March 2007

Introduction

This knowledge path has been compiled by the Maternal and Child Health Library at Georgetown University. It offers a selection of current, high-quality resources about asthma in children and adolescents; its management; and its impact on homes, schools, and communities. The path also identifies tools for staying abreast of new developments in pediatric asthma research. Separate sections identify asthma information for families as well as resources about asthma management in school and asthma and environmental triggers. This knowledge path is aimed at health professionals, program administrators, policymakers, educators, community activists, and families, and it will be updated periodically.

Related knowledge path: Children and adolescents with special health care needs.

Resources for Professionals

Overview

See Asthma's impact on children and adolescents (2006) by the Centers for Disease Control and Prevention (CDC). This overview describes the prevalence of asthma among children and adolescents in the United States and its effects in terms of missed school days, high rates of hospitalization, increasing rates of asthma-related deaths, and high health care costs. The overview also describes CDC's asthma control programs and activities.

Web Sites: A-Z

• Agency for Healthcare Research and Quality (AHRQ). Contains data from the Kids' Inpatient Database (KID), Medical Expenditure Panel Survey (MEPS), and National Quality Measures Clearinghouse™ (NQMC) along with research results about asthma in children and adolescents. AHRQ is the health services research arm of the Department of Health and Human Services (DHHS). Resources include

  Asthma care quality improvement: A resource guide for state action. (2006). Released in partnership with the Council of State Governments, this guide has a companion workbook.

  Chronic care for low-income children with asthma: Strategies for improvement. (2005).

  Closing the quality gap: A critical analysis of quality improvement strategies. Asthma care. (2007).

  Using established initiatives to reduce disparities in pediatric asthma. (2005).

• Allies Against Asthma (AAA). Provides information about programs to improve asthma care for children and adolescents and asthma action plans, asthma education materials, tools for assessing asthma education materials, contact information for community asthma coalitions around the country, and a database of asthma resources. AAA is a national demonstration project funded by The Robert Wood Johnson Foundation. AAA's national program office is located at the University of Michigan School of Public Health. Resources and initiatives include

  Asthma Health Outcomes Project. Offers information and resources about this study, funded by the Environmental Protection Agency (EPA), to better understand factors associated with successful asthma programs for children, adolescents and adults. The Preliminary field report (2006) presents the results of preliminary data analyses of more than 500 asthma programs worldwide to determine the kind of interventions being provided to patients and their families and health professionals, the challenges that program providers face in implementing their interventions, and the factors that help make programs successful.

  Physician Asthma Care Education Program (PACE). Provides a set of seminar materials that have been developed and tested for widespread replication to improve physician awareness, attitudes, ability, and application of communication and therapeutic skills for asthma.

  Also see AAA's OAS+.

• American Academy of Allergy, Asthma and Immunology (AAAAI). Contains fact sheets for families about asthma, a guide to asthma medications, an asthma action plan, an allergist and immunologist directory, Spanish-language resources, training information, and other materials about pediatric asthma for families and health professionals. Resources include

  Tips to remember: Childhood asthma. (2006).

  Also see AAAAI's National Allergy Bureau (NAB).

• American Academy of Pediatrics (AAP): Section on Allergy and Immunology. Offers information about books, brochures, and other resources for families about caring for children and adolescents with asthma. Contains information for health professionals that includes educational programs, policy statements, advocacy efforts, and reference guides. Also see AAP's program, Schooled in Asthma.
  
  
• American Lung Association (ALA). Contains fact sheets, data, program descriptions, information about asthma camps, and other resources about the prevention, diagnosis, management, and treatment of asthma in children and adolescents. Recent publications and initiatives include

  Asthma medications for kids. (2006).

  State of the air. (2007). This report provides state and county air quality assessments and includes data about pediatric asthma patients and other groups who are most vulnerable to ozone and particle pollution.

  Trends in asthma morbidity and mortality 2006. (2006).

  Also see ALA's Asthma-Friendly Schools Initiative (AFSI).

• Asthma and Allergy Foundation of America (AAFA). Offers information about pediatric asthma for families, health professionals, and school personnel. Resources include fact sheets, brochures, posters, asthma action plans and cards, information about asthma education programs, contact information for AAFA chapters and asthma support groups, and electronic newsletters. Some materials are available in Spanish. Recent publications include

  Ethnic disparities in the burden and treatment of asthma. (2005).

• Center for Health Care Strategies (CHCS). Contains program information and publications about two initiatives to improve asthma care for Medicaid and State Children's Health Insurance Program enrollees: Best Clinical and Administrative Practices: Achieving Better Care for Asthma and Improving Asthma Care for Children Program. Also provides asthma education materials for health professionals and patients with asthma and families of children with asthma. CHCS is a nonprofit policy resource center that promotes high-quality health care services for low-income populations and people with chronic illnesses and disabilities. Recent publications include

  Bronx Improving Asthma Care for Children Project. (2006). This paper describes a collaborative effort to address the widespread problem of childhood asthma in New York City by establishing an early detection, early intervention process coupled with state-of-the-art pediatric asthma treatment methods and community- and home-based family education.

