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Overview

The goal of this data management and evaluation guide is to assist the new San Antonio Kids BREATHE (SAKB) asthma program in its planning for and management of data as well as in its evaluation of the program’s processes and outcomes. This document is both a guide and a template. GHHI encourages SAKB to utilize this as a living document as the program progresses—removing, adding, and editing content as necessary. This guide is not meant to be comprehensive, but rather a starting point for SAKB. The document is organized into three main sections: (1) Data Management, (2) Process Evaluation, and (3) Outcomes Evaluation. SAKB should simultaneously incorporate its goals for all three of these sections into its program planning, implementation, and refinement as opposed to doing each section in isolation. Additionally, SAKB should ensure the data management and evaluation plans are aligned with the program’s logic model.

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Initial feasibility overview
Over the course of three months, GHHI worked with partners in Chattanooga to under-take a feasibility study to assess the potential implementation of an integrated energy, housing, and health services delivery model for low and moderate-income households and communities in Chattanooga.

The project focused on five key areas of technical assistance: project planning, stake-holder analysis, data needs assessment, cost-benefit analysis, and payer engagement, which are outlined below. This report will focus on the latter four.

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Pilot Background

Partners in Chattanooga recognized the opportunity to improve health outcomes locally through the design and implementation of a comprehensive asthma intervention program. In 2018, a feasibility study was conducted in partnership with the Green & Healthy Homes Initiative (GHHI) to assess the capacity of local providers to integrate in-home asthma education and trigger remediation services into the existing clinical care structure. Following the study, a core team representing healthcare, healthy housing, and local utility interests was formed to pilot services.

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GHHI’s Theory of Change

Investments in comprehensive housing interventions, with health based housing standards that incorporate energy efficiency, will yield significant improvements in health, economic, educational and other social outcomes.

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Given the widely acknowledged importance of addressing the social determinants of health, health care has shown increased interest in partnering with community-based organizations that improve health and reduce costs. As a result, Medicaid MCOs across the US are beginning to invest in evidence-based comprehensive asthma services for members.

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The City of Utica is surrounded by more prosperous suburbs including Deerfield, Marcy, Whitesboro and New Hartford.

According to the US Census American Community Survey (2018), the City of Utica’s total population is 60,100, and the county population is 229,577.

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The goal of this publication is to disentangle the relationship between asthma and absenteeism, and to estimate the impact to which absenteeism negatively affects the student and her broader community. To illustrate the steps in analyzing this relationship, we use data from Grand Rapids, Michigan, a city where the Green & Healthy Homes Initiative (GHHI) has been working with local partners on a pediatric home visiting project.

The analysis finds that for some individuals, asthma may lead to chronic absenteeism (defined as missing more than 10% of school days) and failure to graduate from high school. As a result, those individuals pay the biggest price for their disease – future lost wages from the absence of a high school diploma total a present value of $745,000 over one’s lifetime. Federal, state, and local income tax revenue is thus reduced throughout the individual’s years in the workforce.

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GHHI worked with Montachusett Opportunity Council (MOC) to build a comprehensive asthma program that would expand upon the work being done in Worcester by UMMMC and the City of Worcester. This case study highlights one of the families that participated in MOC’s pilot program.

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