Asthma in the Central Valley

The Central Valley Asthma Project, in collaboration with the Fresno County Asthma Coalition, UCSF, and Stanford, combines an asthma educator/case manager program with a unique Asthma Registry we have titled the "Fresno Asthma Data Exchange" (FADE). This project tackles the alarming rise of asthma in the at-risk Fresno community. FADE will warehouse asthma morbidity and mortality data, air and water quality data and a biomarker of pollution exposure (a cell surface protein upregulated in the presence of certain pollutants and revealed by Fluorescence Activated Cell Sorting).

This program utilizes culturally fluent Asthma Health Educator/Case Managers, trained specifically in the teaching, support and promotion of asthma treatment. Educators provide evidence-guided case management, assisting community members who are requiring frequent emergency care and may not understand how to use medications and resources to identify, avoid and/or address worsening of symptoms of this deadly disease. A carefully designed tablet-style, simple mobile interface allows educators to intake patients into the asthma registry, enroll them in available programs and point them toward appropriate resources. An open-sourced software program enables the creation of a unique disease registry titled the "Fresno Asthma Data Exchange" (FADE). This houses air and water quality data, disease morbidity and mortality statistics and research data from Stanford and UCSF researchers, providing immediate feedback on care as well as a venue to examine and empirically evaluate the relationship between asthma and pollution.

This program will improve quality of care and reduce asthma morbidity and mortality, which are higher here than anywhere else in the country. In this medically resource poor, highly at-risk population, community members have guided program structure and implementation. Their involvement is the key to sustainability and program success.

Fresno is the 2nd most polluted city in the country, with an overall asthma rate of 3 times higher than the national average (ALA 2009 "State of the Air).  Although the role of pollution is theoretically understood and circumstantially clear, it has not been proven. In this project, GHRF brings together clinical community, educators and researchers to maximize benefits of efforts, so as to clear the path to inform policy and create change.