  Improving asthma care for children: Best practices in Medicaid managed care. (2006). This toolkit presents strategies for improving asthma care tested by a diverse group of health plans and states serving Medicaid consumers.

• Centers for Disease Control and Prevention (CDC). Offers a wealth of resources about asthma in children and adolescents:

  CDC's Morbidity & Mortality Weekly Reports (MMWR). Presents data based on weekly reports to CDC by state health departments. Recent reports about asthma in children and adolescents include

  • QuickStats: Percentage of children aged <18 years who have ever had asthma diagnosed, by age group -- United States, 2003. (2005).
    
    
  • QuickStats: Percentage of children aged <18 years with current asthma, by race/ethnicity and sex -- United States, 2001-2004. (2006).
    
    
  • Reducing childhood asthma through community-based service delivery -- New York City, 2001-2004. (2005).
    
    
  • Self-reported asthma among high school students -- United States, 2003. (2005).

  CDC's National Center for Health Statistics (NCHS). Provides asthma-related data from several sources including the National Asthma Survey. Recent publications include

  • Fastats: Asthma. (2006).
    
    
  • Asthma prevalence, health care use and mortality, 2002. (2006).
    
    
  • Also see the NCHS databases, Data2010 and Health Data for All Ages (HDAA).

  CDC's Public Health Training Network. Contains distance-learning resources for public health professionals, including several about asthma.

  Also see CDC's Healthy Youth! Asthma and CDC's National Center for Environmental Health (NCEH).

• Childhood Asthma Research and Education (CARE) Network. Offers information about clinical trials for evaluating treatments for children with asthma. CARE is sponsored by the National Heart, Lung, and Blood Institute (NHLBI).
  
  
• Community Asthma Prevention Program of Philadelphia (CAPP). Contains information about its community asthma education classes, home visitor program, asthma workshops for school personnel, and primary care health professional asthma education classes. Resources include tools and teaching materials, home visitor assessment forms, and consumer education materials, some of which are available in Spanish. CAPP is a service of the Children's Hospital of Philadelphia.
  
  
• Healthy People 2010. Offers information about this national health-promotion and disease-prevention initiative created by a broad coalition of experts from many sectors to improve the health of all Americans, eliminate disparities in health, and improve years and quality of healthy life. The initiative addresses 467 objectives in 28 focus areas. Focus area 24 addresses respiratory diseases including asthma, and a related focus area addresses environmental health. Healthy People 2010 contains background information on the initiative; the complete text (online and searchable), Healthy People 2010: Understanding and improving health, 2nd ed. (2000); data; a list of the Healthy People partners and related sites; and other Healthy People publications. It is coordinated by the Office of Disease Prevention and Health Promotion (ODPHP). Also see the HP2010 Information Access Project for access to published literature related to the Healthy People 2010 objectives about asthma and other respiratory diseases.
  
  
• MCH Training Program: Pediatric Pulmonary Centers. Offers contact information and links to curricula for these seven centers working to prepare health professionals to develop or improve community-based, family-centered health care for children with chronic respiratory diseases, such as asthma. The training program is part of the Maternal and Child Health Bureau (MCHB).
  
  
• National Heart, Lung, and Blood Institute (NHLBI). Contains a wealth of resources about asthma for health professionals, consumers, and education and child care professionals. NHLBI is part of the National Institutes of Health (NIH). In addition to electronic news services, initiatives include

  Asthma Clinical Research Network (ACRN). Contains information about clinical trials for evaluating new and existing therapeutic approaches for asthma and to disseminate laboratory and clinical findings to the health care community.

  National Asthma Education and Prevention Program (NAEPP). Provides resources aimed at enhancing the quality of life for those with asthma and decreasing asthma-related morbidity and mortality. Publications include

  • Expert panel report 3: Guidelines for the diagnosis and management of asthma. (2007).
    
    
• National Initiative for Children's Healthcare Quality (NICHQ): Asthma. Offers tools for improving the quality of care given by health professionals to pediatric asthma patients. Resources include outcome and process measures, a package for translating the recommendations of the NAEPP practice guidelines into practical steps for primary care practices, and asthma management plans, forms, and tips for care. Some of the tools solicit parent and school involvement in monitoring asthma and in the distribution of asthma medication. NICHQ is dedicated to improving the quality of health care provided to children and adolescents.
  
  
• National Institute of Allergy and Infectious Diseases (NIAID). Offers fact sheets and news releases in addition to information about research activities for asthma and allergic diseases. NIAID is part of the National Institutes of Health (NIH).
  
  
• New England Asthma Regional Council (ARC). Contains conference, workshop, and program information and a wealth of resources on topics that include asthma surveillance, clean buses, environment, housing, schools, pest management, and asthma plans. ARC aims to reduce the impact of asthma across New England, through collaboration with health, housing, education, and environmental organizations with particular focus on the contribution of schools, homes, and communities to the disease and with attention to its disproportionate impact on populations at greatest risk. Recent publications include

  Burden of asthma in New England. (2006).

