In this article we discuss studies of individualized and community-based interventions for control of asthma in children. We posit that successful programs share 8 common characteristics: (1) recognition of the multiple factors affecting childhood asthma; (2) careful assessment of participants' risk factors and needs; (3) tailoring of program elements to address participants' risk factors and needs; (4) consideration of both physical and social environments; (5) use of sound learning and change theories; (6) family involvement; (7) focus on children with the most serious disease; and (8) selection of delivery venues at which learning can be optimized. Challenges for moving practice and research forward also are presented. Pediatrics 2009;123:S185-S192 T HE PARADOX OF asthma is that, although our understanding of its pathophysiological features and the therapies available for treating the disease have increased significantly over the past 2 decades, the prevalence of asthma, the health care use associated with it, and the disruptions it causes to family and community life have not decreased substantially. 1 These facts suggest a need for interventions that enable individuals, families, communities, and health care providers to manage asthma and its consequences effectively.Asthma control requires the attention and involvement of a wide range of stakeholders. Figure 1 depicts the patient at the center of effective disease management efforts and illustrates the relative levels of influence of people and institutions that can help the patient. Within the circle closest to the person with asthma is the family, which must provide extensive support, especially for children. Next are the clinicians and health care institutions whose expertise and services are required to guide the child and the family in their control efforts. Then comes the school (or the workplace, in the case of an adult), where optimal support and understanding are needed. Community organizations, agencies, and individuals must be aware of the prevalence of asthma in the community and the ways in which they can provide services and assistance to reduce the disease burden that families face. Appropriate environmental and other policies (eg, enabling children to carry medicines at school) are needed to ensure consistent, affordable, effective, system-wide, ameliorative actions that assist families in managing the condition.Significant advances have been made in recent years in the design of programs to enhance asthma management by patients and to improve the helping capacity of those within the patient's circles of influence. The challenge for both medicine and public health is how to mount proven programs that can address the needs of individual patients while reaching large numbers of people. This article provides examples of studies of programs that either target individual children with asthma or are designed to offer assistance in community venues such as schools, which provide opportunities for reaching maximal numbers of children.The us...