Box 4. Interactive Seminar for Physicians Based on Self-regulation Theory (Physician Asthma Care Education: PACE)

Physicians were helped to observe, evaluate, and react to their own efforts to treat and educate their patients. The purposes of the seminar were to:

• Help physicians create interactive conversation with patients to derive information for making therapeutic decisions.
• Create a congenial and supportive atmosphere so that patients would be candid.
• Reinforce positive efforts of families to self-manage.
• Provide a supportive climate for mutual problem-solving.
• Strengthen patients' skills in using medicines.
• Provide the patient with a view of the long-term therapeutic plan.
• Build patients' confidence to control symptoms.

The program had two components: optimal clinical practice based on National Asthma Education and Prevention Program guidelines, and patient teaching and communications.

There were two 2 1/2-hour seminars, 2-3 weeks apart. The seminars included:

• Brief lectures on clinical practice by respected asthma specialists.
• A video depicting effective clinical teaching and communication behavior.
• Case studies presenting troublesome clinical problems.
• A protocol by which physicians could assess their own behavior regarding patient communications.
• A review of messages to communicate and materials to use when teaching patients.

The topics included:

• What happens in an asthma attack.
• How medicines work.
• Responding to changes in asthma severity.
• How to take medicines.
• Safety of medicines.
• Goals of therapy.
• Criteria of successful treatment.
• Managing asthma at school.
• Identifying and avoiding triggers.
• A long-term treatment plan showing patients at home how to adjust medications.