  Connecting asthma from the clinic to the community: A role for public health departments. (2006). [Symposium proceedings].

  Enhancing asthma management using in-home environmental interventions: A review of public health department programs. (2006).

  Regional solutions to preventing asthma onset and severity. (2006).

• New York City Department of Health and Mental Hygiene: Childhood Asthma Initiative. Offers a wealth of information for health professionals and families about asthma in children and adolescents. Resources include tools for asthma self- and family management, asthma educational materials, medication fact sheets, school medication forms, statistics, and information about public health programs and partnerships in schools, child care centers, and neighborhoods. Initiatives include

  Creating a Medical Home For Asthma: An Asthma Management Program for Healthcare Providers. Presents training materials for this asthma management program that encourages public health clinics to implement a team-based approach to pediatric asthma management and care in an effort to improve adherence to the NHLBI guidelines for the diagnosis and management of asthma.

  
  

Additional Electronic Publications

• Babey SH, Meng YY, Brown EF, Hastert TA. 2006. Nearly six million Californians suffer from asthma symptoms or asthma-like breathing problems. Los Angeles, CA: UCLA Center for Health Policy Research. This policy brief describes the prevalence of asthma and asthma-like breathing problems in California, particularly among young children, African Americans, and American Indian/Alaska Natives. The brief also details the differences among California counties in terms of asthma symptoms and other asthma-like breathing problems and concludes with policy recommendations.
  
  
• Delaware Department of Health and Social Services, Delaware Department of Natural Resources and Environmental Control. 2005. Burden of asthma in Delaware 2005. New Castle, DE: Delaware Department of Health and Social Services, Delaware Department of Natural Resources and Environmental Control. This report details the prevalence of asthma among children, adolescents, and adults living in Delaware, the health care and economic impacts of asthma, environmental factors, and what's being done and needs to be done in Delaware to address the problem.
  
  
• Harknett K. 2005. Children's elevated risk of asthma in unmarried families: Underlying structural and behavioral mechanisms. Princeton, NJ: Center for Research on Child Wellbeing. This paper uses longitudinal data from the Fragile Families and Child Wellbeing study to provide evidence on the mechanisms underlying the relationship between family structure and children's asthma.
  
  
• New York Academy of Medicine (NYAM). 2006. Asthma detection and treatment program is helping thousands of inner-city youth in New York and could be expanded nationally. New York, NY: New York Academy of Medicine. This press release describes a successful and inexpensive program to identify and treat preschool children with asthma.
  
  
• New York Academy of Medicine (NYAM). 2006. Influenza vaccines commonly recommended for children with asthma and other chronic medical conditions, but infrequently given. New York, NY: New York Academy of Medicine. This press release reports that parents of children with asthma are more likely to have their children vaccinated against the flu when their pediatricians recommend it.
  
  
• Partnership for Solutions. 2004. Asthma: The impact of multiple chronic conditions. Baltimore, MD: Partnership for Solutions. This brief presents facts and charts depicting the age distribution of people with asthma, people with asthma and other chronic conditions, and the costs of asthma.
  
  
• St. Louis Regional Asthma Consortium. 2005. Our report to the community. St. Louis, MO: St. Louis Regional Asthma Consortium. This report describes the efforts of a consortium to help reduce the burden of asthma in the St. Louis area
  

  
  

Databases

The databases listed below are excellent tools for identifying data, additional literature and research, and programs about asthma in children and adolescents. Many of the entries below contain tips on how to use the databases efficiently. Please note that databases vary in how terms should be entered; for example, some require quotation marks and others don't. Enter search phrases as shown in bold below.

Data

• Child Trends DataBank: Asthma. Contains data about asthma in children and adolescents including its prevalence, trends, and differences by gender, race and ethnicity, age, poverty status, type of insurance coverage, and welfare/Temporary Assistance for Needy Families recipient. Child Trends is a nonprofit, nonpartisan research organization providing research and data to inform decision-making that affects children and adolescents.
  
  
• Data2010: The Healthy People 2010 Database. Contains the most recent monitoring data for tracking Healthy People 2010. To obtain data on the topic, click on the field, Data by Focus Area. Under the field, Select a Focus Area, choose 24 - Respiratory Diseases from the pop-up menu. Next, click on the button for Include Related Objectives From Other Focus Areas in the Table. Click on the Submit button. This data set is provided by the National Center for Health Statistics (NCHS) via CDC Wonder.
  
  
• Data Resource Center for Child and Adolescent Health (DRC). Provides access to and use of data from the National Survey of Children's Health, 2003, and the National Survey of Children with Special Health Care Needs, 2001. Users can search and compare results on over 100 indicators of child health and well-being; view state and regional profiles on key measures; explore survey content relevant to Healthy People 2010 objectives; and compare findings at all levels for children by age, race and ethnicity, income, or health status. Several health indicators address asthma. DRC is a project of the Child and Adolescent Health Measurement Initiative (CAHMI).
  
