One-liner: A set of policy recommendations to promote the development and maintenance of communities in which children with asthma can be swiftly diagnosed, effectively treated, and protected from exposure to harmful environmental factors. An estimated 5 million U.S. children have asthma. Too many of these children are unnecessarily impaired. Much of the money spent on asthma is for high-cost health care services to treat acute periods of illness. Many asthma attacks could be avoided--and much suffering prevented and many medical costs saved--if more children received good-quality, ongoing asthma care and if the 11 policy recommendations presented in this report were implemented in a oordinated fashion. A national call to action, the policy recommendations span public and private interests and compel integration of public health activities across local, state, and federal levels. This report summarizes the findings of an effort funded by the Robert Wood Johnson Foundation as part of the Pediatric Asthma Initiative, whose purpose is to address current gaps in national childhood asthma care. It is the first national initiative that simultaneously addresses treatment, policy, and financing issues for children with asthma at the patient, provider, and institutional levels. The purpose of RAND's effort was to:--identify a range of policy actions in both the public and private sectors that could improve childhood asthma outcomes nationwide--select a subset of policies to create a blueprint for national policy in this area--outline alternatives to implement these policies that build on prior efforts.The effort developed a comprehensive policy framework that maps the identified strategies to one overall policy objective: to promote the development and maintenance of asthma-friendly communities--communities in which children with asthma are swiftly diagnosed, receive appropriate and ongoing treatment, and are not exposed to environmental factors that exacerbate their condition. This report is intended as a working guide for coordinating the activities of both public and private organizations at the federal, state, and local community levels.

This report describes the group process used to arrive at the policy recommendations proposed in Improving Childhood Asthma Outc

This report describes the group process used to arrive at the policy recommendations proposed in Improving Childhood Asthma Outc.

Asthma is a complex disease. Although not enough is known about its cause, we do know that risk factors include genetic predisposition, environmental exposures (including tobacco smoke, furry pets, dust mites, and cockroaches), poverty and inadequate health care services. Therefore, an effective strategy for reducing the disease must address multiple fronts. This is particularly important for low-income and minority children, who suffer a greater burden from asthma. They are less likely to have the resources to deal with the disease, and certain racial and/or ethnic groups may also have a greater genetic predisposition.

This issue of Immunology and Allergy Clinics is devoted to Asthma in Childhood and is Guest Edited by Drs. Leonard Bacharier and Theresa Guilbert. Articles in this outstanding issue include: Inception and Natural History of Pediatric Asthma; Recent Diagnosis Techniques in Pediatric Asthma; Management / co-morbidities for Preschool-aged Children with Asthma; Management/ co-morbidities for School-aged Children with Asthma; Effects of the Environment on Disease Activity; New Advances of Self-Management/Adherence Monitoring and Management in Pediatric Asthma; Severe Asthma in Early Childhood; Inner-city Asthma in Early Childhood; Personalized Medicine and Pediatric Asthma; Prevention in Pediatric Asthma; Asthma in the Schools; and New Directions in Pediatric Asthma.

"The We Can Do Better asthma project used proven quality improvement (QI) techniques in a group setting at three regional meetings (Southeast, Midwest, and Northwest) held in November and December 2008. The goal of the project was to obtain information about ways to prevent and control asthma episodes. Participants included public health and health care professionals who worked with programs to prevent and control asthma episodes. This project sought to examine why better asthma outcomes were not being obtained, or at least not apparent, by identifying (1) strategies that worked to prevent and control asthma; (2) strategies that have failed to achieve desired results; (3) contextual characteristics (e.g. social, political, and community contexts) contributing to and/or facilitating success, and (4) contextual characteristics confounding desired results and/or success."--Page 4.

Asthma is the leading chronic health condition among children in the United States and a major cause of childhood disability. It also disproportionately affects low-income and racial and ethnic minorities. Although a wide range of interventions have been implemented to improve asthma-related outcomes among socioeconomically disadvantaged and minority children, disparities persist. This paper, which was commissioned by the JPB Foundation and conducted by MDRC in partnership with the National Academy for State Health Policy, standardizes and compares effects from rigorous evaluations across three main types of interventions: those that focus on improving education and self-management, those that focus on addressing remediation of the conditions that trigger asthma in the home environment, and those that focus on improving health care provider practice. While prior reviews have summarized findings for each intervention type, this review systematically compares findings across a range of outcomes and a spectrum of different approaches to addressing childhood asthma, drawing from about 30 independent studies and earlier published reviews. In addition, the paper includes case studies of various local programs and state-level policy initiatives to illuminate current efforts to address childhood asthma in low-income communities and barriers faced in sustaining asthma programs. Key findings include: (1) Providing education on how to manage asthma is fundamental to improving outcomes, but it may not be enough to alleviate disparities in asthma management; (2) Some local programs are clearly bridging informational gaps among low-income families and are helping them maintain a safe home environment for their children with asthma; (3) The health care benefits of interventions that go beyond education are unclear; (4) Barriers to medication management are complex and medication adherence is difficult to influence; and (5) The role of the state, and the Medicaid program in particular, is relevant for the financing and sustainability of asthma programs for low-income children. Although the long-run sustainability of some of the programs highlighted in this report is uncertain, what is clear is that combating the disparities in the prevalence of asthma among different populations will require more than an agreement on standard asthma management practices within the medical community. The following are appended: (1) Methodology for Literature Review; (2) Summaries of Asthma Studies; (3) Detailed Case Studies of Local Asthma Programs; and (4) Detailed State-Based Case Studies. [This working paper was written with Felicia Heider, Carrie Hanlon, and Taylor Kniffin.].

Severe asthma is a form of asthma that responds poorly to currently available medication, and its patients represent those with greatest unmet needs. In the last 10 years, substantial progress has been made in terms of understanding some of the mechanisms that drive severe asthma; there have also been concomitant advances in the recognition of specific molecular phenotypes. This ERS Monograph covers all aspects of severe asthma – epidemiology, diagnosis, mechanisms, treatment and management – but has a particular focus on recent understanding of mechanistic heterogeneity based on an analytic approach using various ‘omics platforms applied to clinically well-defined asthma cohorts. How these advances have led to improved management targets is also emphasised. This book brings together the clinical and scientific expertise of those from around the world who are collaborating to solve the problem of severe asthma.

Childhood asthma still imposes an enormous burden on children and their families. To the best of our knowledge, no study reviewed the literature on the effect of family asthma education on major asthma outcomes. This study aimed to explore the effect of family education programs on major asthma outcomes in children. Quasi-experimental studies and randomized controlled trials were conducted among children with asthma aged 6,Äì18 years and their parents were included. Pub Med, Science Direct, and Trip databases were used to extract data published in English from 2010 to 2021. Twenty-two studies were reported in this review. It was demonstrated that family empowerment interventions were effective in improving the quality of life of children and their parents, asthma symptom control, and pulmonary function. Family education that was specific to medication improved medication adherence, inhalation technique, and asthma control. Family asthma education enhanced asthma management and family functioning. This approach should be a cornerstone of pediatric asthma therapy. It helps health care professionals to build a strong connection and trustful relationship with children with asthma and their families.