratory flow (PEF) measurements, weekly fractional exhaled nitric oxide (FeNO) tests and spirometry tests during the first and fourth weeks of data collection.
Results: Linear mixed model tests revealed an expected association between symptoms and peak expiratory flow (p < 0.01) and between average peak expiratory flow for the first and fourth weeks and spirometry measures of forced expiratory volume in one second (FEV1) during those weeks (p < 0.01), demonstrating the validity of data collected. The number of participants experiencing symptoms ranged from 0 to 7per day, with a two-day period in week 4 when no participants reported symptoms. A Friedman test comparing weekly average FeNO results was not significant (df=3, χ² = 2.89, p=0.41). However, a Friedman test for weekly mean PEF values indicated a significant difference (df=3, χ² = 17.58, p < 0.01). Post-hoc Wilcoxon signed-rank tests showed no significant differences among weeks 1–3 (p > 0.44), but each was significantly different from week 4 (p < 0.01).
Conclusions: There is evidence that data collected was valid due to consistency between measures and lack of significant changes among FeNO results over the study period. Symptom and PEF trends indicate that there may have been an improvement in airway function during the fourth week of data collection. PM 2.5 analysis should investigate any changes in air pollution in the fourth week of data collection to determine if air pollution could be related to the improvements seen during this period. Pollen counts during this period will also be investigated to see if lowered pollen levels during the fourth week could have been associated with the clinical improvements observed.
Poster #3: Asthma in Healthy Homes: A Public Health Department Approach
Author: Ajanta Patel, Chicago Department of Public Health
Co-Authors: Emily Hoover, BS, Chicago Department of Public Health, Isabella Xu, MPH, University of Chicago, Emile Jorgensen, Chicago Department of Public Health, Jasemen Hatcher, Chicago Department of Public Health, Sharita Holmes, Chicago Department of Public Health
Project Objective
- Develop the strategies, actions, and project management to pursue home repairs for children with asthma and indoor, structural airway triggers and irritants.
Abstract
Rationale: Asthma is driven by immunologic asthma triggers and irritants (ATI); home environments feature in pediatric asthma burden. Evidence supports that age of homes can be correlated with childhood asthma.
Home-centered asthma programs focus largely on education that encourages home cleaning and behavioral risk reduction to mitigate ATI. There is little evidence that local government public health departments have sustained programs to directly abate or mitigate ATI in the structure of homes.
Chicago Department of Public Health (CDPH)’s current home mediation initiative is the federally-funded Childhood Lead Abatement program. Temporary COVID-19 relief funding for CDPH is now available to expand home repairs in a Healthy Homes (HH) model (“City Bond HH funding”). In 2025, CDPH was awarded funding from the US Department of Housing and Urban Development (HUD) Production Grant series to remediate homes in the HH model.
Methods: From 2021-2023 a CDPH “HH Team” worked with the National League of Cities (NLC) to identify strategies and action steps for HH in Chicago. A subgroup identified overlaps between CDPH’s Lead Program, which conducts home remediation, and ATI abatement in homes. Working with NLC, we developed 3 strategies: 1) promote protections against youth asthma by reducing home health hazards through the HH program, 2) asthma training and education, and 3) sustainability planning.
Over 2023-2024 the subgroup launched CDPH’s Asthma in HH Initiative, focusing on a proposed design to use City Bond funding released to CDPH for HH improvement. Early stakeholdership development used data analysis to align Asthma in HH with current infrastructure. Our approach developed to reduce respiratory harm through ATI reduction, leveraging the existing Lead program’s infrastructure and as allowable with City Bond HH funding constraints.
Using early data and program design, CDPH applied for a novel grant series through HUD, the HUD Production Grants, which allow HH remediation beyond disease categories (i.e. no ties to lead poisoning are required). CDPH applied specifically to use this funding for pediatric asthma. This award is being launched in spring 2025.
CDPH is partnered with CAC to provide training to home inspectors in March 2025.
Results: Early collaboration analyzed data for inclusion in internal memos to build support for an Asthma in HH Initiative. Sources include the MySidewalk data portal; Chicago Hospital Admission data; and pediatric blood lead levels (BLL). MySidewalk data show high correlation between Chicago homes with high lead potential and adult asthma prevalence (Figure 1). Correlation between age of housing stock and adult asthma prevalence, by zip code, reveals an R = 0.39 for homes built 1940-49 vs R = -0.08 for homes built 1970-79. Adult asthma prevalence is 16% greater in Chicago zip codes with majority of housing built pre-1970 vs zip codes with majority housing built post-1970s (p=0.0005). We found correlation of R2 >0.6 between pediatric asthma ED visits (2017) vs prevalence of high BLL (2022) by zip code.
Programmatic opportunities for ATI mitigation include leak, wall, floor, roof, and ventilation repair; carpet removal; mildew abatement; and permanent air filter installation.
For the HUD production grant, data were provided correlating areas of high pediatric asthma burden to areas of high lead, old homes, and economic distress.
Discussion: The purpose of the Asthma in HH Initiative in Chicago is to leverage existing infrastructure and available HH funding to reduce structural contributors to ATI. Analysis of existing data can build stakeholdership for ATI mediation through HH funding. Ongoing actions towards program development and framing, program launch through training, and sustainability are multi-step.
