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Reducing asthma health disparities in poor Puerto Rican children: The effectiveness of a culturally tailored family interventionGlorisa Canino, PhD,a Doryliz Vila, MS,a Sharon-Lise T. Normand, PhD,b Edna Acosta-Pe´ rez, PhD,a Rafael Rami´rez, PhD,a Pedro Garci´a, MA,a and Cynthia Rand, PhDc San Juan, Puerto Rico, Boston, Mass, and Baltimore, Md. Puerto Rican children are sicker from asthma than any other ethnic group in the United States and more likely to die because of their asthma. In this March article in JACI, the authors present the results of a randomized, controlled clinical trial to test the effectiveness of a culturally adapted family-based intervention called CALMA. Its aim was to reduce asthma morbidity in poor Puerto Rican children (age 5-12 years) who have persistent asthma. The main goal of CALMA was to improve asthma outcomes through family education about asthma self-management. For the primary outcome of symptom-free days, no significant differences were observed between the intervention and control groups. However, the data did show an increase in symptom-free nights of 1 day a month which was statistically significant though it may not be considered clinically significant. Nevertheless, large effects were observed for parent reports of their children’s better asthma control and fewer ED visits and hospitalizations. The program’s positive outcomes were likely due to its customized family asthma education that was tailored to local cultural needs and used community-based participation. The development of this intervention is of particular importance for low-income groups of Puerto Rican children from the island and mainland because of their known high morbidity and asthma mortality. |
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