Policy and System Change and Community Coalitions

Subsequent to the Allies Against Asthma Program, low-income, minority children experienced less frequent asthma symptoms; parents felt less helpless or frightened when faced with asthma symptoms.

The Robert Wood Johnson Foundation developed the Allies Against Asthma Program (Allies), an array of community coalitions in seven regions of the U.S. This article presents a five-year evaluation, focusing on three outcomes of the program:

Policy and System Changes: The evaluation defined policy change as enactment of new policies and changes to existing policies. System change was a substantial change in one or more elements of a public health system. Independent reviewers tallied and categorized changes for each coalition.

Health and Quality of Life Outcomes: The evaluation diagnosed asthma symptoms, according to established guidelines, as controlled or poorly controlled. The authors compared asthma symptoms where Allies activities did and did not take place. Parents reported how their child’s asthma affected their own quality of life.

Engagement of Coalition Members: Periodic surveys collected data on the number and type of organizations and individuals in each of the seven coalitions. The Coalition Self-Assessment Survey collected quantitative data on the degree of participation among coalition members. The authors classified the degree of partnership as: core, ongoing, intermittent, or peripheral.

Key Findings:

  • Allies coalitions realized 89 substantial policy and system changes in 5 key areas.
  • Allies children experienced fewer daytime and nighttime asthma symptoms.
  • Coalitions that brought about the most policy and system changes had more core and ongoing partners and a lower proportion of peripheral partners.

The Allies Against Asthma Program provides evidence that community coalitions can achieve policy and system change and improve health outcomes.