Poster #4: Barriers and Challenges to Asthma Management in the Community Setting After Disasters: A Systematic Review
Author: Omar M. Khaium, University of Illinois at Urbana Champaign
Co-Authors: Dr Soyoung Choi, Assistant Professor, Department of Health and Kinesiology, University of Illinois at Urbana-Champaign, Cassandra Johnson, Program Manager, University of Illinois at Urbana-Champaign, Sabiha Sayeed, Medical College for Women and Hospital, Dhaka, Bangladesh, Dr. Sarah Dee Geiger, Assistant Professor, Department of Health and Kinesiology, University of Illinois at Urbana-Champaign
Project Objective
• To systematically analyze existing literature to identify key barriers and challenges to asthma management faced in disaster events by asthma patients and caregivers, healthcare providers, and emergency responders.
• To highlight gaps in effective asthma management, providing recommendations for interventions to improve healthcare readiness and response strategies.
Abstract
Background: Asthma patients are particularly vulnerable during disasters, as disasters can disrupt healthcare access, aggravate asthma symptoms, and introduce environmental and psychological stressors that exacerbate asthma-related complications. Understanding the barriers and challenges to effective asthma management during or after crises is crucial for developing interventions that improve preparedness and resilience in affected communities. This study synthesizes literature on barriers and challenges to community-level asthma management post-disaster, identifies gaps in current approaches, and proposes enhanced healthcare strategies to improve patient outcomes during crises.
Methodology: This mixed method systematic review includes empirical studies, both qualitative and quantitative, published between 2010 and 2024 that were conducted in community settings and focused on the challenges related to asthma management following natural and man-made disasters. Following PRISMA guidelines, the search strategy yielded 25 studies across eight countries that met the inclusion and exclusion criteria. Quality appraisal was done using the ROBINS-E and ROBINS-I tools.
Results: The findings of the 25 studies have been categorized into five types of crises that arose from natural and man-made disaster events worldwide- Thunderstorm Asthma events; Natural Disasters excluding Thunderstorm Asthma; Man made disaster, specifically the World Trade Center Attack; Impact of COVID-19 on Asthma Patients; and Management of Asthma during COVID-19 Pandemic. Six key categories of barriers and challenges to asthma management in the aftermath of these crises- financial constraints, mental health challenges, disruptions in healthcare practices, disparities due to crisis susceptibility, environmental exposures, and healthcare system overload- have been identified as significant public health obstacles impacting asthma care and outcomes.
Conclusion: Findings highlight how natural and man-made disasters disrupt community asthma management through multiple barriers and challenges. The study stresses the need for effective intervention strategies and policies addressing socioeconomic factors, environmental exposures, and healthcare continuity in disaster-prone communities to improve health outcomes during crises.
Project Objective
- Provide scholarship funding to healthcare students who counsel patients on proper inhaler techniques
Abstract
Background: The Chicago Asthma Consortium Community Engagement Committee annually facilitates asthma education and support within the community. One proposal is to offer scholarships to pharmacy students enrolled at the University of Illinois at Chicago Retzky College of Pharmacy who provide inhaler counseling for the community.
Methods: After receiving training on proper inhaler techniques, pharmacy students record the number of patients they counsel. Data is collected using the REDCap mobile application on the students' phones. Scholarships are offered during the Spring and Fall Semesters of 2022, Winter Break 2023, and Spring Semester 2025.
Results: A total of 270 patients with inhalers were counseled by 21 pharmacy students. Six students received scholarship funding. The most commonly counseled inhaler device was the metered-dose inhaler. Results for Spring Semester 2025 are still pending.
Discussion: Offering scholarship funding for community service not only increases the number of patients receiving inhaler technique education but also boosts the number of pharmacy students actively counseling patients in their work or experiential sites. Pharmacy students in graduate school often struggle with the high cost of tuition and many work while completing challenging courses. This scholarship provides an alternative form of financial assistance, allowing students to use skills learned in school while working or during their experiential courses. Despite efforts through emails, class announcements, and preceptor encouragement, participation in the scholarship remains low. Data collection questions are improving with each offering to better identify if counseling is provided to patients in high asthma admission areas or if students' confidence in counseling improves with experience. Expansion of the scholarship to other colleges of pharmacy and other professions, including nursing, medicine, and respiratory care, is under discussion.
Conclusion: Scholarship support for inhaler education is a positive investment in both healthcare professionals and the community.
Poster #6: Chicago Coordinated Asthma Care Program
Author: Rachael Morkunas, Respiratory Health Association
Co-Authors: Rachael Morkunas, MPH, Respiratory Health Association, Jalia Wilkins, Respiratory Health Association, Anna Volerman, MD, University of Chicago, LaToya Gregory, University of Chicago, Bolanle Ogbara, University of Chicago, Julie Kuhn, MSW, Sinai Urban Health Institute, Matt Siemer, Mobile Care Chicago, Kamari Thompson, Mobile Care Chicago
Project Objective
- Coordinated school-based intervention for students with asthma
Abstract
Background: Asthma is a leading cause of school absenteeism, emergency room visits, and hospitalizations among children, disproportionately affecting underserved communities. While Respiratory Health Association (RHA) and its partners long recognized the need for a coordinated school-based intervention, limited resources previously hindered efforts. With funding now in place, RHA, University of Chicago Medicine (UCM), Mobile Care Chicago (MCC), and Sinai Urban Health Institute (SUHI) have partnered to provide free asthma screening, education, and medical care to students and caregivers in Chicago Public Schools (CPS). The program ensures timely diagnosis, treatment, and support, but sustained coordination across school, healthcare, and community systems remains essential.