  
• Health Data for All Ages (HDAA). Presents data tables that provide CDC health statistics for infants, children, adolescents, adults, and older adults. Customize tables by age, gender, race/ethnicity, and/or geographic location. To identify data about asthma in children and adolescents, type asthma in the Search Tables box and click on GO. HDAA is a service of the National Center for Health Statistics (NCHS). The data used to create these tables originate from the Behavioral Risk Factor Surveillance System, the National Health Interview Survey, the National Hospital Ambulatory Medical Care Survey, the National Hospital Discharge Survey, the National Health and Nutrition Examination Survey, and the birth and mortality components of the National Vital Statistics System.
  
  
• Kids' Inpatient Database (KID). Contains data from 2 to 3 million hospital discharges of children and adolescents in the United States that researchers, policymakers, and others can use to identify, track, and analyze national trends in children's health care utilization, access, charges, quality, and outcomes. KID provides data on children and adolescents hospitalized with asthma. KID may be purchased for $200 for each year produced. For general descriptive statistics on asthma admissions in KID, access

  HCUPnet. Provides access to health statistics and information on hospital stays at the national, regional, and state level. To identify data about asthma admissions in KID, select National and Regional Statistics on Children Only from KID. Select Researcher, medical professional. Under type of query, select Statistics on specific diagnosis or procedures. Select a year (e.g., 2003). Select Diagnoses grouped by Clinical Classifications Software (CCS). Select Principal diagnosis. Under the field, Enter the name of a diagnosis to search for the category, type 128 Asthma and click on Search. Under CCS Diagnosis Category Selection, highlight 128 Asthma and click on Next. Select the outcomes and measures of interest (e.g., Number of discharges) and click on Next. Select patient and hospital characteristics (e.g., All patients in all hospitals) and click on Next. View your results. HCUPnet is part of the Healthcare Cost and Utilization Project (HCUP) of the Agency for Healthcare Research and Quality (AHRQ).

• Medical Expenditure Panel Survey (MEPS). Contains data on the specific health services that Americans use, how frequently they use them, the cost of these services, and how they are paid for, as well as data on the cost, scope, and breadth of private health insurance held by and available to the U.S. population. Data is collected about chronic conditions, such as asthma. MEPS is sponsored by the Agency for Healthcare Research and Quality (AHRQ). Analyses include

  Asthma treatment: Use of medications and devices, 2000. (2003).

  Children living with adult smokers, United States, 2004. (2006).

• National Quality Measures Clearinghouse™ (NQMC). Contains evidence-based health-care-quality measures and measure sets for physicians, hospitals, and health plans to evaluate and improve the quality of health care for consumers. Identify measures about asthma in children and adolescents by entering asthma in the Disease/Condition field of the detailed search form. Scroll down on the search form to select Age Range (e.g., Adolescent, Child, Infant). Hold down the control key (ctrl) or Apple command key and click your mouse to make multiple selections. The database is sponsored by the Agency for Healthcare Research and Quality (AHRQ).
  
  
• Title V Information System (Title V IS). Contains data from annual Title V Block Grant applications and reports submitted by all 59 U.S. states and jurisdictions. To learn about states' efforts to address asthma in children and adolescents, conduct two searches. Select Measurement and Indicator Data and go to the State Data section. Select State Priority Needs Keyword Search and choose Keyword: Asthma and Population: Children (1 through 21). Click on Start Search to get your results. Go back to the home page and select Measurement and Indicator Data. Under State Data, select State Performance Measures and click on Search by Keyword/Population. Select Keyword: Asthma and Population: Children (1 through 21). Click on Start Search to get your results. Title V IS is a service of the Maternal and Child Health Bureau (MCHB).
  
  
• Also see CDC's Morbidity & Mortality Weekly Reports (MMWR) and CDC's National Center for Health Statistics.
  

Literature and Research Databases

• Allies Against Asthma (AAA) Resource Bank. Contains information on consumer education materials about asthma, resources to help implement asthma intervention programs, instruments for measuring asthma-related activities or outcomes, and materials for developing and sustaining effective community coalitions. AAA is a national demonstration project funded by The Robert Wood Johnson Foundation. Its national program office is located at the University of Michigan School of Public Health.
  
  
• ClinicalTrials.gov. Provides access to information about clinical research studies for a wide range of diseases and conditions, including asthma. Included are a summary of the purpose of the study, recruiting status, criteria for patient participation, location of the trial, and contact information. To identify asthma-related studies, enter asthma in the search field. ClinicalTrials.gov is a service of the National Institutes of Health (NIH) and is developed by the National Library of Medicine (NLM).
  
  
• Cochrane Database of Systematic Reviews. Presents systematic reviews of health care interventions internationally. Type asthma in the Search the abstracts field and click on Search Reviews to access the abstracts of reviews on asthma. Access to the full-text article requires a subscription that is available in many hospital and university health sciences libraries. The database is published by the Cochrane Collaboration, an international nonprofit organization based in the United Kingdom.
  
