1. Exo/Community Level Influences
1.1. Poverty
1.2. Air quality and health disparities
1.3. Beliefs
1.3.1. Fear of side effects
1.3.1.1. Personal demands
1.4. Practices
1.4.1. Family eating habits
1.4.1.1. Lack of breast feeding
1.4.1.1.1. Indoor environmental control
1.5. Detroit-Warren-Ann Arbor ranked 12th for annual particle pollution
1.6. Asthma Initiative of Michigan
1.7. Outdoor air quality tools including EnviroFlash
2. Macro/Institutional/Governmental level influences
2.1. Metered Dose Inhaler Law (MDL)
2.2. Michigan Home Visiting Initiative
2.3. MDHHS Asthma Program
2.4. Michigan Medicaid and spacer access
2.5. FLARE
2.5.1. Follow up-Learn about asthma-Asthma is life-long-Respond to the warnings-Emergency care if needed
2.6. MATCH (Home based case management)
2.7. Michigan 21.2% medication adherence rate-75% greater with children with asthma on Medicaid
2.8. Hispanic children highest prevalence of current asthma in Michigan (17.2%)
2.9. Controlling Childhood Asthma and Reducing Emergencies (CDC objective)
2.10. Guidelines for Diagnosing and Management of Asthma
2.11. EXHALE
2.11.1. A resource by the CDC and DHHS to reduce asthma healthcare costs. E - Education on asthma self-management X - Extinguishing smoking and secondhand smoke H - Home visits for trigger reduction and asthma self-management education A - Achievement of guidelines-based medical management L - Linkages and coordination of care across settings E - Environmental policies or best practices to reduce asthma triggers from indoor, outdoor, and occupational sources
3. Micro/Individual level influences
3.1. Education
3.1.1. Misuse of medications
3.1.1.1. Proper use of inhaled corticosteroids
3.1.2. Knowledge of importance of Influenza vaccine
3.1.3. Access to healthcare
3.1.4. Access to health education
3.2. Challenges communicating with children
3.3. Primary health preventions
3.3.1. Avoidance of tobacco smoke
3.3.2. Avoidance of allergens
3.3.3. Fear of doctors/hospitals
3.3.4. Avoidance of triggers-animal hair, dust mites
3.4. Misconceptions
3.4.1. View on exercise and exercise-induced asthma
4. Meso/Family level influences
4.1. Beliefs/Perception
4.1.1. View of their ability to manage asthma
4.1.2. Parent(s) understanding of child's condition
4.1.3. Siblings view of asthma condition
4.1.4. Communication between parents regarding symptom management
4.2. Behaviors/Pactices
4.2.1. Extracurricular activities tailored to avoid asthma triggers
4.2.2. Avoidance of family having pet
4.2.3. Financial restrictions to accommodate cost associated with asthma
4.2.4. Parents developing closer report with school staff managing child's asthma
4.2.5. Increase awareness of household air quality