ABSTRACT
Asthma case management and education programs improve pediatric asthma outcomes, but designing rigorous randomized controlled studies that accurately measure effects while encouraging parent participation is challenging. This is especially so for low-income African American families, who face significantly more severe asthma and social stress than their middle-class counterparts. Action research can help health education researchers negotiate between the elegant and complex designs favored by scientists with the real-life challenges of recruitment, implementation, and retention. This article discusses how a multidisciplinary team uses action research concepts to continuously adjust originally proposed protocols through the planning and implementation phases to encourage participation in a year-long randomized controlled trial of a program that combines telephone asthma case management and comprehensive online asthma education. As a result of these efforts, a higher proportion of low-income African American families are recruited into the study than originally proposed.
Subject(s)
Asthma/therapy , Case Management/organization & administration , Community-Based Participatory Research/methods , Health Education/methods , Internet , Black or African American/statistics & numerical data , Asthma/ethnology , Child , Cooperative Behavior , Humans , Medicaid/statistics & numerical data , Medication Adherence/statistics & numerical data , Patient Care Team/organization & administration , Patient Selection , Poverty Areas , Randomized Controlled Trials as Topic/methods , Research Design , Telephone , United StatesABSTRACT
This article reports on the development of a personalized, Web-based asthma-education program for parents whose 4- to 12-year-old children have moderate to severe asthma. Personalization includes computer-based tailored messages and a human coach to build asthma self-management skills. Computerized features include the Asthma Manager, My Calendar/Reminder, My Goals, and a tailored home page. These are integrated with monthly asthma-education phone calls from an asthma-nurse case manager. The authors discuss the development process and issues and describe the current randomized evaluation study to test whether the year-long integrated intervention can improve adherence to a daily asthma controller medication, asthma control, and parent quality of life to reduce asthma-related healthcare utilization. Implications for health education for chronic disease management are raised.
