title: Reducing inequities among children with asthma in the island of Puerto Rico: experiences of a community-based, trans-sectoral effort.
abstract: Children living in the Commonwealth of Puerto Rico have the highest poverty and asthma prevalence rates of all U.S. children. Since 2000, a group of community, health care, education, housing, and academic representatives have been collaborating in a project to improve quality of life and reduce disparities among children with asthma in very poor communities in Puerto Rico. To date the project has implemented a successful intervention in the Luis Lloréns Torres Housing Project, aimed at adapting evidence-based interventions to improve the social and physical environment of children with asthma. The program has recently been extended to another San Juan housing area, the Manuel A. Pérez Housing Project. Using implementation theory, the authors report and reflect on the project's experience to date, provide recommendations, and discuss implications of lessons learned to address inequities in asthma care throughout other underserved areas in the U.S., Latin America, and the Caribbean.
authors.affiliation: RAND Corporation in Santa Monica, CA, USA.
authors.forename: Marielena
authors.initials: M
authors.lastname: Lara
authors.forename: Gilberto Ramos
authors.initials: GR
authors.lastname: Valencia
authors.forename: Jesús A González Gavillán
authors.initials: JA
authors.lastname: Gavillán
authors.forename: Beatriz Morales
authors.initials: BM
authors.lastname: Reyes
authors.forename: Carmen
authors.initials: C
authors.lastname: Arabía
authors.forename: Fernando López
authors.initials: FL
authors.lastname: Malpica
authors.forename: Dharma M
authors.initials: DM
authors.lastname: Freytes
authors.forename: Mario H
authors.initials: MH
authors.lastname: Rodríguez-Sánchez
authors.forename: Matthew
authors.initials: M
authors.lastname: Chinman
mesh_terms: D001249:Asthma / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D003153:Community Health Services / Q000458:organization & administration*; D003299:Cooperative Behavior; D004777:Environment; D019317:Evidence-Based Medicine; D006284:Health Plan Implementation; D054624:Health Status Disparities; D006305:Health Status Indicators; D006801:Humans; D008507:Medically Underserved Area; D011647:Puerto Rico / Q000453:epidemiology; D011788:Quality of Life; D012959:Socioeconomic Factors