Asthma prevalence, morbidity and mortality are disproportionately increasing in low-income minorities despite excellent asthma pharmacotherapy. Inhaled corticosteroids (ICS), the cornerstone of asthma therapy, remain poor. Preliminary data and literature reviews suggest that complementary and alternative medicine (CAM), folk and spiritual practices are common in this population. Interestingly, Blacks may use uniquely different CAMs as compared to Whites and low-income groups may use distinctly different CAMS than middle- and upper class patients. The overall aim of this proposal is to extend the preliminary work, which narrowly focused on urban Black adults with severe asthma by discovering the CAM, folk and spiritual practices of a more representative sample of low-income White and Black adults with mid-,moderate- and severe-persistent asthma, residing in 1 of 2 urban areas.
In Aim 1, a rigorous inductive qualitative semistructured interview of 25 Whites and 25 Blacks will discover CAM use and provide the initial data for a new CAM tool.
In Aim 2, ICS use will be objectively measured to more comprehensively characterize patients' asthma management. This knowledge is necessary before interventional studies can be designed, implemented and evaluated.
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