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Q&A with Michael Schechter, MD, MPH

In 2015, thanks to a $422,514 grant from Children’s Hospital Foundation, Michael Schechter, MD, MPH, Professor and Chief, Pulmonary Medicine; Director, Cystic Fibrosis Center; and Director, You Can Control Asthma Now (UCAN) program, Children’s Hospital of Richmond at VCU (CHoR), developed a community asthma program to provide coordinated care to the disproportionately high number of children with asthma in Richmond. Since that time, nearly 500 children have enrolled in the program, which was recently recognized by the U.S. Environmental Protection Agency with the 2017 National Environmental Leadership Award in Asthma Management. Results from the UCAN program also contributed to VCU being awarded a $4.73 million grant to improve the overall health and well-being of children with asthma in Richmond.

Based on the overall success of the UCAN program in its first two years, the Foundation was proud to renew its support this year with a two-year, $496,883 pledge.

Pictured above: The core You Can Control Asthma Now (UCAN) team includes (left to right) Kathleen Bowden, MSW; Michael Schechter, MD, MPH; and Ginger Mary, CPNP, MSN, AE-C.

What is asthma, and why is proper asthma management important?

Asthma is a condition where there is inflammation and irritation of the airways leading to acute attacks of breathing problems that are most commonly triggered by colds, exercise, strong smells or exposure to allergens. Asthma is the most prevalent childhood disease and is one of the most common causes of hospitalization in children. It often causes restricted activity among children because many families don’t understand that there are ways to control asthma without limiting activity. Proper asthma management reduces emergency room visits and hospitalizations, decreases missed school and work days, and prevents restricted activity for children.

Why was there a need for the UCAN program at CHoR, and what kind of results have you seen since the program’s inception?

For the last five years, the Asthma and Allergy Foundation of America’s Asthma Capitals report has listed Richmond as one of the worst cities to live in with asthma, citing Richmond’s higher than average emergency room visits and death rates in children with asthma. Although asthma is usually fairly easy to manage, for some of our patients, there are a variety of economic, social and cultural factors that make asthma treatment difficult. Working with a nurse program manager and social worker, the UCAN program educates children and families about asthma care and prevention and helps identify other issues that interfere with a family’s ability to care for these children. Caring for a chronic disease is a complex endeavor, and our approach needs to be multi-factorial. A child’s social and physical environment is as strong a determinant of health as his or her medical treatment. Since the UCAN program began, we have seen a reduction of about 50 percent in emergency room use, hospitalizations, and missed days of school and work for the children and families in our program. We also have families coming to clinic happy that their children can do activities they used to not be able to do. That’s what keeps me going.

What does it mean to be recognized by the Environmental Protection Agency with the 2017 National Environmental Leadership Award in Asthma Management?

The EPA recognition shows that we’ve been able to make an impact on our patients. It also allows me to raise awareness of the issues surrounding asthma management and gives me access to ongoing resources to continue our work. The UCAN program is currently supported entirely by philanthropy so I hope this recognition will allow us to receive additional funding for our program.

Can you tell us a little about the grant VCU has received to help improve lives for children with asthma in Richmond?

Results from the UCAN program have allowed us to receive grants to expand our work through other partnerships. We recently received a $4.73 million grant from the National Institutes of Health to conduct a program that relies on community-based interventions utilizing home health workers and school nurses to make an impact on children with asthma in Richmond’s urban areas. The multi-year program will involve 300 children with asthma and their caregivers participating in a randomized clinical trial measuring the impact of asthma education, home remediation and/or school intervention. At the end of the study, the NIH grant also provides support to work with community partners including insurers to sustain and expand the interventions as a more cost-effective way to ensure the health of urban children with asthma.

To learn more about the NIH grant, click here.