In its seventh year, the ACAAI Asthma Screening Program focuses on workplace settings.

In its seventh year, the ACAAI Asthma Screening Program focuses on workplace settings. To publicize the events, volunteers use media, community outlets, a lung education bus—even nonallergenic petting zoos.

Volunteers help out at the local Boys & Girls Club’s Annual Asthma and Allergy Fair in Bellingham, Wash.

Several years ago, two men from a homeless shelter walked into an upscale mall in Toledo. One of the men, evidently kept up nights by the other man’s troubled breathing, had seen a newspaper advertisement for a free asthma screening. He scraped up money for bus fare and escorted his friend from downtown to the suburbs. John Winder, MD, the screening’s attending physician, examined the afflicted man and sent him straight to a hospital.

Although most people who visit the nationwide screenings coordinated by the American College of Allergy, Asthma, & Immunology (ACAAI) are not such extreme cases, Winder says it is for this type of person, whom he calls the “walking wounded,” that the program exists.

“When [the ACAAI] started this, they recognized the need for reaching people with asthma who didn’t have a diagnosis,” says Winder, chair of the college’s Nationwide Asthma Screening Program.

A young girl has her breathing checked on the Battleship New Jersey in Camden as part of the Nationwide Asthma Screening Program.

It was there in Toledo, 7 years ago, that the ACAAI began the asthma screening program in a single location. The next year, the number of sites jumped to 100, and last year more than 370 screening days throughout the country accommodated approximately 12,500 adults and children. Funded by an educational grant from a major pharmaceutical company and cosponsored by the Asthma and Allergy Foundation of America and the Allergy and Asthma Network Mothers of Asthmatics, the program has screened more than 73,500 people since it was launched in 1997.

The screening stations, set up at malls, civic centers, hospitals, schools, community health fairs, and other high-traffic locations, serve two main purposes, according to Winder. The first is to determine whether people suffering from breathing problems may have asthma, and the second is to provide those who know they have asthma with more information about the disease and symptom management. Each day-long screening is coordinated and staffed by at least one allergist who must be a member of the ACAAI, and a group of volunteers, including respiratory therapists, physicians, nurses, and other allied health professionals.

This year’s screenings, most of which are taking place this month during National Asthma and Allergy Awareness Month, will be especially focused on workplace screenings. “We recognize that asthma not in control or asthma unrecognized can certainly decrease someone’s productivity and ability to function, or for that matter increase time off work,” Winder says.

Also this year, the college is looking to broaden its state capitol focus, Winder says. The program annually kicks off on Capitol Hill in Washington, DC, on asthma awareness day—May 5 this year. Any of the general public can come to screenings held at the national or state capitols, and Winder says that they help get policymakers more involved and aware of the asthma epidemic.

During a screening, adults complete a 20-question Life Quality Test provided by the ACAAI. Children under the age of 15 take a specially designed test called the Kids’ Asthma Check that enables them to answer questions themselves about breathing problems. Another version of the questionnaire is available for parents of children up to 8 years of age to complete on their child’s behalf.

Participants then take a lung function test, usually spirometry, and meet with the attending allergist or physician, who determines whether to recommend a thorough examination and diagnosis. The process takes about 15 minutes per person, and usually between 50 and 100 people come to a screening. Those who screen positive for asthma receive a list of local allergists and have the option of taking free fliers and brochures from pharmaceutical companies about asthma and treatment options.

Since the program’s inception, about 50% of screening participants have been sent on for further evaluation, Winder says.

Getting the Word Out
One of the most important—and challenging—aspects of a successful screening program is ensuring that people show up. High-traffic locations such as malls help in this endeavor, but John A. Wolfe, RRT, who volunteers yearly with an ACAAI screening program in Fort Collins, Colo, says a better “quality” of people attend when screenings are held in a hospital as opposed to a mall where many people who stop were just walking by. “Even though it’s hard to park and a pain in the butt to walk in the door and find your way to someplace in the hospital, we end up getting people who really need screenings,” says Wolfe, who has helped with the screenings organized by the educational support group Parents of Allergic and Asthmatic Children (PAAC) for the past 6 years. Last year, the event attracted 75 participants; the year before, 135 people came to be screened.

Especially when the screenings are held in a hospital, publicity is essential. The ACAAI sends each coordinating allergist a screening program manual detailing how to work with local media to publicize the event. The college says that local press outlets are usually very receptive to covering public service and health information events, so volunteers rarely spend out-of-pocket money on advertising. Cindy Coopersmith, president of PAAC, says publicity is the most challenging aspect of setting up the annual screening event because of the organization’s limited budget. Coopersmith says one of the most successful techniques has been putting up fliers in physician’s offices, hospitals, and libraries. One year, a pharmacy handed out an advertisement for the event with every filled prescription of albuterol.

PAAC also incorporates offbeat means of enticing participants. A wildly popular program initiated a few years ago is the allergy and asthma friendly petting zoo, which features nonfurry types of animals, such as iguanas, spiders, and snakes, to encourage screening participants to own pets that do not aggravate their condition. Some of the participating pharmaceutical companies also contribute refreshments. The Colorado chapter of the American Lung Association (ALA), which helps coordinate the event, hosts a booth with a breathing lung exhibit, which is a real swine lung that teaches attendees about the anatomy and physiology of the lungs.

Riding the Wave
Recently, the Breathe Better Bus has helped to attract people who otherwise might not have any interest in the asthma screening. A lung education tool on wheels developed by the nonprofit Breathe Better Foundation of Denver, the full-sized, converted commercial bus is powered by natural gas and includes six interactive learning stations designed to teach about healthy lungs, asthma, lung measurement, air quality, indoor air triggers, and smoking prevention. The PAAC also uses the screening day as a time to promote its summer camp designed for children with allergies. (See the February/March 2003 issue of RT for more information about the bus.)

Wolfe stresses that physicians involved in screenings do not generate referrals. “It is totally, completely no strings attached,” he says. “There is nothing in it for [volunteers], other than to serve their community.”

But Winder says the screenings do create a “trickle-down” community awareness marketing effect. “For every one who ends up getting personally touched by the program, many more are exposed to the message through the local publicity,” he says.

And while publicizing the screenings is not easy, spreading the message about the ramifications of untreated asthma is helping tens of thousands of people nationwide. “The majority of the people who come through either have negative results or are just confirming that they’re on the right track with asthma management,” Wolfe says. “But for the minority of people, even if it’s only a handful, who have fairly extreme cases and really needed to have this happen, that makes the whole thing worthwhile.”

Kelly Stephens is the news editor of RT.