The Merck Childhood Asthma Network, Inc., (MCAN), a nonprofit 501(c)(3) organization established in 2005, is the only private foundation solely focused on addressing the complex and growing problem of childhood asthma in the United States.
Funded by The Merck Company Foundation, MCAN’s mission is to enhance the quality of life for children with asthma and their families, and to reduce the burden of the disease on them and society.
Led by Floyd Malveaux, M.D., Ph.D., a nationally recognized expert in asthma and allergic diseases and Emeritus Dean of the College of Medicine and Professor of Microbiology and Medicine at Howard University, MCAN is a respected authority, effective catalyst and influential advocate for children with asthma. Through research, community programs and partnerships, MCAN is working to:
- Improve access to, and quality of, asthma healthcare for children, especially the vulnerable and medically underserved
- Advocate for policies that expedite implementation, dissemination and sustainability of evidence-based asthma care
- Increase awareness and knowledge of asthma and quality asthma care
MCAN funds programs that involve tailored asthma case management and the reduction of environmental risk factors/triggers in the home. These programs are implemented in several different settings: community health centers, school systems, community-based organizations, public housing and primary care centers.
MCAN advocates for policies that support science-based asthma care by working with partners such as the George Washington University School of Public Health and Health Services, the U.S. Environmental Protection Agency, the Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH).
The Merck Company Foundation has committed $41 million to support MCAN over 10 years (2005–2014). The investment in MCAN for 2010 was $4.4 million and in 2011 was $5.4 million.
MCAN Phase One Program Sites (2005–2009)
In December 2005, the Merck Childhood Asthma Network (MCAN) awarded $10 million in grants to five innovative childhood asthma programs in cities experiencing high prevalence rates of childhood asthma.
The four-year programs took place in Chicago, Los Angeles, New York City, Philadelphia, and San Juan, Puerto Rico. An independent research group conducted a cross-site evaluation and found that, overall, children and their caretakers who participated in these programs experienced better health outcomes and better access to quality care. The findings were published in a supplement to Health Promotion Practice.
MCAN Care Coordination Program Sites (2010–2014)
Through the Care Coordination grant portfolio, MCAN is seeking to demonstrate the feasibility and effectiveness of implementing and sustaining care-coordination models developed during MCAN Phase One in communities with significant childhood asthma morbidity and/or disparities in outcomes.
These are the current program sites:
Los Angeles Unified School District, "Yes We Can Children's Asthma Program"
The program uses a care-coordination and education model that extends beyond the immediate school clinic to include system changes among health, educational and community settings. The program triages students and families into the appropriate level of intervention, improves the coordination of care among schools, clinics and community providers, and focuses on measuring symptom reduction and school days missed.
Respiratory Health Association of Metropolitan Chicago, “Addressing Asthma in Englewood”
The program centers on a community educator model, linking children with asthma to appropriate services, education programs in schools, community groups and local agencies. A home-visit case-management program is also provided to enhance asthma education and to identify and mitigate asthma triggers.
RAND Corporation, La Red de Asma Infantil de Merck de Puerto Rico
The program carries out evidence-based interventions as part of an asthma care coordination program across home, healthcare and community settings. Implemented in the Nemesio Canales Housing Project in San Juan, Puerto Rico, La Red promotes asthma-friendly communities throughout the island of Puerto Rico and improves access to quality asthma healthcare for this highly vulnerable and underserved community.
Children’s Hospital of Philadelphia, Asthma Health Care Navigator Program
In this program, asthma healthcare navigators located within four primary care centers, operated by the hospital, work with primary care providers as an integral member of the families’ asthma care teams. They assist families in identifying and reducing asthma triggers in the home, and provide self-management education and other support and resources for families of high-risk children with asthma.
Care Coordination program sites are also participating in a cross-site evaluation to assess outcome and process measures focused on care coordination and clinical outcomes. Specific process and outcome measures are being developed.
Community Healthcare for Asthma Management and the Prevention of Symptoms (CHAMPS)
CHAMPS is an innovative translational research and community-based clinical partnership, funded by MCAN and led by the George Washington University (GWU) School of Public Health and Health Services. Additional partners include Rho, Inc., and the RCHN Community Health Foundation. The project is designed to demonstrate how tailored, evidence-based asthma management programs that have been proven efficacious in controlled trials, can be implemented in Federally Qualified Community Health Centers, where many impoverished children and families receive health care. Community health centers participating in the CHAMPS program include: El Rio Community Health Center (Tucson, Arizona); Cherry Street Health Services (Grand Rapids, Michigan); and Rincon Health Center (Rincon, Puerto Rico).
