Asthma is the most common chronic illness of childhood and one of the leading health problems of children worldwide. U.S. minority groups are disproportionately affected by the burden of asthma. Studies have documented that particularly Puerto Ricans, have the highest rates of asthma, are more likely to die because of their asthma, and are more likely to be under-treated for asthma, as compared with other children. Poor management of asthma is related to high morbidity, hospitalization and emergency visits. This study intends to obtain better understanding of a set of beliefs, principles, and values about client involvement with Latinos, and to teach Latino patients skill-building techniques that help to think critically and ask the “right questions”, leading to the answers they need.

As part of the Research Core of the UPR-CHA Research Center of Excellence, this study, specifically addresses aim #3 of the Puerto Rico Pediatric Community Based Program (PACBP). The CALMA project is an evidenced-based educational intervention designed for families of asthmatic children to teach them how to better manage pediatric asthma.

The CALMA intervention has already be proven to be effective in improving asthma outcomes for asthmatic children between ages 5 to 12. This educational intervention uses an asthma counselor to visit families and teach them eight educational modules culturally-adapted and developed for Puerto Rican families. In this new proposed study CALMA will be further tested in a new Randomized Clinical Trial but in combination with an additional project known as “Respirando con CALMA” which is a separate intervention developed for health providers that treat these asthmatic children.

In Puerto Rico, 400 families will be recruited from 12 clinics in the Metro North Region. The sample will consist of families/parents that have a child or adolescent that has asthma symptoms within the last 4 weeks or 2 emergency room visits in the last 2 years.


Funding Acknowledgement

This work was supported by Grant NIH: 0160408, UPR/CHA Research Center of Excellence





To empower patients/families to communicate better to the primary care physician (PCP) about asthma


Intervention Materials (available only in Spanish)

Proyecto CALMA: A Visual Aid to Learn about Asthma

Proyecto CALMA: Parent’s Manual

Proyecto CALMA: Asma Instructor’s Manual

Proyecto CALMA (brochures)

  • What you should know about Asthma
  • Asthma and Food Allergies
  • How to take care of Equipment used to treat Asthma
  • Control or Maintainance Medication for Asthma
  • Rescue Medication for Asthma


Child’s Demographics and Medical History

  • History of Allergies
  • History of Significant Asthma Attacks

Asthma Knowledge

Child’s Quality of Life

Asthma Symptoms

Treatment of Asthma

  • Prescribed Medication
  • Home Remedies
  • Treatment Plan
  • Adherence to Treatment
  • Health Beliefs

Asthma Management

  • Judgment (Clark’s Measures of Self-Regulation)
  • Self-Efficacy for Accessing Physician
  • Asthma Triggers and Avoidance Techniques

Health Care Utilization

Barriers to Care

Relationship with Provider

  • Communication
  • Perception of Patient Provider Communication

Family Empowerment Scale – FES

Personal Health Questionnaire Depression Scale (PHQ-9)

Depression Scale (CES-D)