A SELF-MANAGEMENT PROGRAM FOR ADULT ASTHMA .1. DEVELOPMENT AND EVALUATION

Background: We developed and evaluated a self-management program for a dult asthma. In developing the program, we considered questions of for mat and behavior control. The for-mat we selected included components known to be effective in educational settings. We regulated asthma man agement behavior through the introduction of environmental cues. Metho ds: Seventy-six subjects, whose asthma was generally under medical con trol, were assigned randomly to either a treatment group or a waiting- list control group. Those in the treatment group were exposed to a 7-w eek program that incorporated proven features of providing effective t raining and establishing behavioral control. Subsequently, subjects in the control group received the treatment. Short-term evaluation of th e treatment was made after the subjects in the experimental group were trained but before the control subjects were trained. Long-term evalu ation was conducted after both groups of subjects were trained. Result s: Over the short term, self-management training led to fewer. asthma symptoms and physician visits and improvement in asthma management ski lls and cognitive abilities. Over the long term, self-management train ing was related to lower asthma attack frequency, reduced medication u se, improvement in cognitive measures, and increased use of self-manag ement skills. Conclusions: The program improved asthma management in p atients whose conditions were already under good medical control. The effects of the program were apparent a year after the conclusion of se lf-management training.