Neighborhood Organization for Pediatric Asthma Management in the Neighborhood Asthma Coalition: CASS Worker Program
To address social isolation, the original proposal called for the development of “asthma advocates” to provide social support, information, and encouragement to regular care to caretakers and their children so generic claritin. Representatives of the neighborhood Wellness Councils changed this to “CASS workers,” for “changing asthma through social support.” The primary role of the CASS workers, who must be neighborhood residents, is to be a source of understanding and assistance to caretakers and children who may need a sympathetic ear to listen to their problems regarding asthma management, problem-solve with them, and suggest possible resources, as well as to constantly emphasize the need for ongoing care, encourage the proper use of medication and rescheduling of missed appointments, and to provide asthma education as needed. The CASS workers are to provide a bridge to available clinical resources, not to serve as clinicians. While exact staffing patterns have varied, the Neighborhood Asthma Coalition employs one full-time equivalent CASS worker for each neighborhood.
Roles of CASS Workers: To evaluate success in establishing the CASS workers as approachable and supportive, we have interviewed both caregivers and the CASS workers themselves. In open-ended interviews, caregivers indicated the CASS workers were providing not only basic education, but also specific tips and advice (eg, “gives me tips on going through the right channels”), tangible support (eg, help in getting a free air conditioner), and emotional support (eg, “gives me feeling that someone cares”). The CASS workers indicated they provided similar types of support and assistance. The perspectives of caregivers and CASS workers can be compared in their responses to forced choice questions about the CASS workers. As indicated in Table 3, both the caregivers and the CASS workers themselves saw the CASS workers as more like friends and equals than like doctors or authorities, and as encouraging more than checking-up on people.’ The disparity in responses for listener/advisor (66% of the caregivers indicated CASS workers were “both” listeners and advisors, but 89% of CASS workers, themselves, indicated they were listeners) probably reflects the CASS workers’ training. Borrowing from approaches to counseling skills, this training distinguished “listening” from “advice giving,” a distinction apparently not so salient to the caregivers. Taken as a whole, these findings indicate congruence between the workers and those they seek to help in viewing the CASS workers as having established peer, supportive, nonjudgmental roles in their work.
Table 3—Caregivers3 and CASS Workers’ Perceptions of CASS Workers’ Roles