***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND Whether asthma morbidity in minority groups can be reduced by preventative health care measures delivered in the relevant ethnic dialects requires further evaluation . This study reports clinical outcomes and quality of life from a community based project investigating white European ( W/E ) and Indian subcontinent ( ISC ) ethnic groups with asthma living in deprived inner city areas of Birmingham , UK . METHODS Six hundred and eighty nine asthmatic subjects ( 345 W/E , 344 ISC ) of mean ( SD ) age 34.5 ( 15 ) years ( range 11–59 ) and mean forced expiratory volume in one second ( FEV1 ) of 80 % predicted were interviewed in English , Punjabi , Hindi , or Urdu . Subjects r and omised to the active limb of a prospect i ve , open , r and omised , controlled , parallel group , 12 month follow up study underwent individually based asthma education and optimisation of drug therapy with four monthly follow up ( active intervention ) . Control groups were seen only at the beginning and end of the study . Urgent or emergency interactions with primary and secondary health care ( clinical outcomes ) and both cross sectional and longitudinal data from an Asthma Quality of Life Question naire ( AQLQ ) were analysed . RESULTS Clinical outcomes were available for 593 subjects . Fewer of the active intervention group consulted their GP ( 41.8 % versus 57.8 % , odds ratio ( OR ) 0.52 ( 95 % CI 0.37 to 0.74 ) ) or were prescribed antibiotics ( 34.9 % versus 51.2 % , OR 0.51 ( 95 % CI 0.36 to 0.72 ) ) , but by ethnicity statistically significant changes occurred only in the W/E group with fewer also attending A&E departments and requiring urgent home visits . Active intervention reduced the number of hospital admissions ( 10 versus 30 ) , GP consultations ( 341 versus 476 ) , prescriptions of rescue oral steroids ( 92 versus 177 ) , and antibiotics ( 220 versus 340 ) , but again significant improvements by ethnicity only occurred in the active W/E group . AQLQ scores were negatively skewed to the higher values ; regression analysis showed that lower values were associated with ISC ethnicity . Longitudinal changes ( for 522 subjects ) in the mean AQLQ scores were small but statistically significant for both ethnic groups , with scores improving in the active and worsening in the control groups . CONCLUSIONS Active intervention only improved clinical outcomes in the W/E group . AQLQ scores , although lower in the ISC group , were improved by active intervention in both ethnic groups The purpose of this study was to assess the impact of asthma Self Management Training on the health status and re source use of patients with chronic asthma . The study consisted of a r and omized control design of chronic asthmatic patients in a tertiary care center in India . The intervention group ( 153 patients ) received four training sessions in addition to the regular care provided to the control group ( 150 patients ) .  Health status and re source use were measured at baseline and over a one year follow-up period . The intervention group had significantly better health status ( measured by breathing ability ) , fewer productive days lost , and lower re source use ( hospitalizations and emergency room visits ) than the control group . Total annual costs ( direct and indirect ) were also lower , though physician costs were not included in the assessment . Therefore , incorporation of asthma Self Management Training as part of clinical management of asthma can result in improvements in health status and reductions in hospital use Summary Background Recent studies have demonstrated marked international variations in the prevalence of asthma , but less is known about ethnic variations in asthma epidemiology within individual countries and in particular the impact of migration on risk of developing asthma . Recent within country comparisons have however revealed that despite originating from areas of the world with a low risk for developing asthma , South Asian and Afro-Caribbean people in the UK are significantly ( 3 × and 2 × respectively ) more likely to be admitted to hospital for asthma related problems than Whites . Methods Using data from the Fourth National Study of Morbidity Statistics in General Practice , a one-percent broadly representative prospect i ve cohort study of consultations in general practice , we investigated ethnic variations in incident asthma consultations ( defined as new or first consultations ) , and compared consultation rates between those born inside and outside the UK ( migrant status ) . Logistic regression models were used to examine the combined effects of ethnicity and migration on asthma incident consultations . Results Results showed significantly lower new/first asthma consultation rates for Whites than for each of