Asthma prevalence in Philadelphia: Description of two community-based methodologies to assess asthma prevalence in an inner-city population

OBJECTIVES: Local asthma prevalence, especially in high-risk areas, may vary greatly from those estimated by national or regional data and targeted, community-specific approaches may be needed to assess the burden of childhood asthma. The Philadelphia Merck Childhood Asthma Network project sought to understand the local prevalence of asthma in Philadelphia communities and schools of low-income, disadvantaged children utilizing a grassroots approach that would access traditionally hard-to-reach families.
METHODS: Two asthma-screening methodologies were implemented using the Brief Pediatric Asthma Screen. Door-to-door screening was conducted in disadvantaged neighborhoods by community health workers. School screening was implemented in each class through partnership with the school principals and teachers in disadvantaged neighborhoods within the same target area.
RESULTS: A total of 2368 children were screened through door-to-door methodology and 5563 children were screened in the schools. Door-to-door screening revealed asthma prevalence of 21.7%, with an additional 4.9% reporting symptoms consistent with asthma. School screening results revealed a higher prevalence with more than a quarter (27.5%) of the students screened positive for asthma. An additional 16.7% had symptoms indicative of asthma.
CONCLUSIONS: Both methods were able to successfully identify children with asthma in hard-to-reach populations. These methods can easily be replicated in other cities and the results can be used to inform programs, services, and policy developments.