Asthma is a chronic inflammatory disease of the airway, affecting more than 20 million Americans. Without proper management it can be life-threatening. Children aged 0-17 have the highest prevalence of asthma, impacting an estimated 8.9 million children. Racial disparities exist in asthma prevalence for children;African- American children are (a) the most likely to suffer from asthma, (b) three times more likely to be hospitalized, and (c) four times more likely to die from asthma than Euro-American children. Children with asthma report higher incidences of asthma attacks, emergency room visits, and hospitalizations than adults;these are all indicators of uncontrolled asthma. Along with the burden of the disease, children with asthma are more likely to exhibit anxiety and stress disorders and have lower school performance than their non-asthmatic peers. Missed school and work days add to the financial burden of the disease for parents. The goal of this proposal is to create an asthma self-management skills training program for children and their parents in Internet/CD-ROM and DVD formats. This behaviorally based program will emphasize increasing: (a) knowledge regarding asthma and proper use of medications, (b) motivation to use prevention methods effectively, (c) self-efficacy in managing asthma, and (d) compliance with health care provider directions. Content will be based on clinical practice guidelines (NHLBI) and will include: (a) understanding asthma, (b) preventing asthma attacks, and (c) creating an asthma management plan. Materials in the child program will be tailored to the three largest racial/ethnic groups impacted by asthma (Euro-American, African- American and Hispanic) to increase relevance and efficacy, and intended for viewing with a parent. A separate and more detailed program for parents will be created with additional materials for schools and care providers.
The potential benefits of this research to public health include improved understanding of cultural factors in pediatric asthma self-management, improved self-management skills for children, and better asthma management skills for their parents. This could result in eased suffering and improved quality of life for millions of children and their families, and also reduce the economic burden borne by society in the forms of medical expenditures and lost productivity.