the ethnic minority groups studied ( mean age-adjusted consultation rates per 1000 patient-years : Whites 26.4 ( 95%CI 26.4 , 26.4 ) ; South Asians 30.4 ( 95%CI 30.3 , 30.5 ) ; Afro-Caribbeans 35.1 ( 95%CI 34.9 , 35.3 ) ; and Others 27.8 ( 27.7 , 28.0 ) . Within each of these ethnic groups , those born outside of the UK showed consistently lower rates of incident asthma consultations . Modelling the combined effects of ethnic and migrant status revealed that UK-born South Asians and Afro-Caribbeans experienced comparable risks for incident GP consultations for asthma to UK-born Whites . Non-UK born Whites however experienced reduced risks ( adjusted OR 0.82 , 95%CI 0.69 , 0.97 ) whilst non-UK born South Asians experienced increased risks ( adjusted OR 1.33 , 95%CI 1.04 , 1.70 ) compared to UK-born Whites . Conclusion These findings strongly suggest that ethnicity and migration have significant and independent effects on asthma incidence . The known poorer asthma outcomes in UK South Asians and Afro-Caribbeans may in part be explained by the offspring of migrants experiencing an increased risk of developing asthma when compared to UK-born Whites . This is the first study to find heterogeneity for incident asthma consultations in Whites by migrant status BACKGROUND Despite significant medical advances , many ethnic and racial minority children who live in inner cities continue to experience disproportionately high levels of asthma morbidity and mortality compared with white children . As a result , a growing number of psychosocial asthma management interventions are being developed to address their needs ; however , only a few of these interventions have incorporated cultural variables into their treatments and have had their efficacy evaluated . OBJECTIVE To examine the efficacy of the Multifamily Asthma Group Treatment ( MFAGT ) , design ed to enhance asthma management and reduce emergency department ( ED ) visits among African American and Hispanic families . METHODS Twenty-four African American and Hispanic families who have children with asthma were r and omly assigned to either the MFAGT or the St and ard Psychoeducational Asthma Intervention . Differences in the number of ED visits and the level of asthma management in both groups were compared 1 year before and 1 year after the intervention . In addition , these groups were contrasted to a control group that did not receive any psychoeducational intervention . RESULTS The MFAGT was significantly ( P = .04 ) more effective than the St and ard Psychoeducational Asthma Intervention and the control in decreasing ED visits and increasing parental asthma knowledge . CONCLUSIONS These preliminary results suggest that the MFAGT is efficacious in enhancing asthma management and in reducing ED visits in inner-city African American and Hispanic children from a lower socioeconomic background Background People with asthma from ethnic minority groups experience significant morbidity .  Culturally-specific interventions to reduce asthma morbidity are rare . We tested the hypothesis that a culturally-specific education programme , adapted from promising theory-based interventions developed in the USA , would reduce unscheduled care for South Asians with asthma in the UK . Methods A cluster r and omised controlled trial , set in two east London boroughs . 105 of 107 eligible general practice s were r and omised to usual care or the education programme . Participants were south Asians with asthma aged 3 years and older with recent unscheduled care . The programme had two components : the Physician Asthma Care Education ( PACE ) programme and the Chronic Disease Self Management Programme ( CDSMP ) , targeted at clinicians and patients with asthma respectively . Both were culturally adapted for south Asians with asthma . Specialist nurses , and primary care teams from intervention practice s were trained using the PACE programme . South Asian participants attended an outpatient appointment ; those registered with intervention practice s received self-management training from PACE-trained specialist nurses , a follow-up appointment with PACE-trained primary care practice s , and an invitation to attend the CDSMP . Patients from control practice s received usual care . Primary outcome was unscheduled care . Findings 375 south Asians with asthma from 84 general practice s took part , 183 registered with intervention practice s and 192 with control practice s. Primary outcome data were available for 358/375 ( 95.5 % ) of participants . The intervention had no effect on time to first unscheduled attendance for asthma ( Adjusted Hazard Ratio AHR = 1.19 95 % CI 0.92 to 1.53 ) . Time to first review in primary care was reduced ( AHR = 2.22 , ( 1.67 to 2.95 ) . Asthma-related quality of life and self-efficacy were improved at 3 months ( adjusted