Asthma Health Outcomes Project |
A number of analyses, both quantitative and qualitative, were conducted using the data collected:
Findings from these analyses can be found in the AHOP final report.
Case Studies
A narrative description of each of the 223 programs was developed and can be found in Appendix B of the AHOP final report.
Descriptive Data of 223 Programs
Frequency tables in Appendix C of the AHOP final report were constructed for available quantitative survey responses to provide further description of the asthma programs reporting successful health outcomes.
Subgroup of Peer-Reviewed Programs
At the time of review, approximately half (n=111) of the eligible programs had results published in peer-reviewed publications. Quantitative analyses of these peer-reviewed programs were conducted to provide greater confidence in the overall results. All peer-reviewed articles on programs that met the initial AHOP inclusion criteria were included in these analyses. 
Bivariate relationships between programmatic factors and health outcomes were analyzed with chi-squared statistics using Fisher's exact tests (p<0.05). Odds ratios were calculated as estimates of the association between various program factors and health outcomes and 95 percent confidence intervals were obtained using unconditional logistic regression.
Outcome variables examined included improvement in various health care utilization measures, quality of life (QOL), school/work loss, behavioral changes, and clinical outcomes. Additional outcome variables were constructed that combined several related outcomes into summary measures for health care utilization, school and work loss, and QOL. These summary variables were examined in addition to the single health outcome variables for associations with program factors.
All analytic file construction and statistical analyses were performed using the SAS/PC program, version 8.2 (SAS Institute, Inc., Cary, North Carolina). Findings of variables significantly related to at least one of the health-related outcomes are included in the AHOP final report.
To facilitate comparison between the peer-reviewed programs and those not published in peer-reviewed literature, Appendix C of the final report includes tables with frequencies of quantitative responses for three groups of programs: peer-reviewed programs, programs not peer-reviewed, and all programs included in the study.
Subgroup of Peer-Reviewed Programs using Randomized Controlled Trial Evaluation
The analysis of the 111 peer-reviewed programs yielded interesting results related to evaluation design in that programmatic factors that indicated less rigorous evaluation methods (e.g., pre-post evaluation design) were associated with several positive health outcomes. To find out whether the results might be an artifact of the study design utilized, a subgroup of peer-reviewed programs that used a randomized control trial (RCT) evaluation (n=65) was examined to determine if the same associations were found among the programs with the most rigorous evaluation design.
Although the sample of the RCT programs (n=65) did not allow for detailed statistical comparisons, odds ratios were calculated for all factors that were shown to be significant among the broader population (n=111). The results confirmed most of the associations identified previously. Confirmed results are indicated in Section IV of the AHOP final report.
Qualitative Analyses of Open-ended Questions
Programs were asked to respond to open-ended questions related to program successes, barriers, and unintended impacts. Interviewers paraphrased respondents' answers and recorded direct quotes. Responses to these questions were categorized and a summary is presented in Section VI of the AHOP final report. A more comprehensive analysis was conducted on the unintended impacts reported, and a discussion of these results is in Section VII. Results from these qualitative analyses are also presented in the discussions that follow each group of findings from the quantitative analyses.
Other Analyses
Additional analyses explored results associated with variation in program approach, including whether the focus was on a single strategy or was comprehensive, and with intensity of interventions. An analysis of the subgroup of programs that reached low income participants was also conducted. These analyses did not yield findings different from those already observed.
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