The VCU Department of Psychology's Robin Everhart, PhD, in collaboration with the Center and the Division of Pediatric Pulmonary Medicine's Michael S. Schechter, MD, MPH, received a U34 grant from the National Heart, Lung, and Blood Institute to conduct a community needs assessment in collaboration with Engaging Richmond in order to design an intervention for low-income, minority children at risk for asthma in urban Richmond. The project built on a prior work with Engaging Richmond that resulted in an asthma education newsletter for affected families. The one-year NIH planning grant focused on a needs assessment to develop a multi-level, culturally tailored asthma intervention. The elements included a Community Advisory Group, a community survey of caregivers of children with asthma, and caregiver and child focus groups. The community survey, distributed by Engaging Richmond, assessed 100 anonymous caregivers of children ages 5-17 to identify caregivers’ concerns and needs for managing their children’s asthma. Engaging Richmond conducted five focus groups with caregivers and two focus groups with children (ages 10-14 years and 15-17 years, respectively). The focus groups sought feedback about barriers to effective asthma management, environmental triggers, cooperation from schools, perceived concerns related to asthma care, and the acceptability and feasibility of the proposed approach to asthma management.
The results of the survey and focus groups were reviewed by the Community Advisory Group. Engaging Richmond and the research team met monthly with this group, which was comprised of three caregivers and three youth, as well as representatives from the Healthy Homes Initiative through the Virginia Department of Health, members of the Community Health Workers Initiative with the Virginia Coordinated Care Program, and officials with the Virginia Asthma Coalition. The group considered possible interventions and assessed asthma health education materials with the goal of ensuring that the proposed intervention was appropriate to the family, community, and cultural context. Using system dynamics methods, Engaging Richmond and the Community Advisory Group generated models to demonstrate the potential outcomes of proposed interventions, highlighting the relatedness of health behaviors and health outcomes, and engaging stakeholders in discussions of pediatric asthma disparities. The group also developed pathway models for asthma management in the home, school, community, and physical environment (mold, pests, triggers).