The Investigator and his collaborators propose to establish an ACRN Center at Harlem Hospital. This hospital already is the site for the HART, a group of investigators which have been working together for the past 5 years in order to determine the reasons for high asthma morbidity and mortality in the Harlem community. As a result of the presence of this team two parallel administrative structures exist. These include a group of physicians who have worked together closely under the leadership of Dr. Ford to identify people of color in the Harlem area who have asthma, recruit them into clinical studies, and use the data derived from these studies to further their understanding of asthma. In parallel with this group of physicians, an administrative structure of clinical research personnel and advisors has been assembled which provides the needed support for the physicians to complete their scientific goals successfully. The investigators have established a liaison with the practicing physicians within the Harlem community, most of whom are part of the Renaissance Capital Health Care Network, as well as the practitioners within the Harlem Hospital complex. The latter are important as they comprise the largest number of physicians seeing asthma patients within the Harlem community on a regular basis. Through a closely established liaison with these physician groups, patients with asthma have been shown to be recruitable for observational clinical trials. In these activities the group has demonstrated its experience recruiting patients, gathering data from them, and handling the data. The investigators already have a clinical facility established for the HART program which is equipped for pulmonary function testing. That provides a physical location where the ACRN component at Harlem Hospital can be located. Through the REACH (Reducing Emergency Asthma Care in Harlem) program they have established a clinical research coordinator and data acquisition system. They have demonstrated their experience in following patients with asthma by peak flow monitoring in the Chest Clinic at Harlem Hospital, as well as experience with quality of life measures in diseases other than asthma. The investigators have outlined plans to allow them to use standard asthma quality of life indicators in their community. Finally, detailed plans are given on how an intervention trial research network will be established and how practical advice from others will be solicited and used.
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