The purposes of the program are:

• To help staff link the goals of continuing care for asthma to the preventive care mission of the clinics.
• To help staff resolve organizational problems blocking acceptance of the new approach to asthma care.
• To build teamwork and a sense of owning the program by involving staff in planning how to implement the program in each clinic.

The program has three main components:

1. Training sessions for all clinic staff.
   • Five 3-hour sessions over a 5-month period were attended by all clinic staff. Emphasis was placed on defining the roles of clerks, public health assistants, and lab technicians and teaching them to answer questions and encourage compliance.
     • Session 1 introduced the Creating a Medical Home for Asthma Program and asked clinic staff to assess assets and barriers to implementing the program.
     • Session 2 used a skit written by faculty and performed by staff showing how the program would work and also introduced an interactive exercise called "force field analysis" to help clinic teams plan how to start the program in each clinic.
     • Session 3 introduced prevention and treatment protocols based on the National Asthma Education and Prevention Program Guidelines.
     • Session 4 modeled optimal communication skills for medical interviews and family education using videotapes showing a faculty doctor and nurse conducting an initial visit for asthma with a patient.
     • Session 5 introduced a screening process to identify children with asthma and invite them to receive treatment in the clinic.
   • Two additional 3-hour sessions were held at the end of the first followup year to reinforce communication skills and discuss patients they had worked with.
2. Tutorial session for each clinic physician. Each clinic physician spent 3 hours observing a Columbia University faculty physician treating children with asthma in a hospital setting.
3. Visits by a full-time nurse educator. Once a month, a nurse educator visited to help solve problems and continue the educational process.

In addition to this training, all clinics received appropriate medications and delivery devices.