DefinitionLevel of asthma control is measured in accordance with the recommendations of the National Asthma Education and Prevention Program's Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma (National Heart, Lung, and Blood Institute, 2007). ("Poorly controlled asthma" as defined here is consistent with the combination of the two categories " not very well controlled" and "very poorly controlled" defined in EPR-3.) This hybrid outcome measure captures the frequency and intensity of the onset of asthmatic symptoms that impose functional limitations on daily activities: the number of symptom days per week, the number of nighttime awakenings per month, whether asthma limits the normal activity, and the frequency of use of short-acting beta agonists for symptom control (rather than prevention of exercise-induced bronchospasm).
NumeratorEstimated number of adults 18 years of age or older with poorly controlled asthma based on the weighted number of survey respondents who reported 1) having had asthma symptoms on at least nine of the past 30 days and/or 2) having had nighttime awakenings on at least three of the past 30 days and/or 3) limiting usual activities at least to some extent during the past 30 days and/or 4) having used short-acting beta agonists for symptom control for an average of more than 2 days per week over the past three months.
DenominatorEstimated number of adults 18+ who currently have asthma, based on the weighted number of adults who responded "Yes" to both questions: "Has a doctor or other health professional EVER told you that you had asthma?" "Do you still have asthma?"
Data Interpretation IssuesData from the New Jersey Behavioral Risk Factor Survey are intended to represent non-institutionalized adults in households with telephones. Data are collected using a random sample of all possible telephone numbers. Prior to analysis, data are weighted to represent the population distribution of adults by age, sex, and "race"/ethnicity. As with all surveys, however, some residual bias may result from nonresponse (e.g., refusal to participate in the survey or to answer specific questions) and measurement error (e.g., social desirability or recall). Attempts are made to minimize such error by use of a strict calling protocol (up to 15 calls are made to reach each household), good questionnaire design, standardization of interviewer behavior, interviewer training, and frequent, on-site interviewer monitoring and supervision.
Starting in 2011, BRFSS protocol requires that the NJBRFS incorporate a fixed quota of interviews from cell phone respondents along with a new weighting methodology called iterative proportional fitting or "raking". The new weighting methodology incorporates additional demographic information (such as education, race, and marital status) in the weighting process. These methodological changes were implemented to account for the underrepresentation of certain demographic groups in the land line sample (which resulted in part from the increasing number of U.S. households without land line phones). Comparisons between 2011 and prior years should therefore be made with caution. (More details about these changes can be found at [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6122a3.htm].)
Why Is This Important?Asthma is a chronic disease that affects the lungs. It bears important medical, economic, psychosocial, and public health implications. Uncontrolled asthma is associated with an increased risk of adverse asthma outcomes, significantly decreased quality of life, and increased health care use^1^. Asthma can be controlled by adhering to control medicine and avoiding the triggers that can cause an attack.
1. National Asthma Education and Prevention Program. Expert panel report 3: guidelines for the diagnosis and management of asthma. Bethesda, MD: National Institutes of Health, National Heart, Lung, and Blood Institute. 2007.
Healthy People Objective: Increase the proportion of persons with current asthma who receive appropriate asthma care according to National Asthma Education and Prevention Program (NAEPP) guidelinesU.S. Target: Not applicable, see subobjectives in this category
How Are We Doing?An estimated 59% of New Jersey adults with current asthma had uncontrolled (not well-controlled or poorly controlled) asthma in 2013-2016.
What Is Being Done?The NJDOH funds the [http://pacnj.org/ Pediatric/Adult Asthma Coalition of New Jersey] (PACNJ) to act as a statewide clearinghouse for asthma programs and services. NJDOH has partnered with key stakeholders within the state to create an Asthma Strategic Plan to serve as a coordinated statewide planning guide. The [https://nj.gov/health/fhs/chronic/asthma/ Awareness and Education Program] (AAEP) provides information on asthma for consumers and health professionals. The Occupational Health Service has a [https://www.state.nj.us/health/workplacehealthandsafety/occupational-health-surveillance/work-related-asthma/ Work-Related Asthma Program] that provides information to workers and employers about prevention of asthma in the workplace.
State law (Statute Amendment 18A:40-12.3) requires school districts to allow students to carry and administer their own asthma medication. The law further requires both public and non-public schools to provide and maintain at least one nebulizer for students with asthma.
Additional information can be found at: [https://www.nj.gov/health/fhs/chronic/asthma/in-nj/]
Evidence-based PracticesThe [https://www.thecommunityguide.org/task-force/about-community-preventive-services-task-force Community Preventive Services Task Force] (CPSTF) recommends the use of text messaging interventions to increase medication adherence among patients with chronic medical conditions.