Rebanal R David, Leman Richard
Oregon Health Services, Health Promotion and Chronic Disease Prevention Program, 800 NE Oregon St, Suite 730, Portland, OR 97232, USA.
Prev Chronic Dis. 2005 Nov;2 Spec no(Spec No):A12. Epub 2005 Nov 1.
Environmental tobacco smoke is a leading environmental asthma trigger and has been linked to the development of asthma in children and adults. Smoking cessation and reduced exposure to secondhand tobacco smoke are key components of asthma management. We describe a partnership involving two state agencies and 14 health plans; the goal of the partnership was to decrease smoking and exposure to environmental tobacco smoke among Medicaid-insured Oregonians with asthma.
Oregon's asthma rate is higher than that of the national population, and approximately one third of Oregonians with asthma smoke. The Health Promotion and Chronic Disease Prevention Program (HPCDP) in the Oregon Department of Human Services has collaborated with the Office of Medical Assistance Programs (OMAP) to promote preventive care at the population level.
Two HPCDP programs--the Oregon Asthma Program and the Oregon Tobacco Prevention and Education Program--worked with OMAP to launch the statewide Asthma-Tobacco Integration Project in 2003. A primary focus of the project is the development of partnerships among health plans, health care providers, and large health care organizations to integrate asthma management and smoking control through systems innovations and provider education. OMAP and its participating health plans also decided to focus cessation efforts on its members with chronic diseases. In addition, HPCDP has collaborated with OMAP to distribute educational tools and information about tobacco's impact on asthma morbidity to Oregon's health care providers who serve low-income Oregonians.
The partnership between OMAP and HPCDP program staff members has allowed them to discuss problems, leverage resources, and obtain support for many public health initiatives. In addition, OMAP-HPCDP collaboration on educational workshops and outreach to health care providers has helped convince quality improvement specialists and administrators about the importance of addressing smoking among patients with asthma. The Asthma-Tobacco Integration Project has also led to formative research aimed at increasing community involvement in promoting tobacco-free environments.
Collaboration between HPCDP and OMAP has been an important factor in Oregon's successful smoking cessation efforts in general and in recent efforts to address tobacco use among Oregonians with asthma.
环境烟草烟雾是导致哮喘的主要环境诱因，且与儿童和成人哮喘的发病有关。戒烟和减少接触二手烟草烟雾是哮喘管理的关键要素。我们描述了一项涉及两个州机构和14个健康计划的合作项目；该合作项目的目标是减少俄勒冈州患有哮喘的医疗补助参保者的吸烟行为以及接触环境烟草烟雾的情况。
俄勒冈州的哮喘发病率高于全国平均水平，且约三分之一的俄勒冈州哮喘患者吸烟。俄勒冈州人类服务部的健康促进与慢性病预防项目（HPCDP）已与医疗救助项目办公室（OMAP）合作，在人群层面推广预防性护理。
HPCDP的两个项目——俄勒冈哮喘项目和俄勒冈烟草预防与教育项目——与OMAP合作，于2003年启动了全州范围的哮喘-烟草整合项目。该项目的一个主要重点是在健康计划、医疗服务提供者和大型医疗保健组织之间建立合作伙伴关系，通过系统创新和提供者教育来整合哮喘管理和吸烟控制。OMAP及其参与的健康计划还决定将戒烟工作重点放在患有慢性病的成员身上。此外，HPCDP已与OMAP合作，向为低收入俄勒冈人提供服务的医疗服务提供者分发有关烟草对哮喘发病率影响的教育工具和信息。
OMAP与HPCDP项目工作人员之间的合作使他们能够讨论问题、利用资源并为许多公共卫生倡议获得支持。此外，OMAP与HPCDP在教育研讨会以及对医疗服务提供者的推广方面的合作，有助于让质量改进专家和管理人员认识到解决哮喘患者吸烟问题的重要性。哮喘-烟草整合项目还促成了旨在提高社区参与促进无烟环境的形成性研究。
HPCDP与OMAP之间的合作总体上是俄勒冈州成功戒烟努力的一个重要因素，也是近期解决俄勒冈州哮喘患者烟草使用问题努力的一个重要因素。
