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

Molly A. Martin; Catherine D. Catrambone; Romina A. Kee; Arthur T. Evans; Lisa K. Sharp; Christopher Lyttle; Cheryl Rucker-Whitaker; Kevin B. Weiss; John Jay Shannon

doi:10.1016/j.jaci.2008.10.057

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

Molly A. Martin^*, Catherine D. Catrambone, Romina A. Kee, Arthur T. Evans, Lisa K. Sharp, Christopher Lyttle, Cheryl Rucker-Whitaker, Kevin B. Weiss, John Jay Shannon

^*Corresponding author for this work

Medicine, General Medicine Division

Research output: Contribution to journal › Article › peer-review

56 Scopus citations

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.

Original language	English (US)
Pages (from-to)	153-159.e3
Journal	Journal of Allergy and Clinical Immunology
Volume	123
Issue number	1
DOIs	https://doi.org/10.1016/j.jaci.2008.10.057
State	Published - Jan 2009

Funding

Disclosure of potential conflict of interest: M. A. Martin received grant support from the National Institutes of Health/National Heart, Lung, and Blood Institute, the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases, and Rush University Medical Center. R. A. Kee receives grant support from the Centers for Disease Control and Prevention, the American Cancer Society, and the Michael Reese Health Trust. L. K. Sharp receives grant support from the National Heart, Lung, and Blood Institute. J. J. Shannon receives grant support from the National Heart, Lung, and Blood Institute. The rest of the authors have declared that they have no conflict of interest. Supported by National Heart, Lung, and Blood Institute grant 1 U01 HL072496-05, PI to K.B.W. and J.J.S.

Keywords

Adult asthma
African American
asthma self-efficacy
behavioral randomized controlled trial
community health worker
low income

ASJC Scopus subject areas

Immunology and Allergy
Immunology

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10.1016/j.jaci.2008.10.057

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Martin, M. A., Catrambone, C. D., Kee, R. A., Evans, A. T., Sharp, L. K., Lyttle, C., Rucker-Whitaker, C., Weiss, K. B., & Shannon, J. J. (2009). Improving asthma self-efficacy: Developing and testing a pilot community-based asthma intervention for African American adults. Journal of Allergy and Clinical Immunology, 123(1), 153-159.e3. https://doi.org/10.1016/j.jaci.2008.10.057

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title = "Improving asthma self-efficacy: Developing and testing a pilot community-based asthma intervention for African American adults",

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.",

keywords = "Adult asthma, African American, asthma self-efficacy, behavioral randomized controlled trial, community health worker, low income",

author = "Martin, {Molly A.} and Catrambone, {Catherine D.} and Kee, {Romina A.} and Evans, {Arthur T.} and Sharp, {Lisa K.} and Christopher Lyttle and Cheryl Rucker-Whitaker and Weiss, {Kevin B.} and Shannon, {John Jay}",

note = "Funding Information: Disclosure of potential conflict of interest: M. A. Martin received grant support from the National Institutes of Health/National Heart, Lung, and Blood Institute, the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases, and Rush University Medical Center. R. A. Kee receives grant support from the Centers for Disease Control and Prevention, the American Cancer Society, and the Michael Reese Health Trust. L. K. Sharp receives grant support from the National Heart, Lung, and Blood Institute. J. J. Shannon receives grant support from the National Heart, Lung, and Blood Institute. The rest of the authors have declared that they have no conflict of interest. Funding Information: Supported by National Heart, Lung, and Blood Institute grant 1 U01 HL072496-05, PI to K.B.W. and J.J.S. ",

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T1 - Improving asthma self-efficacy

T2 - Developing and testing a pilot community-based asthma intervention for African American adults

AU - Martin, Molly A.

AU - Catrambone, Catherine D.

AU - Kee, Romina A.

AU - Evans, Arthur T.

AU - Sharp, Lisa K.

AU - Lyttle, Christopher

AU - Rucker-Whitaker, Cheryl

AU - Weiss, Kevin B.

AU - Shannon, John Jay

N1 - Funding Information: Disclosure of potential conflict of interest: M. A. Martin received grant support from the National Institutes of Health/National Heart, Lung, and Blood Institute, the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases, and Rush University Medical Center. R. A. Kee receives grant support from the Centers for Disease Control and Prevention, the American Cancer Society, and the Michael Reese Health Trust. L. K. Sharp receives grant support from the National Heart, Lung, and Blood Institute. J. J. Shannon receives grant support from the National Heart, Lung, and Blood Institute. The rest of the authors have declared that they have no conflict of interest. Funding Information: Supported by National Heart, Lung, and Blood Institute grant 1 U01 HL072496-05, PI to K.B.W. and J.J.S.

PY - 2009/1

Y1 - 2009/1

N2 - 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.

AB - 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.

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KW - asthma self-efficacy

KW - behavioral randomized controlled trial

KW - community health worker

KW - low income

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

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