R. Evans et al., A randomized clinical trial to reduce asthma morbidity among inner-city children: Results of the National Cooperative Inner-City Asthma Study, J PEDIAT, 135(3), 1999, pp. 332-338
Objective: To evaluate a family-focused asthma intervention designed for in
ner-city children 5 to 11 years old with moderate to severe asthma.
Study design: Randomized, multisite, controlled trial to minimize symptom d
ays (wheeze, loss of sleep, reduction in play activity) measured by a 2-wee
k recall assessed at 2-month intervals over a 2-year follow-up period. The
intervention was tailored to each family's individual asthma risk. profile
assessed at baseline.
Results: Averaged over the first 12 months, participants in the interventio
n group (n = 515) reported 3.51 symptom days in the 2 weeks before each fol
low-up interview compared with 4.06 symptom days far the control group (n =
518), a difference of 0.55 (95% CI, 0.18 to 0.92, P = .004). The reduction
among children with severe asthma was approximately 3 times greater (1.54
d/2 wk). More children in the control group (18.9%) were hospitalized durin
g the intervention compared with. children in the intervention group (14.8%
), a decrease of 4.19% (CI, -8.75 to 0.36, P = .071). These improvements we
re maintained in the intervention group during the second year of follow-up
, during which they did not have access to the asthma counselor
Conclusions: We demonstrated that an individually tailored, multifaceted in
tervention carried out. by Masters-level social workers trained in asthma m
anagement can reduce asthma symptoms among children in the inner city.