Southeast KY Initiative for Pediatric Asthma

The Kentucky River District Health Department (KRDHD) is seeking a professional evaluation of the activities and effectiveness of the Southeast Kentucky Initiative for Pediatric Asthma (SmA). The evaluation wiIl be conducted over an 18 month period from December 1, 2002 through May 31, 2004. The KRDHD defines an eligible applicant as one who has: . Experience using Community-Based Participatory Evaluation Strategies . . Experience with health promotion intervention design and evaluation -preferably in the area of chronic childhood diseases, including childhood asthma. . Experience in both process and outcome evaluation and with questionnaire design, and statistical analysis. . Experience in both qualitative and quantitative data analysis. . Publication in peer-reviewed journals preferred. SKIPA Program Summary: Small children and their families in southeastern Kentucky suffer from pediatric asthma at rates two to three times higher than children in the rest of the Commonwealth and the nation. Asthma is particularly difficult for parents and health care providers in this region since over 70% of the hospilizations for pediatric asthma occur in children less than 5 years of age.Many factors contribute to this problem including the environment, population demographics, and ineffective , treatment. The Southeast Kentucky Initiative for Pediatric Asthma (SKlPA) promotes a healthy, active life for children at risk for or diagnosed with asthma in the target communities. SKIPA's majorgoal is to reduce the disparity between the child asthma morbidity in its target area and that of the rest of the Commonwealth of KYand the U.S. The SKIPA target population is a 4-county area (Harlan, Knott, Owsley, and Perry counties) in southeastern Kentucky in the heart of the Appalachian coalfields. This area is served by Appalachian Regional Health are(ARH) hospitals in Hazard and Harlan, KY. The burden of child asthma disease in the target area is substantiantly greater than the burden in other areas of Kentucky. The 19-county KY Medicaid Region 8 that includes our entire target area had a 1996-98 child asthma hospital discharge rate of 260 per 10,000 children for children fewer than 5 years of age. This rate is almost three times the statewide rate of 88. Although the Kentucky rate of 88 is less than the U.S. 1995-7 rate of150, and is nearly as low as the Healthy People :2010 goal of 80, the rate for the SKIPA target area is markedly higher than these benchmarks. The high prevalence of disease in the target area indicated by hospital discharges is consistent with Medicaid reports. In 1996, children of all ages in Region 8 (which includes our target area) received a primary diagnosis of asthma at a rate 40 to 100 percent higher than the remaining seven Kentucky Medicaid, regions.