Program helps young asthmatics control disease

Program combines basketball, disease management

In the first six months of Keystone Mercy Health Plan’s Healthy Hoops program, which combines basketball and asthma management, the percentage of children in the program with an emergency department visit for asthma fell 26%, the percentage of children with a hospital admission decreased by 8%, and nighttime awakenings decreased by 70% among program participants.

The program, which targets Keystone Mercy’s Medicaid members and other low-income children with asthma, was begun in 2003 after the health plan identified a high incidence of asthma among children in West Philadelphia.

Healthy Hoops is the brainchild of the health plan’s president and chief executive officer, Daniel J. Hilferty, who was looking for innovative ways to reach out to an often difficult-to-manage chronic disease population.

The program uses a four-part strategy — outreach, program events, asthma disease management, and member incentives — to educate young members and their parents on asthma control.

Participants who sign up for the program receive a basketball. If they continue the program, they earn a chance to participate in the Healthy Hoops Fall Challenge.

The program has since been expanded to other areas of Philadelphia, Chester Township, PA, and South Carolina through the health plan’s sister company, Select Health of South Carolina Inc. More than 1,000 children have participated in the program since its inception.

When the program began, Keystone Mercy targeted three zip codes where there were high rates of asthma among the plan’s members and in the community at large.

Initially, the health plan enrolled members by sending a brochure and enrollment form to families with children ages 7 through 15 with asthma in the targeted area. Now in addition to offering the program to members, the plan works with school nurses, coaches, and gymnastics teachers, and community and health care organizations to help identify children with asthma.

Keystone Mercy case managers make follow-up phone calls to everyone who receives the brochure, to encourage them to join the program and to answer any questions about the program.

"The community has embraced it in so many different ways. The school nurses, school teachers, gymnastic teachers, and basketball coaches are all involved and have helped make it grow," says Maria Pajil Battle, senior VP of public affairs and marketing for Keystone Mercy.

To participate in the program, the children must undergo a comprehensive physical examination and a spirometry screening to test lung capacity. Their parents must attend a workshop to teach them how to care for a child with asthma, how to identify asthma triggers, environmental issues that affect asthma, and proper asthma management.

"Our goal was to positively change their behavior and to address medication issues. Many of these children were not using preventative medicine but were relying on rescue medications," Battle says.

The parents’ workshop includes one-on-one coaching by an asthma educator who helps develop a treatment plan for the children and educates the parents on medication and equipment.

"The parents were really enlightened. They didn’t know how to clean a nebulizer or how to operate a peak flow meter," Battle says.

The six-month program opens each spring with a Healthy Hoops kick-off where participants register for the health screenings that are held throughout the targeted neighborhoods. Participants receive a basketball when they complete the health screening.

Professional basketball coaches and celebrity players work with the young participants on basketball drills during the kick-off event. The event was held in 2005 at an entertainment complex. During the kick-off festivities, parents and children are provided with information about asthma, weight management, and the prevention of cardiovascular diseases.

The program culminates in a full-day basketball clinic, the Healthy Hoops Challenge, where participants undergo another round of spirometry screenings to ensure that they are healthy enough to participate in the day’s activities and to determine if they have been managing their asthma.

The Healthy Hoops Challenge features coaching sessions and basketball drills by sports figures and coaches, live entertainment, and workshops for parents.

In the second year of the program, the health plan added a professional education component, to teach area sports coaches and physical education teachers in the Philadelphia public schools about juvenile asthma and the Healthy Hoops program.

"Whether they play basketball, football, or participate in other athletic programs, children with asthma often have to sit on the sidelines. Some of the coaches were telling them to use someone else’s inhaler. They didn’t realize that the children needed medication tailored to their specific needs," Battle says. The coaches have become some of the program’s biggest supporters, spreading the word throughout the community, she adds.

"Children in the program have become peer educators. They teach the young kids how to use the peak flow meters and measure their lung capacity," Battle says.

The health plan provides asthma education training to school nurses, Keystone Mercy Health Plan nurses, provider office nurses, and Pennsylvania Department of Health nurses. The training session, which provides asthma facts, prevention skills, and updated management techniques, was designed to provide continuing education units for participants.

The program was developed by the Keystone Mercy Health Plan and the Healthy Hoops Coalition, which includes doctors, nurses, asthma educators, representatives of community organizations and health departments, and nationally recognized basketball personalities.