Methodology

Literature Review

At the outset of the project, ORC Macro staff initiated a conference call with nationally recognized experts in asthma control and management. The purpose of this call was to a) elicit the experts’ advice on key programs and/or articles to include in the literature review and b) begin identifying criteria for deciding which interventions should be included in the review. Discussions with these experts resulted in the following inclusion criteria.

• It was desired that the asthma intervention would have had a rigorous evaluation design (preferably a randomized control study design), with other approaches (e.g., pre-post and cohort studies) appropriate in certain situations. However, the reality of existing intervention research required some flexibility regarding study design in the identification of effective interventions.
• The intervention was required to have resulted in positive health outcomes.
• An article reporting the intervention research methods and results had to have been accepted for publication or already published in a peer-reviewed journal.

Although identifying potentially effective interventions was intended to be a rigorous process, the complexity and quality of the published intervention research varied considerably. As a result, the task of identifying potentially effective interventions was more difficult than anticipated. It was the decision of the expert group to include several reports that may not have met the desired rigor of study design but represented the best of the published intervention research for otherwise under-represented populations. In addition, although the review was thorough, whether all potentially effective interventions have been identified is unknown; users of this information are encouraged to suggest other interventions to consider for inclusion.

Database searches focused on pertinent articles published from January 1980 through October 2002. To date, the search has identified 202 articles. Updates to this information will be provided. Because multiple journal articles were written for several interventions, and because several articles were reviews of peer-reviewed, research-based asthma interventions, the number of actual interventions was fewer than 202. The complete bibliography of the literature reviewed is available at https://www.cdc.gov/asthma/interventions/bibliography.htm. An updated review of intervention research published after October 2002 is ongoing. Of the interventions identified in the 202 articles reviewed, 42 interventions have been included in the group of potentially effective approaches (https://www.cdc.gov/asthma/interventions/). For interventions described in more than one article, pertinent information from each article has been summarized and presented as one entry.

Case Studies

To provide professionals seeking appropriate asthma interventions with “real-life” experiences, a case-study approach was used. Very few of the interventions identified continued to be implemented after the intervention research was completed. The development of a case study was dependent on the existence of a site currently implementing the intervention with reasonable fidelity to the original research and our awareness of that implementation. When multiple sites were available for case study for any one intervention, the organization owning that particular program (e.g. the American Lung Association for Open Airways) was consulted regarding which site would be the most appropriate and the most interested in sharing their experiences. The case study approach included document review, site visits, and in-depth interviews with individual staff members participating in the intervention activities and, when possible, telephone interviews with the original researchers.