Improving asthma self-efficacy: developing and testing a pilot community-based asthma intervention for African American adults

J Allergy Clin Immunol. 2009 Jan;123(1):153-159.e3. doi: 10.1016/j.jaci.2008.10.057.

Abstract

Background: Low-income African American adults in Chicago have disproportionately high asthma morbidity and mortality rates. Interventions that improve asthma self-efficacy for appropriate self-management behaviors might ultimately improve asthma control in this population.

Objective: We sought to pilot test an intervention to improve asthma self-efficacy for appropriate self-management behaviors.

Methods: Participants for this trial were recruited through 2 primary care clinics located in the largest African American community in Chicago. Participants were then randomized into one of 2 groups. The control group received mailed asthma education materials. The intervention group was offered 4 group sessions led by a community social worker and 6 home visits by community health workers. Telephone interviews were conducted at baseline (before intervention), 3 months (after intervention), and 6 months (maintenance).

Results: The 42 participants were predominantly African American and low income and had poorly controlled persistent asthma. The intervention group had significantly higher asthma self-efficacy at 3 months (P < .001) after the completion of the intervention. Asthma action plans were more common in the intervention group at 3 months (P = .06). At 6 months, the intervention group had improved asthma quality of life (P = .002) and improved coping (P = .01) compared with control subjects. Trends in behavioral and clinical outcomes favored the intervention group but were not statistically significant.

Conclusions: This community-based asthma intervention improved asthma self-efficacy, self-perceived coping skills, and asthma quality of life for low-income African American adults. Larger trials are needed to test the efficacy of this intervention to reduce asthma morbidity in similar high-risk populations.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Asthma* / epidemiology
  • Asthma* / ethnology
  • Asthma* / therapy
  • Attitude to Health* / ethnology
  • Black or African American*
  • Chicago / epidemiology
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Patient Education as Topic*
  • Pilot Projects
  • Quality of Life*
  • Residence Characteristics
  • Socioeconomic Factors
  • Time Factors