Asthma Health Outcomes Project
Overviews of Surveyed Asthma ProgramsSeptember 2005
Domestic Programs: California
Improving Asthma Outcomes and Self-management Behaviors of Inner-city Children
University of California Berkeley
Sylvia Guendelman, PhD, MSW
"Improving Asthma Outcomes and Self-management Behaviors of Inner-city Children: A Randomized Trial of the Health Buddy Interactive Device and an Asthma Diary" was a study that assessed the effectiveness of an interactive device programmed for the management of pediatric asthma. The design was a randomized controlled trial (66 participants were in the intervention group and 68 were in the control group). Interventions were conducted at home and in an outpatient hospital clinic. Participants included inner-city children aged 8 to 16 years diagnosed as having asthma by a physician.
The Health Buddy is a personal and interactive communication device that is connected to a home telephone and can be programmed to present questions and information on a screen and to record responses. The nurse coordinator sends a set of queries each day using a standard internet browser. The patient answers the queries by pressing one of four buttons. The device automatically telephones a data processing center at night, which processes the responses and publishes them to a secure Web site the next day, from which the nurse coordinator reviews the information. All children were asked to return for two follow-up visits at six- and 12-weeks. At these visits families were interviewed by the nurse coordinator and given a standardized teaching session that reinforced peak flow measurement, compliance with medications, and tracking of symptoms.
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.
Compared with the asthma diary, monitoring asthma symptoms and functional status with the Health Buddy increases self-management skills and improves asthma outcomes.
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