title: A randomized clinical trial to reduce asthma morbidity among inner-city children: results of the National Cooperative Inner-City Asthma Study.
abstract: 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.
authors.affiliation: Children's Memorial Hospital, Chicago, Illinois 60614, USA.
authors.forename: R
authors.initials: R
authors.lastname: Evans
authors.forename: P J
authors.initials: PJ
authors.lastname: Gergen
authors.forename: H
authors.initials: H
authors.lastname: Mitchell
authors.forename: M
authors.initials: M
authors.lastname: Kattan
authors.forename: C
authors.initials: C
authors.lastname: Kercsmar
authors.forename: E
authors.initials: E
authors.lastname: Crain
authors.forename: J
authors.initials: J
authors.lastname: Anderson
authors.forename: P
authors.initials: P
authors.lastname: Eggleston
authors.forename: F J
authors.initials: FJ
authors.lastname: Malveaux
authors.forename: H J
authors.initials: HJ
authors.lastname: Wedner
mesh_terms: 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*