Breathe With Ease: A Unique Approach to Managing Stress (BEAMS)

Uncontrolled asthma in at-risk youth responds well to guideline-based therapy when patients
remain adherent to their management plans. Adherence to inhaled corticosteroids (ICS), when
indicated for persistent or uncontrolled asthma, is a critical component of most asthma
management plans, and other self-management practices such as trigger avoidance are similarly
related to improved asthma outcomes. Adherence to self-management practices is mediated by
multiple factors, including psychosocial stress of parents and their children.

A targeted, culturally appropriate intervention to manage psychosocial stress among the
parents of young, African American, and socioeconomically disadvantaged urban children with
asthma who are receiving guideline-based care may improve asthma self-management, and
therefore asthma outcomes.

Our overall aim is to implement and evaluate a highly collaborative, multi-dimensional,
culturally appropriate and community-based asthma intervention to augment existing
guideline-based best practice. The intervention will target the parents of at-risk, urban,
African American youth, and will employ individualized psychosocial stress management and
peer support.

We will conduct a single blind, prospective randomized controlled trial comparing the IMPACT
DC Asthma Clinic's existing intervention of guideline-based clinical care, education, and
short-term care coordination (usual care) to usual care plus parental stress management in a
cohort of up to 200 parent-child dyads of AA youth aged 4-12 years.

We plan to enroll parent-child dyads that meet the following criteria:

Inclusion criteria (Parent):

- self-identify as African-American

- both the legal guardian and primary asthma caregiver of an eligible child.

Exclusion criteria (Parent):

- unable or unwilling to sign informed consent document

- exclusionary psychiatric condition, including but not limited to psychosis, based on
the screening form at recruitment

- enrolled in another asthma research study.

Inclusion criteria (Child):

- parent-identified as African-American

- age 4-12 years inclusive at recruitment

- physician diagnosis of persistent asthma

- publicly financed insurance

Exclusion criteria (Child):

- chronic medical condition (other than asthma) including but not limited to diabetes,
sickle cell disease, heart disease, lung disease or neurological disorder.

In addition, the PI may choose to not include a participant if he does not believe it is in
the family's best interest to participate.