Guide to Effective Programs
for Children and Youth

Asthma Basic Care

OVERVIEW

Asthma Basic Care (ABC) is a five-week home-based asthma education program. Families receive home visits from a trained asthma educator. An evaluation of the program found significantly fewer asthma symptoms and reduced use of corticosteroids among the ABC intervention group compared with the control group. No differences were found for emergency visits or hospitalizations or for refills of inhaled corticosteroid.

DESCRIPTION OF PROGRAM

Target population: Children aged 2 - 10 with asthma residing in an inner-city area.

Asthma Basic Care (ABC) is a five-week home-based asthma education program. Families receive home visits from a trained asthma educator at one, two, three, four, and eight weeks after program enrollment. During home visits, the asthma educator covers five main program components: reviewing physician-prescribed asthma regimen and training in medication, spacer, and peak flow methods; developing an asthma action plan; identifying family barriers to accessing healthcare and develop problem-solving strategies to reduce these barriers; discussing beliefs and concerns about asthma and medications; and providing written asthma education materials to the family. Family home visits generally last 30- to 45-minutes.

A second arm of this study included a randomized group of participants who received asthma education plus asthma medicine adherence monitoring and feedback (AMF). This arm of the intervention, along with the findings, is separately written up and posted on the LINKS’ website.

EVALUATION(S) OF PROGRAM

Otsuki M, Eakin MN, Rand CS, Butz AM, Hsu VD, Zuckerman IH, Ogborn J, Bilderback A, Riekert KA. (2009). Adherence Feedback to Improve Asthma Outcomes Among Inner-City Children: A Randomized Trial. Pediatrics, 124(6):1513-1521.

Evaluated population: A total of 167 families were randomized to either the ABC intervention or control group. The mean age was seven years. Among the ABC intervention group, 52% were male, 84% were black, 62% were insured through Medicaid, 84% had a regular source for nonurgent asthma care, 23% lived with a smoker in the home, and 30% lived in a household with an annual income below $10,000.

Approach: Study participants were recruited into the study, by telephone, after reviewing emergency department discharge records. Children were randomly assigned to the ABC intervention (n=84) or control group (n=83). Children were eligible for the study if they were between two and 12 years of age, diagnosed with asthma by a physician, had two asthma-related emergency department visits or hospitalizations within the past year, were prescribed an asthma controller medication, and resided in Baltimore, MD.

Children assigned to the control group received asthma education information such as a booklet and a resource guide; the resource guide provided information about low-cost asthma care providers, social services, legal services, as well as other resources.

Participants and families were assessed at six, 12, and 18 months after study assignment on the following: self-reported medication adherence, number of refills for inhaled corticosteroids (ICS), and asthma morbidity (cough, wheeze, shortness of breath, or chest tightness/discomfort, nighttime awakenings, emergency department visits, hospitalizations, and courses of oral corticosteroids in the previous six months).

Results: At follow-up assessments, there were significantly fewer asthma symptoms and reduced use of corticosteroids among the ABC intervention group compared with the control group. There were no significant differences between the two study groups on self-reported ICS therapy adherence, number of ICS canisters refilled, and number of emergency department visits or hospitalizations.

An additional analysis compared the ABC intervention group with the AMF intervention group and found no significant differences on any outcome between the two groups.

SOURCES FOR MORE INFORMATION

SUMMARY & CATEGORIZATION

KEYWORDS: Children (3-11), Home-based, Home Visitation, Parent/Family Component, Black/African-American

Program information last updated 7/26/10.