Table 1

Participant inclusion and exclusion criteria

Inclusion criteria

* Age (as of date of enrollment)

- Lower age limit: 18 years

- Upper age limit: 70 years

* Gender: Both men and women

* Race/ethnicity: All racial and ethnic groups

* Body mass index 30.0-44.9 kg/m2

* Suboptimally controlled asthma:

- Documented diagnosis of asthma on the current medical problem list

- Currently prescribed an anti-asthma medication

- Score <20 on the Asthma Control Test [75]

- Demonstrable airway reversibility

* Kaiser member for ≥ 1 year

* Able and willing to enroll and provide written, informed consent, i.e., to: 1) meet the time and data collection requirements of the study; 2) be randomized to one of the two intervention arms; 3) adhere to the recommendations of the study intervention as assigned; 4) participate in follow-up for 12 months; and 5) allow extraction of relevant information from their medical records.

Exclusion criteria

* Inability to speak, read or understand English;

* Intermittent asthma, defined as either seasonal asthma or (daytime asthma symptoms <2×/week and nocturnal symptoms <2×/month and no use of controller medications);

* Diagnosis of COPD (emphysema or chronic bronchitis) suggested by patient report of doctor diagnosis, spirometry, and smoking history;

* Use of weight-loss medications in the past 3 months;

* Initiation or change of antidepressant medication within the past 3 months;

* Regular use (>5 days/month) of the following medications: oral corticosteroids, insulin, oral hypoglycemics, anti-psychotics, and mood stabilizers;

* Currently enrolled in a group or individual intervention program that overtly aimed at weight loss, nutrition and/or physical activity at Kaiser or elsewhere;

* Planning to undergo bariatric surgery during the study period;

* Inability to perform pulmonary function tests by spirometry in a consistent manner;

* Having a medical or physical condition that makes moderate intensity physical activity (like a brisk walk) difficult or unsafe;

* Significant medical co-morbidities, including uncontrolled metabolic disorders (e.g., thyroid, renal, liver), diabetes, heart disease, stroke, and ongoing substance abuse;

* Hospitalization for psychological or emotional problems within the past two years;

* Diagnosis of cancer (other than non-melanoma skin cancer) that is/was active or treated with radiation or chemotherapy within the past 2 years;

* Diagnosis of a terminal illness and/or in hospice care;

* Currently pregnant, lactating, or planning to become pregnant during the study period;

* Already enrolled or planning to enroll in a research study that would limit full participation in the study or confound the interpretation of the study's findings;

* Family/household member of another study participant or of a study staff member;

* No longer a Kaiser patient or planning to transfer care outside of Kaiser during the study period;

* PCP determination that the study is inappropriate or unsafe for the patient;

* Investigator discretion for clinical safety or protocol adherence reasons.

Ma et al. BMC Pulmonary Medicine 2010 10:16   doi:10.1186/1471-2466-10-16

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