Skip left side navigation and go to content
NAEPP Program Description
The National Asthma Education and Prevention Program (NAEPP) was initiated in March 1989 to address the growing problem of asthma in the United States. The goals of the NAEPP are to:
To accomplish these broad program goals, the NAEPP works with intermediaries including major medical associations, voluntary health organizations, and community programs to educate patients, health professionals, and the public. The ultimate goal of the NAEPP is to enhance the quality of life for patients with asthma and decrease asthma-related morbidity and mortality.
Asthma is a major public health problem in the United States. The disease affects approximately 15 million people, nearly 5 million of whom are under the age of 18. People with asthma experience well over 100 million days of restricted activity annually, and the total annual costs of the disease are estimated at $11.3 billion.
Although asthma mortality in the United States is among the lowest in the world, approximately 5,000 asthma-related deaths still occur each year in this country. Moreover, the asthma mortality rate has risen over the past 20 years or so, especially in African Americans and individuals age 85 and older. This increase is of particular concern because it comes at a time when mortality rates from most natural causes in the United States are on the decline.
Rising asthma prevalence, especially among children, is another cause for concern. Between 1980 and 1994, the prevalence of asthma in the United States increased 75 percent overall and 74 percent among those between the ages of 5 and 14. It is estimated that more than 7 percent of children now have the disease.
Also disturbing are the number and rate of asthma-related hospitalizations in this country. In 1994, 466,000 hospitalizations were directly related to the disease. The hospitalization rates since 1979 have increased disproportionately among children and African Americans. The rate of hospitalizations among African Americans was nearly triple that of whites in 1993-1994.
The reasons for the increases in morbidity seen with asthma are not clear. However, certain factors indicate that many asthma-related hospitalizations and deaths are preventable. For example, the patient may fail to avoid environmental factors that make asthma worse, recognize early warning signs of worsening asthma, appreciate the severity of an exacerbation, take appropriate medication, or get prompt medical help when problems occur. The clinician may fail to diagnose asthma, initiate appropriate therapy, adequately monitor the patient's condition, recognize serious exacerbations, or educate the patient to prevent symptoms and develop a crisis plan for emergencies.
These issues indicate the need for asthma educationfor both patients and health professionals. Such was the conclusion at a 1988 NHLBI-sponsored workshop titled Asthma Education: A National Strategy, which involved representatives for a number of lay and professional organizations interested in asthma. The recommendations made at this workshop, combined with the results of research demonstrating the benefits of asthma education on disease outcome, became the impetus for the development of the NAEPP and helped define the program's objectives.
For Patients and the Public
For Health Professionals
Since 1989, when the NAEPP began, much has been accomplished to meet the program's objectives. The first significant achievement was the development and wide distribution of the Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma. This report changed common perceptions about asthma and its treatment by emphasizing the role of inflammation in disease development, noting the importance of objective monitoring of lung function, and stressing the need for establishing partnerships between patients and health care providers through patient education.
Hundreds of thousands of copies of the report have since been distributed to physicians, medical schools, and other health professionals and organizations, as well as to patients with asthma. In 1992, the NAEPP sponsored the First National Conference on Asthma Management to encourage implementation of the recommendations in the report. The guidelines continue to be promoted at national health and medical association meetings and in a variety of journals.
A number of companion documents also have been developed for health professionals and patients. A practical guide with patient handouts was produced to facilitate patient education by clinicians. An easy-to-read booklet instructs patients how to control their asthma in collaboration with their health care providers. Separate guides have been prepared for emergency department personnel, pharmacists, and nurses. Specialized reports on asthma in pregnancy and asthma in the elderly were also developed. These materials and others are continually distributed through the NHLBI Information Network and a variety of other channels.
In 1997, an updated version of the guidelines was released. It builds upon the recommendations in the original report and, based on more recent scientific findings, adds recommendations for clinicians and patients about such important issues as the appropriate medications for controlling asthma and for relieving asthma symptoms, the use of allergy testing to identify perennial indoor allergens for some patients, the importance of reducing patient exposures to tobacco smoke, the need to treat suspected asthma in infants aggressively, and the value of using spirometry and peak flow monitoring in diagnosing and monitoring asthma.
Because children are significantly affected by asthma, a separate initiative is targeted to schools. A variety of materials have been produced not only to teach children with asthma and their parents about the disease, but also to educate school personnel about the important role they can play in children's ability to manage their disease at school.
In 1998, the NAEPP expanded its activities with intermediary organizations to focus on collaborative activities with the many community-based asthma coalitions that are growing up across the country. More than 40 local asthma coalitions were invited to a workshop in Washington in the fall to promote networking among these groups and to identify opportunities for the NAAEPP to support some of them. It is currently working to develop innovative performance-based interventions through selected local asthma coalitions to improve the way physicians manage asthma, to ensure that patients are taught effective self-management skills, and to promote programs and policies that support asthma-friendly environments.
The NAEPP also launched a Web site in December 1998 to provide a focal point through which local asthma coalitions can learn about each other's and the NAEPP's activities and exchange information. The Web site also provides virtually all the scientific literature on chronic asthma that has ever been published for physicians who want to provide the most up-to-date diagnostic and treatment methods for their asthma patients. It is located at .
Complementing all of these efforts has been a number of media campaigns to promote asthma awareness among the general public and to encourage undiagnosed patients to seek care. These messages have been targeted to African Americans and to Hispanics, who are at increased risk of asthma-related hospitalizations and deaths.
In addition to conducting asthma education and prevention activities, the NAEPP also contracts with other organizations to develop educational programs for minority populations.
NAEPP Coordinating Committee
Key to the success of the NAEPP is the participation of representatives from the major scientific, professional, governmental, and voluntary organizations interested in asthma. Members of the NAEPP Coordinating Committee not only provide input on program strategies and materials development, but also implement many activities through their organizations.
Member Organizations of the NAEPP Coordinating Committee
Allergy and Asthma Network/Mothers of Asthmatics, Inc.
Agency for Healthcare Research and Quality
Additional Representatives to the NAEPP School Asthma Subcommittee
American Association for Physical and Health
Education, Recreation, and Dance
For more information on the NAEPP, contact:
National Asthma Education and Prevention Program