TABLE 8-1 Nineteen Self-Management Programs for Childhood Asthma
A.C.T. for Kids
Asthma Summer Camp Program
Children's Hospital of Pittsburgh
Community Program for Childhood Asthma
Educational and Exercise Program
Family Asthma Program
Living with Asthma
Self-Care Asthma Education
Self-Care Rehabilitation in Pediatric Asthma
Self-Help Education-Exercise Program (CASH-IN)
Teaching My Parents/Myself about Asthma
You Can Control Asthma
SOURCE: Wigal et al., 1990
the degree to which patients applied the skills (Creer et al., 1990). The procedures and methods used by children and their families to bring an attack under control were not assessed; neither were the factors that led to an amelioration of the attacks. Also not examined was the relationship between (1) reduced hospitalizations and emergency room visits and (2) the behaviors recommended by physicians and in educational programs. It has yet to be determined whether children who learn these self-management skills can and will apply them to manage their asthma attacks more effectively. Although some studies show that people who learn management skills use them in the short term, it is less clearly documented that these behaviors persist over the long term.
Not all educational programs on asthma have been successful. For example, in an educational program consisting of classes conducted in group settings, only 38 percent of a group of Chicago inner-city children with asthma and their families attended one or more of four scheduled classes (Shields et al., 1990). The median household income of these families was 6 percent below the overall city median of Chicago. Among the participants who remained for the entire study period (29 months), there was no significant improvement (reduction) in postintervention health care utilization for respiratory-related illnesses, and the program did not achieve its goal of decreasing emergency room visits for children with asthma.