title: Clinical and health promotion asthma management: an intervention for children and adolescents.
abstract: BACKGROUND
  Asthma is the leading chronic condition among children. Given this international burden, clinicians and public health professionals applied the Expanded Chronic Care Model to address health adversities of pediatric patients with asthma.
  
  
  OBJECTIVE
  This study examined the influence of a clinical health promotion initiative on asthma control and appropriate medication management among pediatric patients.
  
  
  METHODS
  Patients (n = 304) were recruited and screened for participation in this study. All the patients participated in a motivational interview, received clinical care, and were monitored longitudinally. Eligible patients (n = 53) were referred to one or more intervention pathways regarding physical activity, nutrition, smoking cessation, and psychosocial wellness. A comparison group (n = 90) was eligible for an intervention but chose not to participate. This analysis focused on patients who were identified as needing a health intervention beyond asthma clinical care.
  
  
  RESULTS
  Among patients who were invited to participate in the health promotion pathways, significant decreases in asthma exacerbation were achieved by the patients who participated in the intervention compared with those who did not participate (p = 0.018). Significant improvements in asthma exacerbation, activity limitations, and asthma control were attributed to the time in clinical care (p < 0.001). In this group, asthma control significantly improved with medication (p = 0.002), and age was associated with a significant decrease in asthma exacerbation (p = 0.011).
  
  
  CONCLUSIONS
  This pilot study demonstrated preliminary benefits in a child asthma population. In addition, this experience addressed the chronicity of pediatric asthma through patient-centered care.
authors.affiliation: 1Centro Io e l'Asma, Ospedale dei Bambini, Spedali Civili, Brescia, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Guarnaccia
authors.forename: Charvonne N
authors.initials: CN
authors.lastname: Holliday
authors.forename: Emanuele
authors.initials: E
authors.lastname: D'Agata
authors.forename: Ada
authors.initials: A
authors.lastname: Pluda
authors.forename: Gaia
authors.initials: G
authors.lastname: Pecorelli
authors.forename: Valeria
authors.initials: V
authors.lastname: Gretter
authors.forename: Susanna
authors.initials: S
authors.lastname: Facchetti
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bilonick
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Masiello
authors.forename: Edmund
authors.initials: E
authors.lastname: Ricci
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D019468:Disease Management; D005260:Female; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018802:Patient-Centered Care; D010865:Pilot Projects; D012307:Risk Factors