Methods: RHA initiates outreach to CPS schools, connecting them with UCM, which implements a 6-question pediatric asthma screening tool to identify students with symptoms. Families of identified students receive follow-up calls with education, resources, and referrals. UCM also conducts school-wide environmental assessments to identify and mitigate asthma triggers.
For students without a regular healthcare provider, RHA and UCM coordinate referrals to MCC’s mobile asthma van, a fully equipped clinic providing free asthma and allergy testing, medications, and preventive care directly at schools. MCC ensures continuity of care through referrals to Federally Qualified Health Centers as needed.
Students with uncontrolled asthma are referred to SUHI, where community health workers (CHWs) conduct up to five home visits to assess and reduce asthma triggers. CHWs provide culturally tailored one-on-one education, hands-on demonstrations, and strategies to mitigate triggers like pet dander or mold.
RHA delivers evidence-based asthma education for students, caregivers, and school staff. The Fight Asthma Now program serves students in grades 3-12 and includes a free spacer and asthma self-management workbook. Additionally, RHA provides a 60-minute Asthma Management training for parents and school staff to recognize and respond to asthma symptoms and emergencies.
Barriers & Challenges: Despite its comprehensive approach, the program faces key challenges:
• Parent/Caregiver Engagement: Return rates for screening forms remain low despite incentives, limiting student identification.
• School Participation & Staffing Constraints: Limited school personnel and scheduling conflicts hinder program implementation.
• Logistical Barriers to Medical Care: Families face transportation, language, and healthcare access challenges, even when services are free.
• Environmental Challenges: Addressing home and school asthma triggers requires ongoing engagement, yet follow-through on referrals remains inconsistent.
Results & Impact: Despite challenges, the initiative has increased asthma screening, education, and connections to medical care for CPS students. Schools have identified undiagnosed asthma cases, improved response strategies, and facilitated access to free care. While participation rates vary, sustained outreach efforts continue to address barriers. Addressing environmental triggers at home and school remains a long-term goal requiring ongoing collaboration.
Conclusion: Effective asthma care requires a flexible, community-centered approach. By embedding services within schools and homes, this program reduces access gaps for children with asthma. However, continued efforts are needed to enhance parent engagement, strengthen school-based asthma policies, and provide sustainable support for families facing environmental and socioeconomic challenges. Lessons learned can guide future school-based health interventions aimed at reducing pediatric asthma disparities in urban communities.
Poster #7: Evaluating the Impact of a Mobile Unit and Home Visiting Program on Asthma Outcomes
Author: Danielle Loftus, Southern Illinois University Edwardsville
Co-Authors: Kerry Basarich, MSN, RN, Southern Illinois University Edwardsville WE CARE Clinic, School of Nursing, Jerrica V. Ampadu, PhD, RN, CCP, Southern Illinois University Edwardsville WE CARE Clinic, School of Nursing, Myjal Garner, DNP, APRN, FNP-C, Southern Illinois University Edwardsville WE CARE Clinic, School of Nursing
Project Objective
- Our objective is to evaluate the impact of the mobile unit and home visiting program on asthma outcomes for enrolled patients in St. Clair and Madison County. The mobile van was added to the home visiting program and implemented in September 2024. The outcomes evaluation will include comparing 2019-August 2024 (pre-implementation) data to September-December 2024 (post-implementation) data. Outcome data include ACT scores, emergency room and urgent care visits, hospitalizations, number of days of school/work missed, and asthma knowledge scores.
Abstract
Background: Asthma is one of the most common diseases in childhood, and the top reason children are hospitalized in the St Louis region. Asthma prevalence is higher in children who are minorities, on state health insurance, and those with lower socioeconomic status. In Illinois, 13.5% of Black children have asthma compared to 5.9% of white children. Black children are 4.5 times more likely to be admitted to a hospital for asthma and they are three times more likely to die from an asthma-related cause than their white counterparts. The Asthma Trigger Assessment Program (ATAP) through the Southern Illinois University Edwardsville (SIUE) We Care Clinic works to address health disparities related to asthma in East St. Louis, Illinois, and the surrounding communities.
Program Purpose: The ATAP team strives to reduce health inequities through home visits and education. We follow the CDC’s EXHALE strategies to improve the daily living conditions of the community that we serve. We provide education on asthma medication self-management and home visits for asthma trigger identification and reduction. The program provides the community members with supplies to care for the home and their asthma including spacers, peak flow meters, cleaning supplies, air filters, HEPA vacuums, dehumidifiers, and allergen encasings for mattresses and pillows. Through education and trigger remediation, our patients are equipped to manage asthma at home and avoid emergency room visits.
