Through the following specific aims, the investigators will:
Aim 1: Assess the effectiveness of the new ambulatory care model, by comparing outcomes at the 1.a. child (child's quality of life (QOL), asthma control, missed school days), 1.b.parent (satisfaction, parent missed work days) and 1.c. clinic (ED/hospital visits) levels, between clinics randomly assigned to either the standard e-AT intervention vs. intensive e-AT intervention. 1.d. Use non randomized comparisons to determine the effectiveness of the e-AT relative to a control group (usual care) in which the e-AT was not used
Aim 2: Assess the association of QOL, asthma control, and ED/hospital admissions with the prior frequency of e-AT use and assess if the association differs between parent subgroups (high vs. low literacy, Medicaid vs. private insurance, and frequent vs. less frequent e-AT users).
Aim 3: Determine the association of demographic, socio-economic, behavioral, and technology factors with sustained parent participation in asthma self-management.
The outcome measures are:
Primary Outcome:
1. Child quality of life (QOL)
Secondary Outcomes:
2. Child asthma control
3. Child interrupted/missed school days
4. Child use of oral steroids (surrogate measure of an asthma exacerbation)
5. Parent satisfaction with care
6. Parent interruption/missed work days
7. Clinics: ED/Hospital admissions
