Dec 15, 2010


IMPACT is a year-long clinic-based intervention in which children with asthma and their caregivers use an interactive CD to learn about asthma and asthma control. The intervention aims to improve knowledge of asthma, quality of life, and child health outcomes. Positive impacts were found for days with asthma symptoms, number of annual emergency room visits, dose of daily steroids, and knowledge of asthma. There was no impact on quality of life.


Target population: children with asthma and their caregivers

IMPACT is a clinic-based intervention that involves, in addition to traditional patient education materials, the use of a CD that consists of a set of 44 interactive lessons, each about one minute in length. Some of the lessons present real-life scenarios in which the user must make decisions that affect asthma symptoms. Other lessons teach children to accurately describe their symptoms and medication use. The lessons focus on the basic physiology of asthma, environmental triggers, quick relief and control medicines, and strategies to control and manage asthma. After each lesson, the user must answer questions on the material. The CD is used during regular clinic appointments over the course of one year. For children 0 to 6 years old, their caregivers use the program. For children 7 to 17 years old, children use the program while the caregiver observes. At the start of each session using the CD, the program reviews incorrect answers from the previous session and any material that was presented more than six months earlier.


Evaluated population: 246 children ages 0 to 17 and their caregivers. Children were being treated for asthma at a pediatric pulmonary and allergy clinic in Missouri. 35 percent of the children and 88 percent of the caregivers were female. 86 percent of the children and 90 percent of the caregivers were white.

Approach: Children were randomly assigned to the intervention or control condition. The control condition involved printed and verbal asthma education. Children and their caregivers in the control group were presented with information on asthma and asthma control and received an individualized asthma action plan and one-on-one training on the correct use of devices and medication during clinic visits. For children from 0 to 6 years old, data were collected from caregivers on their asthma knowledge, their quality of life, and the child’s health outcomes. For children 7 to 17, data were collected from children on their asthma knowledge, quality of life, and health outcomes, and from parents on asthma knowledge. Assessments were done at baseline, three months, and twelve months.

Results: Children in the intervention group had a greater decrease in days with asthma symptoms and number of annual emergency room visits, and used a lower dose of daily steroids at the end of the intervention, compared with children in the control group. Increase in knowledge was greater for children and caregivers in the intervention group, compared with children and caregivers in the control group. There was no impact on quality of life for children or caregivers.



Krishna, S., Francisco, B.D., Balas, A., König, P., Graff, G.R., & Madsen, R.W. (2003). Internet-enabled interactive multimedia asthma education program: A randomized trial. Pediatrics, 111, 503-510.

KEYWORDS: Infants (0-12 months), Toddlers (12-36 months), Children (3-11), Adolescents (12-17), Males and Females (Co-ed), Clinic/Provider-based, Parent or Family Component, Computer-based, Health Status/Conditions, Other Physical Health

Program information last updated on 12/15/10.