mean difference -2.56 , ( -3.89 to -1.24 ) ; 0.44 , ( 0.05 to 0.82 ) respectively . Conclusions A multi-component education programme adapted for south Asians with asthma did not reduce unscheduled care but did improve follow-up in primary care , self-efficacy and quality of life . More effective interventions are needed for south Asians with asthma The objective of the study was to assess the feasibility of implementing and evaluating a culturally appropriate in-patient asthma education program specifically targeted for African-Americans . A consecutive sample of 28 African-American patients ages 18–50 who were hospitalized for asthma were r and omized to an intervention group , which received three one-on-one sessions on chronic asthma management , or a control group , which received the usual care .  Data on symptom frequency , self-management behaviors , quality of life , depression , and health care re source use were collected at baseline and at 3 and 6 months . Although the time required to recruit our sample took longer than anticipated , 28 subjects agreed to be in the study ( 70 % acceptance rate ) and complete the baseline interview . We observed no statistically significant differences from baseline or changing trends in frequency of asthma symptoms , self-management behaviors , and health care re source use between the intervention and control groups at 3 and 6 months . However , patients in the intervention group demonstrated a greater average increase in asthma-related quality of life and a greater average decrease in depression than the control group . Feasibility issues included shortened length of stay , which necessitated conducting all three self-management sessions together , multiple interruptions during the sessions , and retention issues at 3- and 6-month follow-ups . The lessons learned from this pilot study are invaluable in that they will enable us to make changes in our existing protocol to ensure the success of a larger clinical trial INTRODUCTION Asthma is the most prevalent chronic illness , affecting more than 7 million children younger than 17 years . Asthma has become a leading public health concern because of the dramatic rise in the incidence of this disease during the past 15 years , particularly in minority population s. This study tested a two-part intervention on selected psychosocial and health outcomes of 8- to 13-year-old inner city minority students with asthma . METHOD The intervention consisted of participation in an asthma education program ( Open Airways ) followed by 5 monthly visits with a nurse practitioner . The total sample of 52 children was composed of 28 children in the treatment group who received the intervention and 24 children who served as a control group .  RESULTS Students in the treatment group scored significantly higher than the control group over time on measures of asthma knowledge , asthma self-efficacy , general self-care practice s , and asthma self-care practice s. No significant differences were found between the two groups on health outcomes . DISCUSSION A school-based intervention program can improve psychosocial outcomes for inner-city minority children with asthma . Recommendations for future research and clinical practice are discussed OBJECTIVE To test whether community health workers are able to reach low-income parents of African American children hospitalized for asthma and to reduce rehospitalization among them . DESIGN A r and omized controlled evaluation of usual care vs 2-year asthma coach intervention . SETTING An urban children 's hospital and the surrounding community . PARTICIPANTS A population -based sample of 306 children hospitalized for asthma met the inclusion criteria of being 2 to 8 years of age , of African American ethnicity , and having Medicaid coverage . Of these , 200 were contacted and 191 recruited with commitment to evaluation activities but , in order to assess reach , no commitment to participating in intervention . INTERVENTIONS Coaches reinforced basic asthma education and encouraged key management behaviors through home visits and phone calls tailored to parent 's readiness to adopt management practice s and emphasizing a nondirective supportive style ( cooperative and accepting of feelings and choices ) . OUTCOME MEASURES The reach of intervention to parents , contacts with coaches , and rehospitalization over 2 years based on hospital records . RESULTS Within 3 months of r and omization to the asthma coach group , 89.6 % of parents had at least 1 
    Output:
    
Education , with continuous professional support , was common to most interventions .
Facilitators to asthma self-management included : ensuring culturally/linguistically appropriate education , adapting to learning styles , addressing daily stressors/social support and generic self-management strategies .