Head-Off Environmental Asthma in Louisiana (HEAL), Phase II
With support from MCAN, HEAL, Phase II builds upon the lessons learned from the Head-off Environmental Asthma in Louisiana (HEAL) project, a post-Katrina research initiative that studied the effects of mold and other indoor allergens on children with moderate to severe asthma. HEAL identified the challenges and effectiveness of implementing a multi-faceted intervention of asthma case management and environmental mitigation designed to help improve the health outcomes of children with asthma.
In HEAL, Phase II, the Xavier University of Louisiana Center for Minority Health & Health Disparities Research and Education, Daughters of Charity Services of New Orleans, and the Children’s Health Fund are the on-the-ground partners working to disseminate and implement the multi-faceted intervention in existing healthcare systems. They provide individualized counseling through certified asthma educators who make home visits to children with poorly controlled asthma. The asthma educators will provide tailored counseling for children with asthma, ages 2-18, and their families, to improve asthma management, avoid exposure to asthma triggers, and reduce exacerbation of symptoms.
Comprehensive Asthma Project (CAP)
The Comprehensive Asthma Project (CAP) is a current initiative between MCAN and the American Academy of Pediatrics (AAP) to improve the quality of asthma care for children by pediatricians throughout the United States. CAP provides support to AAP chapters and member practices, to disseminate and facilitate implementation of the asthma guidelines established by the National Asthma Education and Prevention Program (NAEPP) of the National Heart, Lung, and Blood Institute (NHLBI) and to reduce disparities in asthma outcomes in practices that serve impoverished and medically underserved patients/caregivers.
National Ambulatory Medical Care Survey (NAMCS)
The National Ambulatory Medical Care Survey (NAMCS) is a national survey of physicians, to better understand how care is being delivered in providers’ offices. MCAN, the National Institutes of Health (NHLBI, NICHD, NIEHS, NIAID), the Centers for Disease Control and Prevention (NCEH, NIOSH, NCHS), the Environmental Protection Agency and the Agency for Healthcare Research and Quality are providing support and expertise to develop specific questions for the 2012 NAMCS on the NAEPP asthma guidelines and their use.
This will allow evaluation of guideline implementation from the healthcare provider’s perspective, and help in identifying barriers to the uptake of critical elements of guideline-based management of asthma. These findings can inform ongoing strategies to increase effective implementation of the NIH Guidelines.
MCAN is educating stakeholders and policy makers on approaches that not only improve access to quality asthma care, but also can be cost-effective and cost-saving.
Changing pO2licy: The Elements for Improving Childhood Asthma Outcomes
Commissioned by MCAN, in collaboration with the RCHN Community Health Foundation (CHF), this report is the result of a landmark study by health policy researchers at George Washington University (GWU) to determine why children in the U.S. are not benefiting more from science-based asthma treatment and management, and what policy reforms are essential to improve asthma outcomes.
GWU identified the following essential elements that are key to improving asthma outcomes:
- Stable and continuous health insurance
- High quality clinical and case management
- Continuous information exchange and progress monitoring
- Asthma trigger reduction in homes and communities
- Research to learn more about what works
The Affordable Care Act, Medical Homes, and Childhood Asthma: A Key Opportunity for Progress
This policy brief, authored by GWU, and supported by MCAN and RCHN CHF, focuses on how the medical-home model supports comprehensive, patient-centered care by fostering partnerships between patients and their providers, including primary care doctors, pediatricians, specialists and emergency service providers.
Addressing the Challenges of Reporting on Childhood Asthma in a Changing Health Care System: Building Better Evidence for High Performance
In this brief, also funded by MCAN and RCHN CHF, researchers at The George Washington University Department of Health Policy developed recommendations for standardizing surveillance measures and expanding existing reporting functions and systems to improve the collection of on children with asthma.
NIH Asthma Outcomes Workshop
The NIH Asthma Outcomes Workshop was funded by The National Heart, Lung, and Blood Institute (NHLBI), National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Child Health and Human Development (NICHD), National Institute of Environmental Health Sciences (NIEHS), National Institute on Minority Health and Health Disparities (NIMHD), Agency for Healthcare Research and Quality (AHRQ), MCAN and the Robert Wood Johnson Foundation (RWJF), and took place on March 15-16, 2010, in Bethesda, Maryland. The purpose of the workshop was to establish and promote a set of standard definitions and recommended metrics for key variables in asthma-related clinical trials and translational research.
Participants included more than 130 leaders in NIH-sponsored asthma clinical research, representatives of government agencies and members of communities who rely on clinical research findings, such as developers of clinical practice guidelines, healthcare providers, insurance providers, pharmaceutical companies and community organizations. The final recommendations from the workshop were published as a supplement to the March 2012 issue of the Journal of Allergy and Clinical Immunology, and federal agencies will consider implementing the published recommendations in the coming months.
