Please select the eligibility criteria that correspond to the clinical trial below.
Title: Using the Telephone to Improve Care in Childhood Asthma
Brief Summary: Asthma is the most common chronic disease of childhood and a major cause of morbidity in the United States. If asthma symptoms are controlled, a child with asthma can stay well and lead a normal life. Daily use of inhaled steroids controls symptoms and reduces morbidity and emergent health care utilization in children with persistent asthma, and is safe for long-term use. However, inhaled steroids are underused in community asthma care.

The Telephone Asthma Program (TAP) is a series of brief, telephone calls with a trained coach to help the parent manage the child's asthma care. The coach will teach self-management skills, help the parent to use the child's asthma medicines effectively, provide support and remind the parent to go for follow-up care with the pediatrician. We hypothesized that the Telephone Asthma Program will reduce the incidence of acute exacerbations of asthma that require emergent care, improve the quality of life of children with asthma and their parents, and increase the daily use of inhaled steroids in children with persistent asthma. We evaluated the Telephone Asthma Program in a randomized controlled trial involving 362 children aged 5 to 12 years old cared for by community pediatricians. Eligible children were randomized to the TAP program or usual care by their pediatrician.


Options:
A: Inclusion Criteria:

* Physician diagnosis of asthma for at least a year
* At least one acute exacerbation of asthma in past 12 months that required a visit to the emergency department, hospitalization or an unscheduled office visit for acute care and/or a course of oral steroids.
* Taking daily controller medications or symptoms consistent with persistent asthma

Exclusion Criteria:

* No phone
* Unable to speak English
* Child has another disease that requires regular monitoring by pediatrician
* A sibling is already enrolled in the study
* Child's primary asthma provider is an asthma specialist
B: Inclusion criteria:

A. The child of the parent/caregiver has a diagnosis of asthma made by a physician and reported by the parent, or diagnosis of asthma made during the ED visit if the child has experienced two previous wheezing episodes.

B. The child will undergo treatment during the enrollment ED visit for the current asthma exacerbation, as determined by the treating ED clinician. As a result, only parents/caregivers with children experiencing a significant wheezing episode will be entered into the study.

C. The child is 2-10 years of age (second birth date until, but not including, eleventh birth date).

D. The child has Medicaid or no medical insurance. This criterion permits easy identification and selection of low-income children/families, who are the target population for this proposal.

E. The parent/caregiver has a working telephone at home. F. The child attends one of the target practices (7 private practices and 5 federally funded clinics) for routine care.

G. The parent/caregiver and child live within the St. Louis metro area.

Exclusion criteria:

A. The child attends a practice other than the target group. B. The parent/caregiver and child live outside of the St. Louis metro area. C. The child has a chronic illness other than asthma that manifests as wheezing or respiratory symptoms.

D. The parent/caregiver does not have a working telephone in home. E. The parent/caregiver is not able to effectively communicate in English.
C: Inclusion Criteria:

* Diagnosis of JPFS based upon widespread pain for over 3 months, at least 5 tender points, and associated features such as sleep difficulty, fatigue, and abdominal discomfort
* Average pain intensity greater than 4 on the Visual Analog Scale
* Functional disability score greater than 7
* Stable medications for 8 weeks prior to study entry

Exclusion Criteria:

* Other chronic rheumatic diseases, such as juvenile rheumatoid arthritis or lupus
* Significant developmental delay or impairments, such as autism, cerebral palsy, or mental retardation
* Present or lifetime psychiatric diagnosis that meets DSM-IV criteria for panic disorder, bipolar disorder, major depressive disorder, or psychosis
* Opioid medications are disallowed when used on an ongoing basis for treatment of fibromyalgia pain
D: Inclusion Criteria:

* a current hemoglobin A1c(HbA1c) of \>8.0%
* an average HbA1c of \>8.0% during the past year
* diagnosed with Type 1 diabetes for at least one year
* reside in the metro Detroit tri-county area

Exclusion Criteria:

* severe mental impairment/thought disorder
* non-English speaking patient/parent
* co-morbid major medical condition such as cystic fibrosis

Answer: A