Integrating asthma prevention and control: The roles of the coalition. Health Promotion Practice

When the Allies Against Asthma (Allies)coalitions began their work, local activities tocontrol pediatric asthma were fragmented. People with asthma did not know how to access asthma management resources. Some services were unavail-able while others were duplicated. Organizations serv-ing people with asthma were often unaware of the full range of services in the community or did not have mechanisms to refer clients to them. They competed for funding and other resources. The educational materials and messages about asthma prevention and control they offered were inconsistent. Communication among medical providers, school staff, and caretakers of children with asthma was limited; sharing of patient Activities addressing pediatric asthma are often frag-mented. Allies coalitions promoted integration, the align-ment of concurrent asthma control activities across and within sectors. Systems integration describes activities from an organizational perspective. Activities included developing a shared vision, promoting consistency in asthma education and self-management support, improv-ing adherence to clinical guidelines, advocating jointly for policy change, and seeking funds collaboratively. Service integration describes activities focused on ensur-ing seamless, comprehensive services through coordina-tion within and across organizations. Activities included use of community health workers (CHWs) and nurses for care coordination, program cross-referral, and clinical quality improvement. Integration is a sustainable role for coalitions as it requires fewer resources than service delivery and results in institutionalization of system changes. Organizations that seek integration of asthma control may benefit