Objectives: Our objective is to evaluate the impact of the mobile unit and home visiting program on asthma outcomes for enrolled patients in St. Clair and Madison County. The mobile van was added to the home visiting program and implemented in September 2024. The outcomes evaluation will include comparing 2019-August 2024 (pre-implementation) data to September-December 2024 (post-implementation) data. Outcome data include ACT scores, emergency room and urgent care visits, hospitalizations, number of days of school/work missed, and asthma knowledge scores.
Methodology: A retrospective analysis of existing data collected via the SIUE ATAP involving participants including demographics, ACT scores, emergency room and urgent care visits, hospitalizations, number of days of school/work missed, and asthma knowledge scores.
Poster #8: High-Risk Asthma Clinic at Ann & Robert H. Lurie Children’s Hospital of Chicago
Author: Avani Shah, Ann & Robert H. Lurie Children’s Hospital of Chicago
Co-Authors: Tahlia Brake, RRT, Ann & Robert H. Lurie Children’s Hospital of Chicago, Lauren Cullum, MSN, RN, CPN, CNL, AE-C, Ann & Robert H. Lurie Children’s Hospital of Chicago, Kaitlyn Guan, BSN, RN, Ann & Robert H. Lurie Children’s Hospital of Chicago, Alexandra Kacena, MSN, APN, CPNP-PC, Ann & Robert H. Lurie Children’s Hospital of Chicago, Paige Larson, LCSW, Ann & Robert H. Lurie Children’s Hospital of Chicago, Emily Simmons, MSN, APN, CPNP-PC, Ann & Robert H. Lurie Children’s Hospital of Chicago, Kaitlin Togtman, BSN, RN, CPN, Ann & Robert H. Lurie Children’s Hospital of Chicago
Project Objective
- Showcase the High-Risk Asthma Clinic at Ann & Robert H. Lurie Children’s Hospital of Chicago which provides multidisciplinary care to nearly 600 patients.
- Define the High-Risk Asthmatic and display the process for patient referrals to the High-Risk Asthma Clinic at Lurie Children’s Hospital
- Highlight patient care provided at the Asthma Mobile Clinic and how the clinic addresses the social determinants of health
Abstract
The High-Risk Asthma Clinic at Ann & Robert H. Lurie Children’s Hospital of Chicago provides multidisciplinary care to children in the Chicagoland area who are at high risk of morbidity and mortality from their asthma. The clinic was started in 2018 when it served about 150 patients and has since grown to serve nearly 600 patients. By creating a unique referral process and partnering with other providers that care for asthma patients in the hospital, our team has captured patients with the most severe asthma and enabled them to establish care with our program. Members of the High-Risk Asthma Clinic team include: 1 Pulmonologist, 2 Pulmonary Nurse Practitioners, 1 Asthma Educator/Respiratory Therapist, 3 Pulmonary Registered Nurses, including a Pulmonary Nurse coordinator, 1 Social Worker, 2 Endocrinologists, 1 Endocrinology Nurse Coordinator, 1 Allergist, 1 Allergy Nurse Practitioner, and 1 Administrative Assistant. Clinics are held at the main hospital campus as well as at Asthma Mobile Clinics located in Austin and Morgan Park. Our collaborations with Lurie Children’s Hospital’s Allergy and Endocrinology teams have supported our ability to address multiple aspects of asthma care such as environmental allergies and adverse effects of chronic steroid exposure. Our team engages with the local communities by providing care on the Asthma Mobile Clinic and improving access to care. Patients and families seen at the Asthma Mobile Clinic can park free of cost and miss fewer school and workdays given its convenient location. By using a multi-faceted approach to care, the High-Risk Asthma Clinic addresses all aspects of asthma including comorbidities and social influencers of health.
Poster #9: Illinois Asthma Classification Trends in In-Patient and Emergency Department Settings
Author: Sofia Logacho, University of Illinois Urbana-Champaign
Co-Authors: Nancy Amerson, MPH, Illinois Department of Public Health, Division of Chronic Disease Prevention and Control, Sarah Dee Geiger, PhD, University of Illinois Urbana-Champaign, Department of Health and Kinesiology
Project Objective
- In this analysis, we aimed to explore whether trends in classification of asthma status and severity of in-patient and emergency department cases experienced a significant change between 2016 and 2023 in Illinois. Specifically, we wanted to explore the changing proportion of cases classified as “other and/or unspecified,” using Joinpoint Regression Program.
Abstract
Objective: Asthma cases are classified in terms of status and severity by ICD-10 codes, but it is often not a straightforward process. Specifically, a large proportion of asthma emergency department (ED) and in-patient (IP) visits are classified as “other and unspecified asthma." With this analysis, we sought to explore the trends in 1) asthma status and 2) asthma severity classification.
Methods: We used Joinpoint Regression Program, which selects a “joinpoint” year when the software detects a significant change in trend, to explore the changing trends in asthma ED and IP visits between 2016 and 2023. Asthma cases were classified as one of six status categories (mild intermittent, mild persistent, moderate persistent, severe persistent, other, and unspecified) and one of four severity categories (uncomplicated asthma, acute exacerbation, status asthmatics, and other asthma) as defined by ICD-10 codes. We chose to exclude 2020 from the model to explore broader classification trends than those stemming from disruptions during the COVID-19 pandemic.
