ABSTRACT
The purpose of the AIR/Kaiser-Permanente asthma project is to evaluate various approaches to the education of adults with asthma, identifying those types of patients for whom particular approaches are most cost effective. Critical self-management practices for adults with asthma were identified using the critical incident technique. An individualized and a group administered educational program are being developed to teach the identified critical skills, using the instructional models previously employed in AIR WISE and AIR POWER programs for children with asthma. Three hundred patients with moderate to severe asthma from Northern California Kaiser-Permanente Medical Group clinics will participate in a trial of these programs. Patients will be randomly assigned to one of four conditions: One of two educational programs, an information/attention control, or a data-only control condition. Data will be collected on all patients for 15 months; health care utilization data covering a two-year period will be available from medical records. Program effectiveness will be evaluated in terms of pre-post changes in the patients' knowledge, attitudes, self-management practices, medical condition, daily functioning, and utilization of services. Cost effectiveness will be evaluated, paying specific attention to the cost effectiveness of different educational approaches for different types of patients.
Subject(s)
Asthma/therapy , Health Maintenance Organizations/statistics & numerical data , Patient Education as Topic , Adolescent , Adult , Asthma/prevention & control , California , Cost-Benefit Analysis , Data Collection , Humans , Middle Aged , Patient Education as Topic/economics , Research Design , Self Care/economics , Self-Evaluation ProgramsSubject(s)
Asthma/psychology , Self Care , Adolescent , Asthma/prevention & control , Asthma/therapy , Child , Female , Humans , Male , Patient ComplianceABSTRACT
Because patient behavior plays a major role in the prevention or precipitation of acute asthma attacks, patient education is an important adjunct to its medical management. A number of self-management education programs for patients with asthma recently have been developed and made available for widespread use. Many are aimed at children over the age of 6 years and their parents. They are designed for use with several types of patients in a variety of settings. Evidence of program effectiveness is of uneven quality, but what is available suggests that a number of the programs can be of significant value in reducing asthma morbidity. Self-management education programs for parents of preschool-age children and for adults with asthma are much less numerous and well developed than those for school-age children. Particular attention is given to the process by which the AIR POWER and AIR WISE programs for children were developed, since this systematic development process is generalizable to patient education programs for other age groups and health problems.
Subject(s)
Asthma/rehabilitation , Parents/education , Patient Education as Topic , Adult , Camping , Child , Child Health Services , Curriculum , Humans , Residential Treatment , Self Care , United States , Voluntary Health AgenciesABSTRACT
This study was conducted to test the efficacy of AIR WISE, an individually administered asthma self-management program. Subjects were paired and randomly assigned to either an experimental group (N = 7) or a control group (N = 7). The frequency of experimental group emergency visits, analyzed over a 12-month posttreatment period, was substantially less than those of the control group, supporting the hypothesis that AIR WISE is effective in high-utilizer children through improved self-management.
