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Policy and system change and community coalitions: Outcomes from allies against Asthma

Author

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  • Clark, N.M.
  • Lachance, L.
  • Doctor, L.J.
  • Gilmore, L.
  • Kelly, C.
  • Krieger, J.
  • Lara, M.
  • Meurer, J.
  • Milanovich, A.F.
  • Nicholas, E.
  • Rosenthal, M.
  • Stoll, S.C.
  • Wilkin, M.

Abstract

Objectives. We assessed policy and system changes and health outcomes produced by the Allies Against Asthma program, a 5-year collaborative effort by 7 community coalitions to address childhood asthma. We also explored associations between community engagement and outcomes. Methods. We interviewed a sample of 1477 parents of children with asthma in coalition target areas and comparison areas at baseline and 1 year to assess quality-of-life and symptom changes. An extensive tracking and documentation procedure and a survey of 284 participating individuals and organizations were used to ascertain policy and system changes and community engagement levels. Results. A total of 89 policy and system changes were achieved, ranging from changes in interinstitutional and intrainstitutional practices to statewide legislation. Allies children experienced fewer daytime (P=.008) and nighttime (P=.004) asthma symptoms than comparison children. In addition, Allies parents felt less helpless, frightened, and angry (P=.01) about their child's asthma. Type of community engagement was associated with number of policy and system changes. Conclusions. Community coalitions can successfully achieve asthma policy and system changes and improve health outcomes. Increased core and ongoing community stakeholder participation rather than a higher overall number of participants was associated with more change.

Suggested Citation

  • Clark, N.M. & Lachance, L. & Doctor, L.J. & Gilmore, L. & Kelly, C. & Krieger, J. & Lara, M. & Meurer, J. & Milanovich, A.F. & Nicholas, E. & Rosenthal, M. & Stoll, S.C. & Wilkin, M., 2010. "Policy and system change and community coalitions: Outcomes from allies against Asthma," American Journal of Public Health, American Public Health Association, vol. 100(5), pages 904-912.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2009.180869_2
    DOI: 10.2105/AJPH.2009.180869
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    1. Haldane, Victoria & Singh, Shweta R. & Srivastava, Aastha & Chuah, Fiona L.H. & Koh, Gerald C.H. & Chia, Kee Seng & Perel, Pablo & Legido-Quigley, Helena, 2020. "Community involvement in the development and implementation of chronic condition programmes across the continuum of care in high- and upper-middle income countries: A systematic review," Health Policy, Elsevier, vol. 124(4), pages 419-437.
    2. Lombard, Wendy & Burke, Jodi & Waddell, Sandra & Franke, Arthur, 2015. "Utilizing findings from a gender-based analysis to address chronic disease prevention and management among African-American women in a Michigan community," Evaluation and Program Planning, Elsevier, vol. 51(C), pages 63-69.
    3. Jeff French & Sameer Deshpande & William Evans & Rafael Obregon, 2020. "Key Guidelines in Developing a Pre-Emptive COVID-19 Vaccination Uptake Promotion Strategy," IJERPH, MDPI, vol. 17(16), pages 1-14, August.
    4. Laurie Lachance & Laurie Carpenter & Mary Emery & Mia Luluquisen, 2014. "An introduction to the Food & Fitness community partnerships and this special issue," Community Development, Taylor & Francis Journals, vol. 45(3), pages 215-219, July.
    5. Keddie, Arlene & Amerson, Nancy & Johnson, Cassandra & Jenkins, Wiley & Crumly, David & Geiger, Sarah Dee, 2022. "Leveraging secondary data for evaluation: Planning the expansion of the Illinois asthma partnership to reduce pediatric asthma related emergency department visits," Evaluation and Program Planning, Elsevier, vol. 92(C).

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