An economic evaluation of the school-based "power breathing" asthma program.

This study evaluated the cost effectiveness of the "Power Breathing" program for asthma among middle and high school students. Few systematic evaluations of school based interventions--let alone cost-effectiveness programs--have been identified in the literature. Power Breathing was developed by the Asthma and Allergy Foundation of America and is currently available for implementation by school districts. For the overall evaluation, 8 junior high schools and 2 high schools were selected and matched based on grade range, enrollment, income and race/ethnicity. Schools were randomly assigned to the intervention or control group. Surveys were administered at baseline, immediately post-intervention and 3 months' post-intervention. Children in the intervention arm had a significant decrease in the number of days they experienced an asthma attack or had trouble breathing during a 2-week period of 0.18 days per 2 weeks. In contrast, subjects in the control group had an increase in the in the number of days experiencing an asthma attack or having trouble breathing during a 2-week period of 0.102, from 0.696 to 0.793. The program cost approximately $3.9 per asthma attack-free day gained, on par with pharmaceutical interventions, suggesting that Power Breathing may be a cost effective asthma intervention. The results of this study suggest that school-based interventions aimed at asthma, properly implemented and administrated, are an appropriate use of societal resources.

The Inner-City Asthma Intervention: description of a community-based implementation of an evidence-based approach to asthma management.

BACKGROUND: In 2000, the Centers for Disease Control and Prevention funded a 4-year project to implement the Inner-City Asthma Intervention (ICAI)-an asthma treatment and management project based on the protocol developed for the National Cooperative Inner-City Asthma Study (NCICAS) funded by the National Institutes of Health, National Institute of Allergy and Infectious Disease. OBJECTIVE: To describe the ICAI's major components and implementation issues. METHODS: Information contained in this article is based on project activity and management reports, site client tracking and data collection reports, site visit and other program oversight activity, and general subject matter knowledge. The site client tracking data collection process varied among sites during the intervention. Common definitions and processes were developed and implemented as needed. RESULTS: Three of the 24 original sites discontinued participation. The remaining sites enrolled 4,174 children into the intervention. Although the project ended earlier than originally scheduled, 1,035 children completed the entire intervention. Of the 3,139 children who did not complete the entire protocol, 1,355 children and their families completed the core activities or the core activities plus one or more follow-up activities. CONCLUSION: The ICAI project demonstrated that although there were a number of implementation issues to overcome, it is possible to implement effectively a proven National Institutes of Health protocol in the community setting.