The incidence, prevalence and mortality from asthma continues to rise, especially in low socioeconomic status non-white children despite improved understanding of asthma pathogenesis and methods of treatment. Reduction in indoor allergen exposure has been associated with improved symptoms, decreased airway reactivity, and decline in specific immunoglobulin E to home allergens. We have previously shown a computer-based instructional program developed using inputs from children's and parent's experiences with asthma significantly increased implementation of home allergen avoidance measures by adult atopic asthmatic patients over twelve weeks compared to traditional instruction (p=0.023). We now propose to undertake another study using a computer program to educate children 7-12 years about asthma. The uniqueness is children learning how to prevent and manage bothersome symptoms of asthma by controlling home environmental measures with their parents. This is attractive because computer-based education is appealing to children while requiring little staff time. The purpose of this study is to evaluate in a randomized controlled trial over twelve weeks the effects of conventional environmental control education in the clinic setting with reinforcement of that education at a baseline home visit including computer-based instructional program. Additional education will be carried out in the home at six weeks. outcomes are: a) children's bothersome symptoms of asthma, b) home bedroom allergen levels, c) use of health care resources for asthma, d)pediatric asthma quality of life, e) signs of asthma and f) adherence to education programs. Besides the computer-based instructional program, selected predisposing, enabling and reinforcing factors will be examined for their influence on adherence and health outcomes. The implementation of a computer-based instruction program may have more effect on increasing adherence with very little added cost to conventional education.
