Asthma Health Outcomes Project Overview Asthma is a major public health problem of increasing concern in the United States. In the past decade there have been significant advances in asthma management, giving most people with asthma the opportunity to live active and healthy lives. However, the number of new asthma cases has more than doubled in the last two decades, and many people continue to suffer from poorly-managed asthma.   In response to the increasing prevalence of asthma, recent years have seen a proliferation of programs and services aimed at improving the health and quality of life of people with asthma. To better understand factors associated with successful asthma programs, the Asthma Health Outcomes Project (AHOP) at the Center for Managing Chronic Disease, University of Michigan School of Public Health, was created and funded under a cooperative agreement with the Indoor Environments Division of the US Environmental Protection Agency.  The project developed and implemented a process to identify common themes and features of asthma programs that include an environmental component and have reported a positive impact on asthma-related health outcomes.   In an effort to reach beyond academic research programs to include local and community-based efforts, AHOP conducted an outreach effort that included literature searches as well as a broad nomination process.  Between 2003 and 2005, AHOP catalogued over 500 asthma programs throughout the U.S. and internationally, and surveyed the 223 programs that reported improving at least one asthma-related health outcome. Initial analyses found significant variance among the type and quality of evaluations reported.  To increase confidence in the findings, quantitative analyses focused on a subset of 111 programs that had evaluation results reported in peer-reviewed publications.  Bivariate relationships between programmatic factors and health outcomes were analyzed with chi-squared statistics using Fisher's exact tests (p<0.05). Odds ratios as estimates of the association between various program factors and health outcomes and 95 percent confidence intervals were obtained using unconditional logistic regression.   This analysis identified significant differences among programs that utilized pre-post evaluation designs and those that used other designs, including randomized controlled trials (RCT).  An additional analysis was therefore conducted among the 65 programs using RCT to confirm earlier results.  Odds ratios for these associations were calculated to determine which associations pointed in the same direction as those in the preliminary findings.  Results of these analyses suggest themes across programs that are more likely to report a positive impact on health outcomes.  These are that programs were: Community centered  Collaborative Clinically connected Responsive to need These themes were also evident in the qualitative analyses based on the complete dataset of 223 programs. In highlighting the strengths and challenges of their programs, respondents revealed the importance of having close ties with the community, collaboration, being connected with clinical care, and shaping for individual needs.  Analyses also demonstrated programs faced significant challenges working with low income populations and implementing rigorous evaluations that fit with their goals and resources.		Asthma Health Outcomes Project Overview Process Program Identification Data Collection Analyses Products Expert Panel FAQ   Download the final AHOP report