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Improving Asthma Outcomes and Self-management Behaviors of Inner-city Children
A Randomized Trial of the Health Buddy Interactive Device and an Asthma Diary
Sylvia Guendelman, PhD;
Kelley Meade, MD;
Mindy Benson, PNP;
Ying Qing Chen, PhD;
Steven Samuels, PhD
Arch Pediatr Adolesc Med. 2002;156:114-120.
Background Asthma is an important cause of morbidity, absence from school, and
use of health services among children. Computer-based educational programs
can be designed to enhance children's self-management skills and to reduce
adverse outcomes.
Objective To assess the effectiveness of an interactive device programmed for
the management of pediatric asthma.
Design A randomized controlled trial (66 participants were in the intervention
group and 68 were in the control group).
Setting Interventions conducted at home and in an outpatient hospital clinic.
Participants Inner-city children aged 8 to 16 years diagnosed as having asthma by
a physician.
Intervention An asthma self-management and education program, the Health Buddy, designed
to enable children to assess and monitor their asthma symptoms and quality
of life and to transmit this information to health care providers (physicians,
nurses, or other case managers) through a secure Web site. Control group participants
used an asthma diary.
Main Outcome Measures Any limitation in activity was the primary outcome. Secondary outcomes
included perceived asthma symptoms, absence from school, any peak flow reading
in the yellow or red zone, and use of health services.
Results After adjusting for covariates, the odds of having any limitation in
activity during the 90-day trial were significantly (P
= .03) lower for children randomized to the Health Buddy. The intervention
group also was significantly (P = .01) less likely
to report peak flow readings in the yellow or red zone or to make urgent calls
to the hospital (P = .05). Self-care behaviors, which
were important correlates of asthma outcomes, also improved far more for the
intervention group.
Conclusion Compared with the asthma diary, monitoring asthma symptoms and functional
status with the Health Buddy increases self-management skills and improves
asthma outcomes.
From the Maternal and Child Health Program (Drs Guendelman and Samuels),
the Division of Health Policy and Management (Dr Guendelman), and the Division
of Biostatistics (Dr Chen), School of Public Health, University of California,
Berkeley; and Ambulatory Services, Children's Hospital Oakland, Oakland, Calif
(Dr Meade and Ms Benson).
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