The current project is designed to test the impact of an educational/counseling intervention in a setting where medical care can be provided to the asthmatic student. As evidenced in our previous study, the majority of our Southeast San Diego asthmatic children are not currently receiving care in a physician's office. An agreement has been formalized between the Logan Heights Family Health Center and the San Diego Unified School District creating school-associated clinics to provide a medical home for students of identified schools. This agreement is the foundation for the facilitation of identification, referral and care provision for asthmatic students. The clinic setting provides an improved integration of the family/caregiver into the program and allows for access to medical records for outcome analysis. We are able to individualize the educational/counseling intervention to meet the needs of the fourth to sixth grade students served. Our proposal to randomize students by severity level in the school associated clinics will allow for a controlled comparison of outcome in the intervention (asthma counselor) vs contol (usual care) groups. We hypothesize that our asthma counseling program will provide an enhanced quality of care and thereby reduce morbidity for the otherwise underserved asthmatic children in Southeast San Diego. We will continue the process of screening and enrollment into randomized controlled study. In addition to the previously outlined steps for baseline characterization of the asthmatic students we plan to obtain serum for later analysis by RAST or CAP assays for aeroallergens. This is covered under our current Human Subjects protocol, and this will allow the opportunity to compare results in a quantitative way with other participating geographic sites.
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