Improving asthma outcomes in minority children: a randomized, controlled trial of parent mentors.
OBJECTIVE
Because asthma disproportionately affects minorities, we evaluated the effects of parent mentors (PMs) on asthma outcomes in minority children.


METHODS
This randomized, controlled trial allocated minority asthmatic children to the PM intervention or traditional asthma care. Intervention families were assigned PMs (experienced parents of asthmatic children who received specialized training). PMs met monthly with children and families at community sites, phoned parents monthly, and made home visits. Ten asthma outcomes and costs were monitored for 1 year. Outcomes were examined by using both intention-to-treat analyses and stratified analyses for high participants (attending >or=25% of community meetings and completing >or=50% of PM phone interactions).


RESULTS
Patients were randomly assigned to PMs (n = 112) or the control group (n = 108). In intention-to-treat analyses, intervention but not control children experienced significantly reduced rapid-breathing episodes, asthma exacerbations, and emergency department (ED) visits. High participants (but not controls or low participants) experienced significantly reduced wheezing, asthma exacerbations, and ED visits and improved parental efficacy in knowing when breathing problems are controllable at home. Mean reductions in missed parental work days were greater for high participants than controls. The average monthly cost per patient for the PM program was $60.42, and net savings of $46.16 for high participants.


CONCLUSIONS
For asthmatic minority children, PMs can reduce wheezing, asthma exacerbations, ED visits, and missed parental work days while improving parental self-efficacy. These outcomes are achieved at a reasonable cost and with net cost savings for high participants. PMs may be a promising, cost-effective means for reducing childhood asthma disparities.
Flores
Glenn
G
Division of General Pediatrics, Department of Pediatrics, UT Southwestern Medical Center, Dallas, Texas 75390, USA. glenn.flores@utsouthwestern.edu
Bridon
Christina
C
Torres
Sylvia
S
Perez
Ruth
R
Walter
Tim
T
Brotanek
Jane
J
Lin
Hua
H
Tomany-Korman
Sandy
S
D000293:Adolescent; D001741:Black or African American / Q000193:education*; D001249:Asthma / Q000191:economics / Q000208:ethnology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D004636:Emergency Service, Hospital / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000191:economics; D006630:Hispanic or Latino / Q000193:education*; D006801:Humans; D008297:Male; D008611:Mentors; D010290:Parents / Q000193:education*; D011788:Quality of Life / Q000523:psychology; D020377:Self Efficacy; D014922:Wisconsin