  
• Computer Retrieval of Information on Scientific Projects (CRISP). Contains information about federally funded biomedical research projects conducted at universities, hospitals, and other research institutions. Search CRISP to identify scientific concepts, emerging trends and techniques, or specific projects and/or investigators. Type asthma in the search term box of the Query Form. and click on Submit Query to get your results. The database is maintained by the Office of Extramural Research at the National Institutes of Health (NIH).
  
  
• Database of Abstracts of Reviews of Effects (DARE). Contains summaries of systematic reviews that have met strict quality criteria. Included reviews must be about the effects of interventions. Each summary also provides a critical commentary on the quality of the review. Type asthma in the search field and click on Search to identify abstracts about asthma. DARE is produced and maintained by the Centre for Reviews and Dissemination at the University of York.
  
  
• HP2010 Information Access Project: Respiratory Diseases. Provides an automatic search mechanism for published literature indexed in PubMed related to the Healthy People 2010 objectives about asthma and other respiratory diseases. Also links to the narrative for each objective and the complete chapter about respiratory diseases in the text, Healthy People 2010: Understanding and improving health, 2nd ed. (2000). This service is provided by the Partners in Information Access for the Public Health Workforce, a collaboration of federal agencies, public health organizations, and health sciences libraries.
  
  
• Maternal and Child Health Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University. Maintains several databases to collect, manage, and disseminate knowledge about maternal and child health (MCH), with special emphasis on knowledge gained from initiatives and programs supported by the Maternal and Child Health Bureau (MCHB). The library's bibliographic database is

  MCHLine^®. Comprises an online catalog of materials in the Maternal and Child Health Library with several items about asthma. To identify them, type asthma in the keyword field of the database search form. To narrow your search, enter a single publication year or range of years, or add another keyword (e.g., school).

  The Maternal and Child Health Library also offers organizations and programs databases.

• National Guideline Clearinghouse (NGC). Contains evidence-based clinical practice guidelines and related materials for health professionals. Identify guidelines about asthma in children and adolescents by entering asthma in the Disease/Condition field of the detailed search form. Scroll down on the search form to select Age of Target Population (e.g., Adolescent, Child, Infant). Hold down the control key (ctrl) or Apple command key and click your mouse to make multiple selections. The database is an initiative of the Agency for Healthcare Research and Quality (AHRQ).
  
  
• PubMed. Contains over 17 million citations for biomedical articles that date back to the 1950s. These citations are from MEDLINE and additional life sciences journals. PubMed includes links to sites providing full-text articles and other related resources. To identify articles on the topic, enter the term asthma in the search box. Then, click on Limits and make the following selections on the page: select a date (e.g. Published in the last 2 years); click on Humans; click on Languages: English; click on Ages: All Child; and select Tag Terms: MeSH Major Topic. Add search terms to further limit the search (e.g., asthma AND patient education, asthma AND school health services, asthma AND nutrition). PubMed is a service of the National Library of Medicine (NLM).
  
  
• Also see the CHE Toxicants and Disease Database, the Educational Resources Information Center (ERIC) Database, the Household Products Database, the National Healthy Housing Clearinghouse, and the State Level School Health Policies Database.
  

Programs Databases

• Bureau of Primary Health Care (BPHC) Service Delivery Sites. Offers contact information for community health centers that provide free or low-cost care to underserved populations. The database is searchable by geographic area, clinic name, and type of service provided.
  
  
• Maternal and Child Health Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University. Maintains two databases to identify organizations and programs focusing on asthma in children and adolescents:

  MCH Organizations Database. Lists over 2,000 government, professional, and voluntary organizations involved in MCH activities, primarily at a national level. To identify asthma-related organizations, type asthma in the keyword field of the database search form.

  MCH Projects Database. Comprises an online catalog of projects funded by the Maternal and Child Health Bureau (MCHB) through October 1, 2002. To identify projects related to asthma in children and adolescents, type asthma in the abstract field of the database search form. Conduct a second search by typing "pediatric pulmonary center" in the abstract field of the database search form. These centers aim to develop physician, nursing, social work, and nutrition leaders who will improve the health of children and adolescents with chronic respiratory conditions. Also see MCH Training Program: Pediatric Pulmonary Centers.

• Also see Allies Against Asthma (AAA), the Asthma and Allergy Foundation of America (AAFA), the Center for Health Care Strategies (CHCS), the Community Asthma Prevention Program of Philadelphia (CAPP), MCH Training Program: Pediatric Pulmonary Centers, and the New York City Department of Health and Mental Hygiene: Childhood Asthma Initiative.
  

  
  

Electronic Newsletters

• Allergy & Asthma ADVOCATE. This quarterly newsletter contains articles for patients and families about managing asthma and allergies. The newsletter is published by the American Academy of Allergy, Asthma and Immunology (AAAAI).
  
  
• Asthma and Allergy Foundation of America (AAFA). Offers three electronic newsletters for families, individuals, and health educators about managing asthma and allergies.
  
  
• National Heart, Lung, and Blood Institute (NHLBI). Offers three electronic news services about heart, lung, blood, and sleep disorders:

  FYI from the NHLBI. This electronic newsletter is published three times a year and contains public interest news items on topics that include asthma.

