Reducing asthma health disparities in poor Puerto Rican children: the effectiveness of a culturally tailored family intervention.
BACKGROUND
Island and mainland Puerto Rican children have the highest rates of asthma and asthma morbidity of any ethnic group in the United States.


OBJECTIVE
We evaluated the effectiveness of a culturally adapted family asthma management intervention called CALMA (an acronym of the Spanish for "Take Control, Empower Yourself and Achieve Management of Asthma") in reducing asthma morbidity in poor Puerto Rican children with asthma.


METHODS
Low-income children with persistent asthma were selected from a national health plan insurance claims database by using a computerized algorithm. After baseline, families were randomly assigned to either the intervention or a control group.


RESULTS
No significant differences between control and intervention group were found for the primary outcome of symptom-free days. However, children in the CALMA intervention group had 6.5% more symptom-free nights, were 3 times more likely to have their asthma under control, and were less likely to visit the emergency department and be hospitalized as compared to the control group. Caregivers receiving CALMA were significantly less likely to feel helpless, frustrated, or upset because of their child's asthma and more likely to feel confident to manage their child's asthma.


CONCLUSIONS
A home-based asthma intervention program tailored to the cultural needs of low income Puerto Rican families is a promising intervention for reducing asthma morbidity.
University of Puerto Rico, Medical Sciences Campus, Behavioral Sciences Institute, San Juan, Puerto Rico 00936-5067. gcanino@rcm.upr.edu
Glorisa
G
Canino
Doryliz
D
Vila
Sharon-Lise T
SL
Normand
Edna
E
Acosta-Pérez
Rafael
R
Ramírez
Pedro
P
García
Cynthia
C
Rand
D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000517:prevention & control*; D017028:Caregivers / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003469:Culture; D005190:Family; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods*; D011203:Poverty; D011647:Puerto Rico; D012959:Socioeconomic Factors
D018927:Anti-Asthmatic Agents