A randomized clinical trial of a culturally responsive intervention for African American women with asthma

Abstract

BackgroundFew interventions have focused on the difficulties that African American women face when managing asthma. ObjectiveTo evaluate a telephone-based self-regulation intervention that emphasized African American women's management of asthma in a series of 6 sessions. MethodsA total of 422 African American women with persistent asthma were randomly assigned to either an intervention or control group receiving usual care. Behavioral factors, symptoms and asthma control, asthma-related quality of life, and health care use at baseline and 2 years after baseline were assessed. Generalized estimating equations were used to assess the long-term effect of the intervention on outcomes. ResultsCompared with the control group, those who completed the full intervention (6 sessions) had significant gains in self-regulation of their asthma (B estimate, 0.73; 95% CI, 0.17–1.30; P < .01), noticing changes to their asthma during their menstrual cycle (B estimate, 1.42; 95% CI, 0.69–2.15; P < .001), and when having premenstrual syndrome (B estimate, 1.70; 95% CI, 0.67–2.72; P < .001). They also had significant reductions in daytime symptoms (B estimate, −0.15; 95% CI, −0.27 to −0.03; P < .01), asthma-related hospitalization (B estimate, 0.51; 95% CI, 0.00–1.02; P < .05), and improved asthma control (B estimate, 1.34; 95% CI, 0.57–2.12; P < .001). However, neither grouped changed over time in outcomes. ConclusionDespite high comorbidity, African American women who completed a culturally responsive self-management program had improvements in asthma outcomes compared with the control group. Future work should address significant comorbidities and psychosocial issues alongside asthma management to improve asthma outcomes in the long term. Trial Registrationclinicaltrials.gov Identifier NCT01117805.