  NHLBI Health Information Network. This e-mail news service for health professionals contains announcements about NHLBI's research findings, clinical advisories, programs, and educational materials.

  NHLBI Research and Policy Update. This electronic bulletin provides e-mail updates for researchers about funding opportunities, policy updates, training programs, meetings, and press releases.

  
  

Resources for Families

• Allergy and Asthma Network, Mothers of Asthmatics (AANMA). Gives families information about asthma and allergies. Families can learn about indoor air quality and asthma, how to make sure people with asthma get the right medications, and how to make sure students get their asthma medications at school. AANMA offers a toll-free helpline Monday-Friday from 9:00 a.m. to 5:00 p.m. Eastern time ((800) 878-4403). Other resources include

  Breatherville, USA. This is an online town where families can learn about allergies and asthma.
  

• AsthmaMoms. Gives families links to information about asthma triggers, medications, laws, camps, and other topics. Information is written in English and Spanish.
  
  
• Breath of Life. This is an online exhibition about asthma. Learn about the history of asthma, people who have asthma, and how medical experts are trying to learn more about asthma.
  
  
• Consortium on Children's Asthma Camps. Offers information about teaching children and teens about taking care of their asthma. Includes an asthma action plan, camp directory, and information about asthma camps.
  
  
• Healthy Roads Media: Asthma. You can read about asthma, listen, or watch a video. The information is in English, Russian, Spanish, and Vietnamese.
  
  
• MEDLINEplus: Asthma in Children. Gives links to information about asthma in children and teens. This list is also in Spanish.
  
  
• These Web sites also have information for families: Allies Against Asthma (AAA), the American Academy of Allergy, Asthma and Immunology (AAAAI), the American Academy of Pediatrics (AAP), the American Lung Association (ALA), the Asthma and Allergy Foundation of America (AAFA), the Center for Health Care Strategies (CHCS), the Community Asthma Prevention Program of Philadelphia (CAPP), the Environmental Protection Agency (EPA), the National Heart, Lung, and Blood Institute (NHLBI), the National Institute of Allergy and Infectious Diseases (NIAID), the New England Asthma Regional Council (ARC), the New York City Department of Health and Mental Hygiene: Childhood Asthma Initiative, and Tox Town.
  

  
  

Special Topics

Asthma and Environmental Triggers

• AIRNow: Quality of Air Means Quality of Life. Provides access to national air quality information including daily forecasts as well as real-time conditions for over 300 cities across the United States. Also offers publications about air quality and health. AIRNow is a collaborative effort among several federal agencies, news media, and tribal, state, and local agencies.
  
  
• Association of State and Territorial Health Officials (ASTHO): Children's Environmental Health. Offers information about a state asthma initiative called Catching Your Breath, a collaboration between ASTHO and the Environmental Council of the States (ECOS). Also offers resources about building a national environmental health tracking system. Publications include

  Catching Your Breath -- Implementation to address childhood asthma: Three state experiences. (2006).

  Catching your breath: Strategies to reduce environmental factors that contribute to asthma in children. (2003). This report identifies steps states can take to address asthma in children in indoor home environments, in schools and child care centers, and in outdoor environments. It is intended to serve as a blueprint for state action to address environmental factors that contribute to asthma in children. An executive summary is available. A program update was published in 2006.

  Tracking childhood asthma with school data in three states. (2006).

• Centers for Disease Control and Prevention (CDC): National Center for Environmental Health (NCEH): Asthma. Contains information about CDC's asthma control programs, including those that relate specifically to children and adolescents. Also offers information about asthma data and surveillance, effective interventions, and links to additional asthma-related resources for health professionals and families. Initiatives include

  National Asthma Control Program. Provides information about and resources for this program designed to support the goals and objectives of Healthy People 2010 for asthma: reduce the number of deaths, hospitalizations, emergency department visits, school or work days missed, and limitations on activity due to asthma. Includes contact information for state program grantees and nonfunded asthma contacts.

• CHE Toxicant and Disease Database. Summarizes links between chemical contaminants and approximately 180 human diseases or conditions. Click on Asthma - allergic or Asthma - irritant to identify the contaminants that can trigger an asthma attack in children, adolescents, or adults. This database is presented by the Collaborative on Health and the Environment (CHE).
  
  
• Clean Air Task Force (CATF). Contains reports, maps, and information about programs to address diesel emissions, power plant emissions, international air quality, and state actions in climate change solutions. CATF is a nonprofit organization dedicated to restoring clean air and healthy environments through scientific research, public education, and legal advocacy. Publications include

  An analysis of diesel air pollution and public health in America. (2005).

  Dirty air, dirty power. Mortality and health damage due to air pollution from power plants. (2004).

• Community Action to Fight Asthma (CAFA). Offers data, research findings, coalition development tools, program materials, and other resources about asthma in children and adolescents. CAFA is a network of asthma coalitions in California working to shape local, regional and state policies to reduce the environmental triggers of asthma for school-aged children where they live, learn, and play.
  
