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Pawnee Pediatric Asthma Program

Program Type: Promising Practice -Programs not formally evaluated (or formal evaluation is not yet complete) but identified by experts as programs with results suggesting efficacy and worthy of further study in broader pilot implementation efforts.


  1. Program was started with An original grant from the Environmental Protection Agency (EPA) of $20,000. This grant was maintained into the years of 2006-2007 with additional awards of $30,000.
  2. Kids under 18 years of age.
  3. Asthma Register Database.
  4. Designated Pharmacist & Pediatrician.
  5. Asthma Clinic.
  6. Use of Pediatric Spacer Masks and Adult MDI spacers.
  7. Peak Flow Meters and Asthma Plans.
  8. Pediatric PC Based Spirometry in each Clinic Pediatric Room.
  9. Development of an Asthma PCC+
  10. Required use of IHS Patient Education Protocols and Codes (PEPC).
  11. Home Visit Referrals for Asthma Trigger Evaluation by our Office of Environmental Health .
  12. Asthma Home Trigger Abatement Funding.
  13. Education by a certified Asthma Educator RN/PHN.
  14. Collaboration with the Pawnee Tribe. Collaboration with the Barnsdal, Frontier, Pawhuska and Wynona School Districts.

Target Population: Children, 17 yrs and younger. The Pawnee Indian Health Service Unit serves American Indian children from a 7 county area of Northeast Rural Oklahoma including the counties of Garfield, Grant, Kay, Noble, Osage, Payne and Pawnee. There are an estimated 5,000 Native American children in this area from the following tribes: Kaw, Osage, Otoe Missouria, Pawnee, Ponca, Sac & Fox and Tonkawa. The prevalence for Asthma in our service unit children is about 27%.

Project Evaluated: Yes, grant funding was maintained by the EPA. Clinic Visits for Pediatric Asthma increased from values of less than a 100 per month in 2005 to more than 200 a month by 2007. One month saw more than 300 Pediatric Asthma visits. Every Parent receives a written medication plan for their Asthmatic child. Asthma education is documented in the RPMS database. Before the Pediatrician came, less than 50 Asthma Educations was documented a month. Now in 2007 more than 150 educations are documented and one month saw more than 200 documented. Since the program started only 2-4% of our Asthmatic children have been uncontrolled. About 10 home evaluations have been done by our Office of Environmental Health. The Pawnee Tribe is collaborating with us to fix the home of these children with bad indoor air quality.

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Environmental Health/Quality

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Name: Brady Englestead M.D., M.S.P.H., F.A.A.P
Site or Location Name: Pawnee Service Unit
1201 Heritage Circle
Pawnee, OK 74058
Phone: 918-762-6530