YOUNG CHILDREN W/ ASTHMA--HOME-BASED NURSE INTERVENTION

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DESCRIPTION (Adapted from the Investigator's Abstract): Young inner-city children are disproportionately affected by asthma. Although clinic-based and school-based asthma education programs have been shown to increase effective asthma self management of families, such programs repeatedly report failure to secure attendance of low-income parents. The aim of the randomized control study is to demonstrate that a home-based nursing asthma-education program targeting young inner-city children with moderate to severe asthma and their families is feasible and will: increase the utilization of effective asthma self-management practices of primary caregivers and children; improve the quality of life of the primary caregivers and the children; increase the control of asthma in the children; and decrease medical visits (regardless of site) for acute asthma exacerbations. The sample will consist of 80 low-income children and their families, who will be recruited from an Asthma/Allergy Clinic in an inner-city, public, children's hospital. Criteria for participation of the child include, age 1 year to 6.99 years, and having moderate to severe asthma. The children will be randomly assigned to an intervention and a comparison (usual clinic treatment) group, each group consisting of 40 children; groups will be stratified with respect to age (<3 years and >3 years) and severity of asthma (moderate or severe). The intervention consists of 8 weekly 1.5 hour home visits utilizing the Wee Wheezers Educational Program for Parents of children with Asthma Under the Age of Seven, which has been adapted for home visiting and has been pilot tested with 10 families. Measures will be collected at enrollment (baseline) and at 3 months (immediately following the intervention for the intervention group) and 12 months following enrollment. Primary outcome variables will be: Asthma symptoms (including peak expiratory flow measures) and medical visits for acute asthma exacerbations. Secondary outcome variables will be: Quality of life, asthma management practices, and asthma management skills of caregivers and children. The feasibility of the intervention program will also be assessed, using program implementation measures, and a comparative cost assessment of medical visits made by the children in the intervention and comparison groups.