Despite significant advances in the medical treatment of childhood asthma, there are major barriers to their widespread application. Our preliminary studies indicate that health education in self management practices including the use of home based health records can have a major effect on overcoming these barriers and improving care. The current proposal is based on two major hypotheses: (1) health education techniques will increase the ability of families to manage asthma effectively, improve the child's health and ability to function normally and achieve reductions in inappropriate health care; (2) use of a medical record kept with the child at all times (the home health record) will facilitate treatment of asthma both at home and in the emergency room and reduce costs of health care. This proposal consists of two major education and demonstration research projects (Programs A and B) and is composed of five interrelated projects that can be integrated into the framework of a future lung center. We have five objectives: 1) to test the effectiveness of the health education program in emergency room and scholl settings; 2) to produce training materials that will facilitate widespread replication of the program; 3) to eliminate previously recognized barriers to patient participation in the health education program; 4) to foster increased knowledge of asthma self management among health professionals and school personnel and 5) to enhance home care of asthma and to reduce costs of health care by use of the home care record. Children with asthma will be recruited from the hospital emergency rooms and clinics, neighborhood clinics and community schools. They will be enrolled in the educational program using experimental and control groups. Objective measures of outcome will be made to provide an evaluation of the effectiveness of our health education programs (the self management program and the home helath record) on the management of asthma by families and health professionals. These research projects will also demonstrate the widespread applicability of these health education programs both in the traditional health care delivery system and in community settings. The ultimate impact of these programs will be to improve the health of childern with asthma in cost effective ways.
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