Results: Asthma status trends were similar across both ED and IP visits, the proportion of “non-other” cases increasing significantly while the proportion of “other” cases decreased. In the ED, the proportion of cases with “other and unspecified” status was significantly decreasing until 2021, when it stabilized. There was a significant decrease of IP visits throughout the entire period. Trends in ED and IP visits for asthma severity were less clear-cut than asthma status trends. In the ED, the proportion of cases with “other” severity status significantly decreased until 2021, when it stabilized. IP visits significantly decreased through the entire period. The proportion of “uncomplicated” cases significantly decreased in both settings, and acute exacerbations increased in ED visits in 2021 after being stable, while they significantly decreased in the IP setting. Status asthmaticus did not have a significant trend in ED visits but significantly increased in the IP setting.
Conclusions: These results suggest a general trend towards more specific, or “non-other,” classification of asthma status in both emergency department and hospital settings. These results also highlight a more complicated landscape in the classification of asthma severity, with cases classified as “other” decreasing but those classified as “non-other” following different paths. The National Asthma Education and Prevention Program (NAEPP) of the National Heart, Lung, and Blood Institute (NHLBI) focuses on raising awareness and ensuring appropriate diagnosis and management of asthma to reduce asthma-related morbidity and mortality and to improve the quality of life of individuals with asthma. In the last NAEPP guidance (2020) “classification of asthma severity” was identified as an emerging topic, but lack of sufficient new data for a systematic review on the topic meant there was no recommendations in the report. Our findings show that specific classification of asthma cases in the ED and IP settings remains a challenge.
Project Objective
- To assess the impact of the 18-month Enhancing Asthma Care program by obtaining data on six clinic-based performance measures in primary care clinics in Illinois.
- To provide evidence-based program results to encourage real-world application of the program to support primary care clinics when diagnosing, treating, and educating patient populations
Abstract
Objective: The Enhancing Asthma Care program (EAC) is a quality improvement program focused on aligning clinic-based asthma care with national guidelines. This study evaluated the effectiveness of this program in 57 participating clinics in Illinois from 2016 to 2023.
Methods: This evaluation represents a longitudinal observational analysis of real-world clinic care experiences. Six clinic-based performance measures were collected from a retrospective chart review at three observation points: before EAC implementation; at the end of the 12-month program; and 6 months after program completion (18 months).
Results: The EAC implementation was positively associated with improvement in all measures from baseline to 12 months. Aggregate data is as follows (N = 57 IL clinics): Documentation of asthma severity rating = 87.6% from 74.3% at baseline (a +13.3% change), Asthma Control Test™ = 77.3% from 53.9% at baseline (a +23.4% change), Controller Medications = 87.9% from 79.8% at baseline (a +8.1% change), Asthma Action Plans on file = 63.1% from 46.3% as baseline (a +16.8% change), Spirometry testing conducted = 26.3% from 16.6% at baseline (a +9.7% change), and Inhaler Education = 68.8% from 45.6% at baseline (a 23.2% change).
In evaluating the sustainability of these improvements from the end of the program (12 months) to 6 months post-end of program (18 months), four of the six key indicators not only were sustained but improved. The two indicators which did not improve only slightly decreased and included the indicators for controller medications which went from 87.9% to 84.5% and spirometry which went from 26.3% to 26%.
Improvement was still seen for all six measures from baseline to 6-month post-program completion (18 months). At 18 months, the data shows the following changes: For documentation of asthma severity rating = 95.1% from 74.3% at baseline (a +20.8% change), for Asthma Control Test™= 83.6% from 53.9% at baseline (a +29.7% change), for Controller medications =84.5% from 79.8% at baseline (a +4.7% change), for Asthma Action Plans on file = 68.8% from 46.3% at baseline (a +22.5% change), for Spirometry testing conducted=26% from 16.6% at baseline (a +9.4% change), and for Inhaler Education = 79.8% from 45.6% at baseline (a +34.2% change).
To understand the statistical significance of these changes in overall percentages, the data is being analyzed with chi-square test. Results on statistical significance are pending and will be ready by time of presentation.
Conclusion/Recommendations: This study demonstrated the favorable effect of the EAC program on evidence‐based asthma quality measures by showing improvement in six key indicators from baseline to program end and to 6-months post program end and highlights the value of quality improvement efforts in primary care. This study additionally shows the positive impact of primary care practices partnering with national nonprofit organizations. This vital quality improvement collaboration provides support and technical assistance to primary care so they can improve on key indicators in alignment with national guidelines, such as the proper diagnosis of asthma using spirometry, assessing asthma control, prescribing the appropriate medication, and educating patients on how to properly use their inhalers.
Project Objective
- Display the severe disparity of PM2.5 levels in any given day between the Southeast Side of Chicago and it's neighboring areas
Abstract
The Southeast Environmental Task Force has been working in collaboration with the University of Chicago to create and maintain a mid size air monitor grid in the South East Side of Chicago. The devices being used are Purple Air Monitors that record and report their data to an online map at map.purpleair.com, through this we've been able to capture and compare screenshot of the air quantity at any given moment.
We've gathered quite a collection displaying the disparity of air quality of the Southeast Side compared to the rest of Chicago and it's neighboring areas in Northwest Indiana. With these we plan to create a poster that not only displays the disparity but also celebrates the Southeast Side for its unique attitude and resilience despite its environmental issues.
