Socio-economic factors can be barriers to effective asthma care for vulnerable populations living in urban areas. We hypothesize that a patient care approach called Relationship Centered Care has the potential to reduce the impact of those barriers. Relationship Centered Care encourages providers to develop meaningful and reciprocal interactions with patients, colleagues and the community at large. Phase I funding for this project supported the collection of qualitative data collected from community based health professionals and patients with asthma living in East Harlem, NY, an area with perhaps the highest asthma rates in the country. Phase I also saw the production of a sample version of Bridging the Gap: A Relationship Approach to Asthma Care (video and user's workbook) which was evaluated by community health providers and experts in Relationship Centered Care. The outcome of those efforts was a strong endorsement for the program by health professionals, patients and experts. This Phase II application proposes the production of a four-part educational video based program that will describe and demonstrate the application of Relationship Centered Care for community health professionals who serve people with asthma in socially disadvantaged urban areas. The target audience of health professionals includes physicians, nurses, medical assistants, social workers and other clinic staff members who interact with patients such as receptionists, admitting clerks, and appointment schedulers. Health care research has shown that relationships based on good communication can enhance patient levels of trust, satisfaction, adherence to treatment and health status. But few studies have assessed the effects of communication training on health professionals. Even fewer have assessed the effects of communication training on non-physician health professionals. This program will teach skills that enhance communications and promote relationship building among all the staff members who interact with asthma patients in community clinics. Considering that the burden of asthma is highest among disadvantaged minority populations, the ability to build relationships and communicate in a culturally competent ways is critical. The effectiveness of the Bridging the Gap program will be empirically tested in Phase II. If this intervention is shown to facilitate health professionals' relationships with patients, colleagues and the community, then the potential exists for increasing patient satisfaction and self-management skills, reducing the frequency of acute episodes of asthma and the associated consumption of health care resources. ? ? ?
