Characteristics of successful asthma programs.
OBJECTIVE
We identified characteristics of interventions associated with positive asthma outcomes to understand how programs can be improved.


METHODS
We identified asthma interventions from the peer-reviewed literature or through a nomination process for unpublished programs. Initially, we identified 532 interventions. Of those, 223 met our eligibility criteria (e.g., focus on asthma, completed an evaluation, and demonstrated at least one asthma-related health outcome) and provided information on program components and processes, administration, evaluation, and findings through telephone interviews, program documents, and published reports. We analyzed bivariate relationships between programmatic factors and outcomes using Chi-square statistics, Fisher's exact tests, and unconditional logistic regression. We confirmed findings for all programs by analyzing the subset with published results in peer-reviewed journals.


RESULTS
Our findings indicated that programs were more likely to report a positive impact on health outcomes if they (1) were community based, (2) engaged the participation of community-based organizations, (3) provided program components in a clinical setting, (4) provided asthma training to health-care providers, (5) collaborated with other organizations and institutions and with government agencies, (6) designed a program for a specific racial/ethnic group, (7) tailored content or delivery based on individual health or educational needs, and (8) conducted environmental assessments and tailored interventions based on these assessments.


CONCLUSIONS
Positive asthma outcomes were associated with specific program characteristics: being community centered, clinically connected, and continuously collaborative. Program developers and implementers who build these characteristics into their interventions will be more likely to realize desired asthma outcomes.
Clark
Noreen
N
Center for Managing Chronic Disease, University of Michigan, Ann Arbor, MI 48109-2029, USA. nmclark@umich.edu
Lachance
Laurie
L
Milanovich
Amy Friedman
AF
Stoll
Shelley
S
Awad
Daniel F
DF
D001249:Asthma / Q000628:therapy*; D003153:Community Health Services / Q000458:organization & administration*; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D007373:Interinstitutional Relations; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic; D011788:Quality of Life