A Second-Generation Model of Asthma Self-Management

The past two decades witnessed the proliferation of a number and variety of self-management programs for asthma, particularly for children and their families. Although there are methodologic weaknesses to many of these first-generation programs, it has been shown that the training of patients and their subsequent performance of self-management skills change morbidity indices of asthma in a significant and positive manner. The purpose of the present article is to describe directions a second-generation model of asthma self-management might take in the future. In particular, the article describes second-generation programs from three perspectives: designs of studies, dimensions of behavioral analysis, and assessment. Specific components of the model will improve future self-management programs and, in turn, enhance their value in allowing patients to become partners with their physicians in the control of asthma.