Teen Asthma Control Encouraging a Healthier Lifestyle

Asthma that has persisted in adolescents is likely to persist into adulthood. For 25-30% of
Americans, adolescence is also the period at which they experience their greatest weight
gain, particularly as they approach the final stages of puberty. Asthma management may be
more of a challenge in the overweight adolescent compared to a normal weight youth. Asthma
related morbidity is increased in overweight patients, reflected in higher health care
utilization for this subgroup. Little guidance is given to physicians caring for obese
adolescents with asthma, but findings suggest that interventions designated to achieve
control in these patients are necessary. Because of the psychosocial factors often associated
with obesity and asthma (e.g. low self-esteem, depression and low quality of life) successful
interventions should incorporate a patient-centered approach.

Patient-centered care (or patient focused care) involves a partnership between the patient
and the physician, shared discussion making, as well as productive communication and health
promotion. The objective of this project is to collect the information necessary to develop a
tailored discussion guide for use by the physician caring for the obese teen with asthma.
Project results will provide an evidence base for the development and evaluation of
additional patient-centered health interventions for obese adolescents with asthma. The
investigators will conduct this study among patients whom eligibility can be determined using
the electronic medical record (EMR). The specific aims of this proposal are to:

Qualitatively collect information on outcomes important to obese adolescents with asthma:

Create a tailored discussion guide that incorporates patient preferences and treatment goals
that can be used by providers caring for overweight adolescents with asthma:

Conduct a randomized trial to determine if patient-centered and clinical outcomes improve for
patients whose physicians use the tailored discussion guide compared to those who do not.

Inclusion Criteria:

- BMI >85th Percentile & Diagnosed with asthma; using a modification of Healthcare
Effectiveness Data and Information Set (HEDIS) criteria:

- At least one emergency department visit with a principal diagnosis of asthma, or

- At least one acute inpatient claim/encounter with asthma as the principal diagnosis or
at least four outpatient visits with an asthma diagnosis and at least or

- At least four asthma four outpatient visit with an asthma diagnosis and at least two
asthma medications dispensed, or

- At least four asthma medications dispensed in the last 12 month

Exclusion Criteria:

- Does not meet eligibility criteria for weight and/or asthma;

- Currently enrolled in another investigational asthma management /education/weight
management trial.