We also plan to highlight some of the companies in the area that are the cause for the spikes in PM2.5 levels, which are the incredibly small particulate that cause alot of issues for those struggling with respiratory and cardiovascular health issues.
Poster #12: RESCUE-IL: Statewide Stock Inhaler Programming Serves as an Implementation Model for School-Based Asthma Management Programs
Author: Andrea Pappalardo, University of Illinois Chicago
Co-Authors: Paige Hardy, MPH, University of Illinois Chicago, Departments of Medicine and Pediatrics, Lynn Gerald PhD, MSPH, University of Illinois Chicago, School of Public Health, Alexandra Knitter, MPH, University of Chicago, Department of Medicine, Anna Volerman, MD, University of Chicago, Department of Medicine, Erica Salem, MPH, Respiratory Health Association, Naomi Soto, MPP, Asthma and Allergy Impact and Rescue, Chris Martinez, MIB, CFRE, Asthma and Allergy Impact and Rescue
Project Objective
- To understand participant satisfaction and experiences during the RESCUE-IL statewide stock inhaler program’s first year
Abstract
Rationale: While asthma is common, many students do not have rescue medication readily available at school. Over the 2023-2024 school year, eligible schools across Illinois received free undesignated albuterol, supplies, and training through the Resources for Every School Confronting Unexpected Emergencies Illinois (RESCUE-IL) program. We aimed to understand participant satisfaction and experiences during this statewide stock inhaler program’s inaugural year.
Methods: All 1158 individuals with a nurse profile in RESCUE-IL’s Apricot database were eligible to participate in the survey through RESCUE Connect. Four reminder emails were sent March-May 2024. Descriptive statistics were performed in Excel.
Results: In total, 156 respondents representing 227 schools completed the survey (13.5%). Most schools did not stock inhalers prior to RESCUE-IL (68.3%). No participants reported harm associated with the program. Among respondents, 86% reported feeling satisfied or very satisfied with the RESCUE-IL program and 91.6% were highly likely or likely to participate next year. The most commonly selected benefit of the RESCUE-IL program was the ability to act quickly in an emergency situation (96.0%). Forty percent noted no barriers, while 35.7% expressed fears that children or families would not supply their personal inhaler.
Conclusions: School health personnel report high satisfaction with RESCUE-IL’s execution of their statewide stock inhaler program. Future research into portal usability and follow-up care connections are important next steps in this program’s success. Sustainable state-level funding and program expansion is vital for schools to continue to de-escalate asthma symptoms.
Project Objective
- Decrease asthma admissions in the ED
- Educate the community about asthma
- Better asthma management among patients
Abstract
The Rural Asthma Initiative, implemented at Hillsboro Health, aims to enhance the quality of life for patients suffering from asthma by reducing emergency department (ED) visits related to asthma symptoms. The project focuses on educating both the community and healthcare staff about asthma management, including the proper use of medications and peak flow meters, as well as the development of individualized asthma action plans.
Throughout the project timeline, significant milestones have been achieved, including the creation of educational materials and kits for patients. These kits contain essential resources such as peak flow meters, valved holding chambers to use with inhalers, asthma action plans, and educational cards with a QR code linking to online resources. The initiative also includes a community education course, with plans to host two events annually to raise awareness about asthma and its triggers.
Despite facing challenges such as supply chain delays; the project has made progress in staff training and patient education. Staff members, including respiratory therapists and nurses, have been trained to discuss asthma management with patients during their hospital stays. The project has also established a data collection plan to monitor outcomes, focusing on discharge follow-up calls to assess medication use and quality of life improvements.
The anticipated measurable outcomes include a decrease in ED visits for asthma-related issues, improved understanding of asthma management among patients, and overall enhancements in community health. The project stakeholders include frontline healthcare team members, community partners, and patients, all of whom play a vital role in the initiative's success.
In conclusion, the Rural Asthma Initiative is committed to ongoing education and support for patients and the community, with the goal of fostering better asthma management practices and ultimately improving health outcomes for individuals affected by asthma. The lessons learned from this project will guide future efforts to sustain and expand asthma education initiatives within the community.
Poster #14: SMART Therapy: Addressing Barriers to Implementation
Author: Aashna Shah, University of Illinois at Chicago, College of Medicine
Co-Authors: Anne Osuji, University of Illinois at Chicago, College of Medicine, Anne Volerman, MD, University of Chicago, Pritzker School of Medicine, Joyce Rabbat, MD, Loyola University Medical Center, Rachelle Paul-Brutus, MPH, Chicago Asthma Consortium
Project Objective
- The adoption of SMART (Single Maintenance and Reliever Therapy) has the potential to optimize asthma management by improving medication adherence and reducing severe exacerbations, yet barriers to its implementation persist. This project aims to identify challenges at the patient, provider, and systemic levels and present opportunities for intervention to facilitate guideline-concordant practice and enhance asthma outcomes.
