The purpose of this two-year study is to evaluate the effectiveness of five currently available asthma self-management programs in a large-scale clinical trial. For this clinical trial, a minimum of 350 children with asthma who receive health care from Group Health Plan Inc. and Share Health Plan clinics in the St. Paul-Minneapolis area and who meet objective eligibility requirements and their parents will be recruited. Equal numbers of participants will be assigned to seven groups. A specific program will be administered to each of five different experimental groups. The remaining two groups will serve as control groups, permitting determination of the influence of both the programs and of administration of evaluation measures. Program effectiveness will be evaluated in terms of changes in the patients' medical condition, utilization of the health care system, self-management practices (behaviors), knowledge and attitudes about asthma, and sense of self-efficacy with regard to asthma management. Changes in parental knowledge and attitutdes about astham management, parental management behavior, and the impact of asthma on family functioning will also be evaluated. Cost-effectiveness will be evaluated using average cost-of-case and cost-of-program implementation data. Pre- and post-education costs-of-care will be calculated to determine overall cost-effectiveness of each program.
