title: The continuing problem of asthma in very young children: a community-based participatory research project.
abstract: BACKGROUND
  Asthma is a chronic health condition that has a disproportionate effect on low-income minority children who reside in large urban areas. African-American children report significantly higher rates than the general population of children and have more-severe asthma and poorer outcomes. This article describes the prevalence of asthma in a particularly vulnerable group: children aged 2-5 participating in Detroit Head Start programs.
  
  
  METHODS
  Health screens were distributed to caretakers of all children attending 6 Head Start agencies. Caretakers of children identified with active asthma symptoms were asked to complete an in-depth phone interview regarding their child's asthma.
  
  
  RESULTS
  Data collected from 3,254 children (78% African American) revealed that 27% met criteria for probable asthma. Of those with persistent symptoms, 26% were undiagnosed, and 21% were untreated. Baseline data (n = 675) showed that 95% had a regular doctor, but 36% had had no health care visit for asthma in the previous year. Of children with a history of asthma episodes, more than half reported 3 or more episodes in the preceding year. Forty-three percent of caretakers had discussed their child's asthma with Head Start, and 31% had an asthma action plan on file with Head Start.
  
  
  CONCLUSIONS
  Asthma remains a significant problem in this population, especially for African Americans, as evidenced by high levels of undiagnosed children with persistent symptoms and questions regarding the care they receive. Head Start is a way to reach young children with asthma, but may need help to develop the capacity to assist families.
authors.affiliation: Center for Managing Chronic Disease, University of Michigan, 109 Observatory, Ann Arbor, MI 48109, USA. belindan@umich.edu
authors.forename: Belinda Wilburn
authors.initials: BW
authors.lastname: Nelson
authors.forename: Daniel
authors.initials: D
authors.lastname: Awad
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Alexander
authors.forename: Noreen
authors.initials: N
authors.lastname: Clark