Abstract
Background: Asthma management has traditionally followed a stepwise approach, as recommended by guidelines from the National Asthma Education and Prevention Program (NAEPP) and the Global Initiative for Asthma (GINA). In recent years, Single Maintenance and Reliever Therapy (SMART) has emerged as an alternative to the traditional approach to management. Single Maintenance and Reliever Therapy (SMART) is an evidence-based approach to asthma management that utilizes a single inhaler combining an inhaled corticosteroid (ICS) and a long-acting beta-agonist (LABA) for both maintenance and symptom relief. Clinical trials have demonstrated SMART’s effectiveness in reducing severe exacerbations and improving adherence. As a result, the NAEPP and GINA have incorporated SMART into their guidelines. However, implementation remains inconsistent, highlighting a gap between recommendations and practice.
Methods: This study conducted a scoping review of the literature following PRISMA-ScR guidelines to identify barriers to SMART implementation.
Results: We found that barriers to SMART implementation exist at various levels. Strategies to address gaps in SMART implementation were broken down into the following levels using the Robert Wood Johnson Foundation’s Finding Answers: Disparities Research for Change Program 6-level model: patient/family, provider, microsystem, organization, community, and policy.
Key barriers at the patient-level include lack of familiarity with SMART and its new dosing regimen. Barriers at the provider stem from a lack of awareness of guideline changes and low prescribing confidence. There is also low awareness of SMART among other members of the care team and across specialties, and school staff and nurses have varying levels of familiarity with SMART as well. At the organizational level, integration into electronic medical records (EMRs) is lacking. Due to the lack of U.S. Food and Drug Administration (FDA) approval of inhalers to be used in the SMART regimen, there is inconsistent insurance coverage for this therapy as well.
Targeted strategies can facilitate SMART adoption. Patient and provider education, increased cross-specialty alignment regarding SMART, and school-based training initiatives can improve implementation at local levels. Additionally, asthma action plans and EMR integration with SMART-specific alerts could serve as valuable tools for practical implementation. Addressing policy barriers requires advocacy for FDA approval and expanded insurance coverage to make SMART a cost effective option for patients.
Conclusion: The implementation of SMART represents an opportunity to transform asthma management and significantly improve patient outcomes. By employing a structured framework that addresses multilevel barriers, stakeholders across the healthcare continuum – including healthcare systems, providers, and policymakers – can develop targeted interventions to effectively bridge the gaps between evidence-based recommendations and real-world clinical practice.
Project Objective
- Update county level asthma rates of emergency department (ED) visits and hospitalizations post COVID by supplementing IDPH data with data from bordering states.
Abstract
Objective: The Illinois Department of Public Health (IDPH) maintains the Hospital Discharge Dataset (HDD). The HDD contains records for every emergency department (ED) visits and inpatient hospitalization that occurred in Illinois. Each record collects a primary reason for the visit, as well as secondary diagnosis, using ICD-10 codes. Asthma surveillance activities at IDPH include publishing state-wide asthma rates for ED visits and hospitalizations and producing those rates for county level geography. To capture asthma events of Illinois residents, the IDPH data is supplemented by data from surrounding states. This provides a clearer picture of asthma burden for border counties when patients may cross into another state for a preferred facility.
Methods: Visits that occurred in the IDPH HDD were identified based on an ICD-10 code series of J45. The overall counts, counts by youth (<18 years), adults (18 years and older), Hispanic, Non-Hispanic Black, and Non-Hispanic White for each county were calculated. The asthma epidemiologist contacted the Asthma Programs in Missouri, Wisconsin, Indiana, and Kentucky and the Hospital Association in Iowa to request aggregate tables to supplement IDPH data. The project included visit data between 2020-2023.
Results: Over the four year period, IDPH data contained 167,108 ED visits and 20,341 hospitalizations where asthma was the primary diagnosis. An additional 7,055 ED visits and 1,291 hospitalizations were obtained from Iowa, Missouri, Wisconsin, and Indiana. The metro-east St. Louis area saw the largest increase in hospitalizations (n=613) and second largest in ED visits (n=1,871) following Cook County (n= 3,338). Among the additional records from neighbor states, 74.4% of hospitalizations and 44.0% of ED visits were in youth.
Conclusions: IDPH surveillance of asthma ED visits and hospitalizations is improved by working with neighboring states to identify Illinois residents who received care. It is especially impactful in the metro-east St. Louis area where many Illinoisians cross into Missouri for care at major hospitals in St. Louis. The process of data sharing with other states can be nuanced but is important for accurately reflecting the burden of asthma for Illinoisians.
Poster #16: The Illinois Asthma Partnership: Snapshot of Successes
Author: Cathy Catrambone, Rush University
Co-Authors: Nancy Amerson, MPH, Illinois Department of Public Health, Division of Chronic Disease Prevention and Control, Stacy Ignoffo, MSW, Sinai Urban Health Institute, Asthma Partnership Co-Chair , Nikki Woolverton, MPH, Illinois Department of Public Health, Division of Chronic Disease Prevention and Control
Project Objective
- We aim to describe the statewide asthma partnership in the context of the CDC Foundation’s roadmap for governmental public health to strengthen partnerships. Successes of the partnership will be described relating to a foundation of core values, public health systems, and partnership progressions.
Abstract
Objective: In 1999, IDPH received a three-year grant from the Centers for Disease Control and Prevention (CDC) to launch the Illinois Asthma Program (Program) and the Illinois Asthma Partnership (IAP). As the IAP surpasses 25 years of operation, we reflect on the values, systems, and progression of the IAP. An IAP evaluation was completed in 2011 and described in the context of Tuckman’s theory of group development. This project seeks to describe the current state of the IAP using recommendations from the CDC Foundation.
