According to this study:

* Community health workers trained as asthma coaches effectively reached low-income parents of black children and reduced rehospitalizations.

During a two-year period, Fisher and colleagues had asthma coaches contact low-income, black parents of children two to eight years old who had been hospitalized for asthma at St. Louis Children's Hospital, to determine their effectiveness in reducing rehospitalizations. Participants were randomly assigned to usual care (n = 94), which consisted of following a standard inpatient care pathway, or to an asthma coach (n = 97), who offered coaching as well as usual care. The coaches were two high school-educated black women who were trained for three months in areas such as disease process, communication techniques, and seven key asthma management behaviors: using an asthma action plan, using asthma-controller medications, using asthma-reliever medications, visiting a primary care provider every few months, developing a partnership with the provider, minimizing exposure to secondhand smoke, and minimizing exposure to cockroach allergen. Phone surveys were conducted at baseline, six, 12, 18, and 24 months. Scheduled phone calls and home visits were conducted using a nondirective, suxpportive approach, adapted to the participants' readiness to accept the asthma management behaviors.

The results showed that nearly 90% of parents in the asthma coach group had at least one significant contact with the coach "within three months of randomization." In fact, an average of 21.1 contacts per parent occurred over the course of the study. Accordingly, a significantly smaller proportion of children in the asthma coach group were rehospitalized than in the usual care group (36.5% versus 59.1%, respectively).

According to the study's authors, the use of asthma coaches who are peers of the target population may be quite effective in managing asthma and reducing rehospitalizations.-JC