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The Asthma Guidelines Implementation Steps & Tools (GIST) project was funded in 2009 by the National Asthma Control Initiative (NACI) to develop a program that makes it easier for primary care clinicians to use the NHLBI asthma guidelines in their everyday care of patients with asthma. The Michigan Department of Community Health gathered a statewide team of experts in asthma and practice redesign, and created a set of tools and a program to implement them.

In 2011, NACI funded a second phase for GIST, using asthma champions to promote GIST with health professional audiences, and new practices are welcome to use the GIST materials to improve their asthma care.

GIST Materials can be individualized to suit your organization/practice.

• Questions About Your Breathing – A tool to help patients provide info about their breathing symptoms and history
  • Given to patients being seen for respiratory complaints, no current diagnosis of asthma
  • Usually given to patient before seeing clinician
• Asthma Control Test™ – A validated tool to assess patient's level of asthma control
• Asthma Diagnosis Tool – To help clinician diagnose asthma and assess severity
  • Clinician uses with patient being seen for respiratory complaints
• Asthma Patient Follow-Up Tool – To help clinician assess level of asthma control then take steps to maintain, increase or decrease treatment
  • Clinician can use with patient being seen for symptomatic asthma visit, scheduled asthma visit, or visit for other reason
• Stepwise Approach to Managing Asthma – To help clinician determine medication needs and management approach
  • Use steps as initiated on Diagnosis and Follow-Up Tools to determine medication type and dosage, adherence and environmental checks
• Asthma Action Plan – No set plan for GIST, but many good plans available if needed.

The Minnesota Department of Health has created a free home environmental assessment training, named Reducing Environmental Triggers of Asthma–Home, or RETA-Home. This program teaches you about the triggers of asthma found in the home and suggests simple interventions that can limit or eliminate exposure to them. It also tours a home to show areas where asthma triggers are found. The training takes about 40 minutes to view. It includes pre- and post-test questions that highlight important points, and you may print out a certificate of completion at the end. In addition, there is a resource section that can be accessed both during the program and after the program has been completed.

This training utilizes the expertise of individuals who have extensive experience in both providing in-home asthma management and conducting home assessments. It builds on data from projects showing that environmental interventions, coupled with in-home asthma medical management, are effective in reducing nighttime symptoms, missed school days, and the number of asthma hospital visits and unscheduled, urgent care office visits.

This training program was made possible from grants from EPA Region V and CDC.

CDC’s National Asthma Control Program and state asthma programs are mobilizing resources to reduce the burden of asthma in communities. This step-by-step guide is intended for use by state and territorial public health departments, and groups that focus on improving asthma management practices. Sound evaluation practices can help ensure that we use those resources effectively and efficiently; that we have a means of demonstrating the value of our programs; and that we are developing a body of knowledge that tells us “what works.” Module 1 of Learning & Growing introduces CDC's Framework for Program Evaluation and focuses on evaluation planning--both strategic evaluation planning for a five year grant cycle as well as individual evaluation planning for a specific evaluation project. Subsequent modules will focus on evaluation implementation.