Tools and documents for health care professionals

• Asthma basics
• Colds and asthma
• Communication with provider
• Depression with asthma
• Influenza and flu shots
• Medication adherence
• Peak flow monitoring
• Seeking emergency care
• Unsafe housing
• Using a metered dose inhaler
• Using an action plan
• Warning signs of asthma
• What happens when you call 911
• What to do during an asthma attack

Environmental protocols:

• Air pollution
• Allergies and pollen
• Assessing household products
• Clutter
• Cold homes
• Dust control
• Dust mites
• Environmental tobacco smoke
• Mold and moisture
• Obesity
• Occupational
• Pets
• Roaches
• Rodents
• Using a dust mask and asthma management
• Woodsmoke

English:

• KCAP asthma brochure
• KCAP flyer
• KCAP clinic fax referral form
• CDC recruitment letter - Molina
• CDC recruitment letter - CHPW

Spanish:

• Recruitment letter
• Recruitment letter - CHPW
• KCAP asthma brochure - Spanish
• KCAP flyer - Spanish

English:

• Assent scripting for children ages 3 through 6
• Assent scripting for children ages 7 through 17
• Authorization and consent for use or disclosure of photography
• HIPAA authorization
• Parent consent form
• Parent consent form/Adolescent assent form

Spanish:

• Assent scripting for children ages 3 through 6, Spanish
• Assent scripting for children ages 7 through 17, Spanish
• Authorization and consent for use or disclosure of photography, Spanish
• HIPAA authorization, Spanish
• Parent consent form, Spanish

English:

• Asthma triggers
• Good Questions for Your Health
• Stop Germs, Stay Healthy! handwashing posters in multiple languages
• Nebulizer for children and families
• Questions about the flu and flu vaccine
• Using a Peak Flow Meter
• What is Asthma?

Spanish:

• Good Questions for Your Health, Spanish
• Stop Germs, Stay Healthy! handwashing posters in multiple languages
• Questions about the flu, Spanish
• Please Take Off Shoes, Spanish

• King County Asthma Program (KCAP) seasonal newsletters

• Community Health Worker Visit Organizer
• Eligibility Phone Screening Questionnaire
• Enrollment Baseline Intervention Group
• Home Environmental Checklist
• Home Visit Encounter Form
• Pre-Randomization Interview
• Pre-Visit Phone Screening Reminder

Letters:

Forms:

Spanish:

• Consent Form, English
• HIPAA, English
• Photo Release form

Spanish:

• Consent Form, Spanish
• HIPAA, Spanish

• King County Asthma Program (KCAP) seasonal newsletters

• Section 5
• Section 6
• Section 7
• Section 10
• Section 11
• Section 15
• Section 16
• Section 19
• Section 23
• Section 24

Instruments and tools:

• 6 month Gift Card Letter
• 6 month Telephone Survey Letter

• Allergy Test Order Form
• Allergy Report Form
• KCAP 2008 Calendar
• Pinprick procedure

Questionnaires:

• Phone screening
• Home Environment Checklist
• General Clinical Research Clinic Visit Reminder Call & Screening
• Exit Home Environment Checklist
• Exit Questionnaire
• HomeBASE Baseline Questionnaire
• 6 Month Telephone Interview

• HomeBASE Summary Report, 2008-09
• KCAP Intervention problems, issues, or concerns
• Program Client Tracking Report

• HomeBASE Asthma Support and Education
• HomeBASE Spirometry Procedure
• Medications Screening
• Spirometry Report Form