The purpose of this 5-year Demonstration and Education research study is to develop and evaluate AIRCONTROL, a behaviorally- oriented Family Asthma Cooperative Treatment System for minority, inner-city children with asthma and their families. The family management program, based on the AIRWISE model, will be designed to provide individualized educational materials concerning medication to inner-city children with asthma and their parents. Education will be integrated with medical care in an effort to enhance participation by inner-city subjects. AIRCONTROL will be an adaptation of AIRWISE, an individualized self-management education program for children with asthma. AIRCONTROL will be simplified to make it easier to administer and will consist of a series of colorful, age-appropriate """"""""fact sheets"""""""" about asthma medication that the trained health advocate will use as a teaching guide and that can be given to the child and family for home use. AIRCONTROL will be administered in two stages. The first stage will be given by a health advocate trained to use the program. Children and their parents will learn how to follow the medication regimen and to use a peak flow meter to monitor the severity of attacks of asthma. A second stage of reinforcement education will also be provided by the trained health advocate for children whose asthma is not adequately controlled after Stage 1 treatment. AIRCONTROL will be available in a version for children, ages 8-12, and in a version for adolescents, ages 13-17. The research study will be conducted in two phases. During the first phase, AIRCONTROL will be developed and pilot tested. During phase 2, a clinical trial of the program will be conducted. One hundred and twenty children with asthma, ages 8-17, will be recruited from the service area of La Rabida Children's Hospital and Research Center. All research subjects will be African Americans and all of the subjects randomized will be receiving some form of public assistance. Subjects enrolled in the study will be followed for one year to assess program effectiveness. The major outcome variable will be the degree to which AlRCONTROL brings about a reduction in the number of emergency visits and hospitalizations for acute asthmatic episodes. Another variable to be examined will be the patient's skill at using a metered-dose inhaler as determined by the score of an inhaler-use checklist.
