Box 3. National Cooperative Inner-City Asthma Study Intervention

This is a comprehensive social-worker-based education program combined with environmental control.

• Social workers were trained as asthma counselors (ACs) over a 3-month period.
• Training included three separate 2 ½-day sessions plus attending local asthma clinics for at least 2 weeks.
• ACs worked with child's caretaker to improve communications between family and physician.
• Primary care physicians were sent a blank asthma care plan, a spacer, a peak flow meter, and National Heart, Lung, and Blood Institute's asthma treatment guidelines.
• Caretakers attended two adult group asthma education sessions and one individual meeting with their AC during the 2 months after baseline assessments.
• Group sessions covered asthma triggers, environmental controls, asthma physiology, strategies for problem solving, and communicating with their child's physician.
• Two group sessions for children were conducted during the next 2-month period.
• ACs met with caretakers in person every 2 months and spoke with them on the telephone on alternate months.
• Families were given pillow and mattress covers and were encouraged to minimize exposure to tobacco smoke and pets.
• All children participating were given comprehensive 2-hour baseline assessments regarding health status, asthma symptoms, use of health care services, and psychological status.