Recent innovations to improve asthma outcomes in vulnerable children.
OBJECTIVE
Despite overall improvements in asthma care through an increasing evidence base, disparities in outcomes of children of ethnic minorities and low socioeconomic status are well documented across healthcare systems. New interventions to reduce gaps in outcomes among these children are continually being evaluated. This article reviews the most relevant and influential recent studies.


RESULTS
A number of interventions aimed at vulnerable children with asthma have been successful. Most of these include a component of education and self-management. There is some evidence that culturally competent care produces improved outcomes, whereas stronger evidence exists for multifaceted programs and community health workers providing home visits for education and environmental allergen reduction. Targeting children and families through school-based programs may be an effective outreach strategy. Use of novel technologies such as educational messages on MP3 players shows promise in reaching at-risk adolescents.


CONCLUSIONS
There are promising strategies proven to significantly decrease disparities in asthma among vulnerable children. Further research must be performed to elucidate the interventions that produce the greatest impact on asthma-related outcomes while being feasible, sustainable, and cost-effective.
Li
Patricia
P
Division of Paediatric Medicine, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Guttmann
Astrid
A
D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D002648:Child; D003153:Community Health Services / Q000379:methods; D054521:Cultural Competency; D005006:Ethnicity / Q000706:statistics & numerical data*; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods; D010372:Pediatrics / Q000379:methods; D012648:Self Care / Q000379:methods; D012959:Socioeconomic Factors; D016896:Treatment Outcome