A randomized clinical trial to reduce asthma morbidity among inner-city children: results of the National Cooperative Inner-City Asthma Study.
OBJECTIVE
To evaluate a family-focused asthma intervention designed for inner-city children 5 to 11 years old with moderate to severe asthma.


METHODS
Randomized, multisite, controlled trial to minimize symptom days (wheeze, loss of sleep, reduction in play activity) measured by a 2-week recall assessed at 2-month intervals over a 2-year follow-up period. The intervention was tailored to each family's individual asthma risk profile assessed at baseline.


RESULTS
Averaged over the first 12 months, participants in the intervention group (n = 515) reported 3.51 symptom days in the 2 weeks before each follow-up interview compared with 4.06 symptom days for the control group (n = 518), a difference of 0.55 (95% CI, 0.18 to 0.92, P =.004). The reduction among children with severe asthma was approximately 3 times greater (1.54 d/2 wk). More children in the control group (18.9%) were hospitalized during the intervention compared with children in the intervention group (14. 8%), a decrease of 4.19% (CI, -8.75 to 0.36, P =.071). These improvements were maintained in the intervention group during the second year of follow-up, during which they did not have access to the asthma counselor.


CONCLUSIONS
We demonstrated that an individually tailored, multifaceted intervention carried out by Masters-level social workers trained in asthma management can reduce asthma symptoms among children in the inner city.
Evans
R
R
Children's Memorial Hospital, Chicago, Illinois 60614, USA.
Gergen
P J
PJ
Mitchell
H
H
Kattan
M
M
Kercsmar
C
C
Crain
E
E
Anderson
J
J
Eggleston
P
P
Malveaux
F J
FJ
Wedner
H J
HJ
D001249:Asthma / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003376:Counseling / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009017:Morbidity; D010290:Parents / Q000193:education*; D015397:Program Evaluation; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D012947:Social Work / Q000458:organization & administration*; D014481:United States / Q000453:epidemiology; D019037:Urban Health Services / Q000458:organization & administration*