  
• Environmental Protection Agency (EPA): Asthma and Indoor Environments. Presents a wealth of information for health professionals, families, community advocates, and the media about childhood asthma and common asthma triggers indoors. Resources for families include fact sheets, brochures, materials for children, and checklists about how to eliminate asthma triggers in homes. Resources for health professionals include new asthma studies and materials for helping patients manage environmental asthma triggers. Also includes information about community outreach and education programs. Some materials are available in Spanish. Recent resources and initiatives include

  Asthma Awareness Month event planning kit. (2006). This kit contains material for planning community asthma education events for Asthma Awareness Month each May. The material can be adapted for other uses.

  Attack Asthma. Learn More. Offers facts for families about asthma and asthma triggers, an asthma action plan, and public service announcements for television, radio, and print media. Resources are available in English and Spanish.

  EPA's asthma research results highlights. (2005).

  Implementing an asthma home visit program: 10 steps to help health plans get started. (2005).

  Also see EPA's Healthy School Environments.

• Household Products Database. Links information for over 6,000 consumer brands to health effects from Material Safety Data Sheets (MSDS) provided by consumer product manufacturers. Researchers and consumers can search by product, chemical ingredient, or health effects as listed in the MSDS, including asthma. This database is a service of the National Library of Medicine (NLM).
  
  
• National Allergy Bureau (NAB). Reports on current pollen and mold spore levels from 78 counting stations throughout the United States and 3 counting stations in Canada. NAB is a service of the American Academy of Allergy, Asthma and Immunology (AAAAI).
  
  
• National Center for Healthy Housing (NCHH). Provides resources and program information for research and evaluation, technical assistance and training, and regulations and policies for public health and housing professionals to promote practical and cost-effective methods for making homes healthier. Topics include identifying and removing asthma triggers in the home. NCHH is supported by the Centers for Disease Control and Prevention (CDC), the Department of Housing and Urban Development (HUD), and the Environmental Protection Agency (EPA). Resources include

  Asthma and weatherization in Maine. (2006).

  National Healthy Housing Clearinghouse. Comprises an online catalog of journal articles, publications from federal agencies, and other materials about the connection between health and housing and safety hazards in the home. Type asthma in the keyword field and click on Search to identify publications on the topic.

  Pediatric Environmental Home Assessment: Tools for Public Health and Visiting Nurses. Offers two forms for public health and visiting nurses to use to identify potential environmental hazards in homes and to address those hazards. Also offers an online training module for conducting a pediatric environmental home assessment.

• National Children's Study. Contains information about this study to examine the effects of environmental influences on the health and development of more than 100,000 children and adolescents across the United States, following them from before birth until age 21. As part of the study, the Asthma Working Group will evaluate environmental factors that are associated with asthma. The National Institute of Child Health and Development (NICHD) and a consortium of federal agencies are conducting the study.
  
  
• National Institute of Environmental Health Sciences (NIEHS): Asthma Research. Contains information about several asthma research programs and related journal articles. NIEHS is part of the National Institutes of Health (NIH).
  
  
• Tox Town. Offers information for consumers in English and Spanish about the connections between chemicals, the environment, and the public's health. Click on the A-Z index and scroll to Asthma Triggers for information. Tox Town is a project of the National Library of Medicine.
  
  
• Also see the American Lung Association (ALA), Healthy People 2010, the New England Asthma Regional Council (ARC), and the New York City Department of Health and Mental Hygiene: Childhood Asthma Initiative.
  

Additional Electronic Publications About Asthma and Environmental Triggers

• Clapp R, Culver A, Donahue S, Fuller T, Hoppin P, Jacobs M, Sutherland L. 2006. Risks to asthma posed by indoor health care environments: A guide to identifying and reducing problematic exposures. Arlington, VA: Health Care Without Harm. This guide focuses on 11 key agents of concern as potential risk factors for asthma and recommends alternative practices and products that can decrease potential harm.
  
  
• Institute of Medicine (IOM). 2000. Clearing the air: Asthma and indoor air exposures. Washington, DC: National Academies Press. This book examines how indoor pollutants contribute to asthma in the general population and in sensitive subpopulations including children, low-income individuals, and urban residents. The book also evaluates the scientific basis for mitigating the effects of indoor air pollutants implicated in asthma and identifies priorities for public health policy, public education outreach, preventive intervention, and further research.
  
  
• Joint Center for Political and Economic Studies, PolicyLink. 2004. Breathing easier: Community-based strategies to prevent asthma. Washington, DC: Joint Center for Political and Economic Studies. This issue brief discusses how contributing causes of asthma, such as industrial air pollution, pesticide exposure, and poor air quality in schools and homes, can be reduced through a strong, community-centered approach that actively engages hospitals, clinics, schools, community-based organizations, and local leaders.
  
  
• Meng YY, Rull RP, Wilhelm M, Ritz B, English P, Yu H, Nathan S, Kuruvilla M, Brown ER. 2006. Living near heavy traffic increases asthma severity. Los Angeles, CA: UCLA Center for Health Policy Research. This policy brief examines the link between traffic-related air pollution and asthma severity.
  
