The growing asthma problem in the United States has in part been attributed to poor understanding of the disease by patients, health care practitioners, and the general public. Health education programs can potentially improve health outcomes through improved knowledge. The Grady Asthma Project (GAP) is a competency-based curriculum for asthma education that seeks to improve asthma knowledge, enhance asthma management behaviors and attitudes, and to reduce asthma morbidity in an inner-city indigent-care institution and its surrounding community. The curriculum draws from effective features of previously reported health education interventions and consists of parallel learning tracks for medical students, house staffs medical school faculty, hospital health care providers, adult and pediatric asthma patients and their families, community-based health professionals, and local educators. GAP provides for the facilitation of interdepartmental communication and co-ordination of asthma care on the medical center campus through creation of an interdisciplinary Asthma Steering Committee. Based on the PRECEDE-PROCEED organizational model, and on the principles of self-efficacy and social learning theory, GAP gives particular attention to patients with poor literacy skills. Critical domains of asthma-related knowledge, skills, and attitudes identified by the National Asthma Education Program (NAEP) constitute the initial learning objectives of the program. Formative evaluation of the curriculum will involve review of needs assessments by a multidisciplinary team of pulmonologists, general internists, emergency physicians, allergists, general pediatricians, and obstetricians with teaching channels designed by health education and patient education specialists. Patient material will be adjusted to a sixth-grade reading level. Educational methods will include lectures, small group discussions, one-on-one counseling, videotapes, audiocassettes, skills demonstrations, brochures, posters and pamphlets, role-playing exercises, newsletters, computer-aided instruction, an on-line electronic asthma knowledge base and bulletin board service. Half-day symposia, miniresidencies, broadcast media presentations, and inservices will be offered to health care professionals and inservices will be presented to local school personnel. Ongoing evaluation of the curriculum's effectiveness will be assessed by randomized experimental and quasi-experimental designs to test whether increases in knowledge, improvements in care practices, and reductions in morbidity have occurred. Data will be collected with instruments designed or adapted for the Grady Asthma Project and by reviews of hospital records for data on asthma-related care encounters and medications used. Effective elements of the program will be collated and made available to other institutions.