Methods: The CDC Foundation recently developed a roadmap for governmental public health to strengthen partnerships with community-based organizations. The current IAP operations were assessed based on four public health system dimensions in the roadmap: organizational culture, governance and leadership infrastructure, data, measurement and evaluation, and funding and other investments.
Results: The organizational culture has strengthened over time as members have crafted a goal, mission, and priorities. Leadership and governance are dictated through the IAP Executive Committee’s roles and responsibilities. Member of the Executive Committee include two co-chairs, chairs of the Surveillance and Evaluation workgroup, and members-at-large. The Executive Committee provides direction on asthma grant programming, priorities, and policies supportive of asthma control and assists with partnership meeting planning. The IAP is comprised of individuals and organizations that bring premier subject matter expertise, experience, and integrity. Partners often lend their time and expertise in providing educational presentations, assisting in the development of data and surveillance reports, serving as subject matter experts, offering guidance and strategic direction, and connecting to innovation collaboration with multiple sectors.
Data, measurement, and evaluation are central is the work of the IAP. Data is transparently shared and IAP members serve as experts on community issues, policy strategies, and data needs.
Funding and other investments are primarily routed to the asthma program. The asthma program is both federally and state funded and supports two staff members. An annual meeting and ad-hoc programming is offered to partnership members.
Conclusions: Illinois is fortunate to have a dedicated statewide partnership, and funded and unfunded partners all support the common goal of addressing health equity and asthma disparities, particularly in communities of greatest need. The reach and sustainability of asthma programming has expanded throughout the years due to instrumental work of partnership leadership, the use of data and evaluation to drive decisions, policy initiatives, and support of the multi-component, multi-sector programming across Illinois.
Poster #17: The Impact of Neighborhood Factors on Asthma Medication Adherence in Adults
Author: Christian Carrier, BA, University of Chicago Pritzker School of Medicine
Co-Authors: Christian Carrier, BA, University of Chicago Pritzker School of Medicine, Barbara Polivka, PhD, RN, FAAN, University of Kansas School of Nursing, Luz Huntington-Moskos, PhD, RN, University of Louisville School of Nursing, Kamal Eldeirawi, PhD, RN, FAAN, University of Illinois, Chicago, Emily Cramer, PhD, University of Kansas School of Nursing, Sharmilee Nyenhuis, MD, FAAAAI, University of Chicago Medical Center
Project Objective
- To identify neighborhood characteristics associated with decreased asthma medication adherence
- To examine the cumulative effect that these neighborhood characteristics may have on asthma medication adherence
Abstract
Objective: In children, more attention has been turned recently to how neighborhood characteristics, such as safety, can impact their asthma symptomatology and prevalence. Lack of asthma medication adherence is known to be linked to increased morbidity, and increased reliance on short acting beta agonists (SABAs) is associated with progression of asthma severity. It is well-established that asthma medication adherence is low in adults, but less research has gone into how it is impacted by neighborhood characteristics. The purpose of this study was to identify neighborhood characteristics associated with asthma medication adherence, and the cumulative effect that these neighborhood characteristics may have on adherence in adults.
Methods: Eligible patients were those 18 years or older who had been diagnosed with, and still carry the diagnosis of, asthma. Patients were recruited across the United States through an online survey advertised through social media and other digital avenues. Demographic data and their answers to the Adult Asthma Adherence Questionnaire (AAAQ) were recorded. Patients were also asked to respond to a series of questions assessing their agreement with certain statements about their neighborhood characteristics and personal and household health habits and behaviors on a 5-point Likert scale. When they responded with an answer ranging from “Neither Agree nor Disagree” (3) to “Strongly Agree” (5), they were identified as having a problem for that specific neighborhood factor. The number of problems they had were then summed into a cumulative score (Maximum 9).
Their asthma medication adherence, as influenced by various neighborhood factors, was determined by logistic regressions controlling for their age, gender, ethnicity and education.
Results: 1,134 patients completed the survey, of which 988 provided complete data. Of these 988, 79% were female and the average age was 43.5 years. The majority of patients identified as white (80%), and not Hispanic or Latino (93%). 44% of patients self-identified as having a general asthma medication adherence issue.
Feeling that one’s neighborhood was not a good place to live in was significantly associated with lower asthma medication adherence (OR: 1.79, 95% CI 1.07 – 2.99, p < .001).
Only 8% of patients without an adherence issue were in the highest tertile (Score of 7-9) of cumulative problem scores, while 13% of patients with an adherence issue were in this tertile. The distribution of patients in these tertiles when compared by having or not having asthma medication adherence issues was statistically significant.
Conclusion: Decreased asthma medication adherence was associated with feelings that their neighborhood was not a good place to live in. Additionally, as the cumulative problem score increased, the odds of decreased asthma medication adherence increased, suggesting that patients in under-resourced areas may have difficulty adhering for various reasons. This may represent an allostatic load – where neighborhood stressors individually do not directly manifest as wear and tear, but the cumulative effects of these problems do. Future studies should examine how targeting these neighborhood factors can improve asthma medication adherence in adults.