  
• Office of the Surgeon General. 2006. Health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Rockville, MD: Office of the Surgeon General. This report provides a detailed review of the epidemiologic evidence on the health effects of involuntary exposure to tobacco smoke. The report addresses secondhand smoke's affects on children, including worsened asthma. An executive summary, a consumer education brochure, fact sheets, and a poster accompany the report.
  
  
• Steinzer R, Clune M. 2006. Paper tigers and killer air: How weak enforcement leaves communities vulnerable to smog. Washington, DC: Center for American Progress, Center for Progressive Reform. This report documents the paltry number of inspectors available to inspect permitted air pollution facilities, which in turn makes it more difficult to improve air quality and achieve compliance with the ozone standard. The public health consequences of higher ozone levels are outlined.
  

  
  

Asthma Management in School

• Allies Against Asthma (AAA): OAS+. Includes the Open Airways for Schools curriculum and materials to implement a school-based asthma program designed to improve health outcomes for children with asthma.
  
  
• American Academy of Pediatrics: Schooled in Asthma. Offers information about and tools to support this training program encouraging pediatricians to incorporate school health concepts with current asthma treatment guidelines. Contains tools and forms to obtain an accurate asthma history based on symptoms both at home and school, facilitate communication between school personnel and pediatricians, and provide the child, parent, and school with information about a child's medication program, along with guidance as to what to do if the child's asthma worsens. Schooled in Asthma is a project of the American Academy of Pediatrics (AAP) under a cooperative agreement with the Centers for Disease Control and Prevention (CDC).
  
  
• American Lung Association (ALA): Asthma-Friendly Schools Initiative (AFSI). Offers resources to develop a comprehensive asthma management program in schools.
  
  
• Centers for Disease Control and Prevention (CDC): Healthy Youth! Asthma. Contains school health policies and program information, statistics, guidelines, and other resources addressing asthma in schools. Recent publications include

  Addressing asthma in schools, rev. ed. (2006).

  School Health Index (SHI). Comprises a self-assessment and planning tool to enable schools to identify the strengths and weaknesses of health promotion policies and programs and to assist schools in developing an action plan for improving the school environment. The SHI includes a section on asthma.

  Strategies for addressing asthma within a coordinated school health program, rev. ed. (2004).

• Educational Resources Information Center (ERIC) Database. Covers all aspects of education-related issues through journal articles, research reports, teaching guides, curricula, conference papers, and books. To identify resources on the topic, type asthma in the Search Term(s) box. Click on the Search button to get your results. Click on Search Within Results to narrow your search. ERIC is sponsored by the Department of Education.
  
  
• Environmental Protection Agency (EPA): Healthy School Environments. Offers self-assessment tools and other online resources to help school districts address environmental health issues in schools. Topics include asthma.
  
  
• National Association of School Nurses (NASN). Offers professional education program information and resources for school nurses about asthma management and awareness. NASN collaborated with the American Academy of Pediatrics (AAP) and 30 other organizations in the development of the Health, mental health and safety guidelines for schools (2004), which addresses asthma management, among other topics.
  
  
• National Association of State Boards of Education (NASBE). Offers policy guides and best-practice model policy language on school health topics that include asthma. Resources and recent publications include

  School indoor air quality. (2005).

  State Level School Health Policies Database. Comprises a collection of state policies in key areas of school health policy, such as asthma management. Click on Policies by Topic and select Asthma Awareness Education, or scan the list to select a broader topic that affects children and adolescents with asthma (e.g., Indoor Air Quality).

  Summary and analyses of state policies on asthma education, medications, and triggers. (2005).

• Taras H, Duncan P, Luckenbill D, Robinson J, Wheeler L, Wooley S, eds. 2004. Health, mental health and safety guidelines for schools. Elk Grove Village, IL: American Academy of Pediatrics; Castle Rock, CO: National Association of School Nurses. This online compendium is designed to help community and school leaders determine the breadth of school health, mental health, and safety issues and set priorities for future action. The compendium was developed by health, education, and safety professionals from more than 30 different national organizations; parents; and other collaborators with support from the Maternal and Child Health Bureau (MCHB). The compendium draws upon published guidelines on specific components of school health and safety programs and on overall coordination of these programs. Topics include asthma.
  
  
• Also see the Asthma and Allergy Foundation of America (AAFA), the Community Asthma Prevention Program of Philadelphia (CAPP), the National Heart, Lung, and Blood Institute (NHLBI), the New England Asthma Regional Council (ARC), the New York City Department of Health and Mental Hygiene: Childhood Asthma Initiative, and PubMed.
  

  
  

Author: Susan Brune Lorenzo, M.L.S., Maternal and Child Health Library.
Reviewers: Elizabeth M. Klements, M.S., A.P.R.N., B.C., A.E.-D., Children's Hospital Boston; Olivia Pickett, M.A., M.L.S., Maternal and Child Health Library; Elizabeth R. Woods, M.D., M.P.H, Harvard Medical School and Children's Hospital Boston.