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In this article, authors describe the work of Regional Asthma Management and Prevention (RAMP) in developing a comprehensive model for reducing the burden of asthma through the integration of clinical management and environmental protection. Over the past 15 years, RAMP grew a small legal settlement involving air pollution into a nationally recognized asthma program. RAMP collaborates, coordinates, shares resources, advocates, and promotes policy change to reduce inequities, strengthen asthma prevention efforts, and improve management for all communities. RAMP's 4 functions-provide technical assistance, serve as a clearinghouse, serve as a convener, and lead policy advocacy efforts-have provided an important structure for implementing a broad and comprehensive program aimed at reducing the burden of asthma. RAMP has demonstrated that asthma interventions must take place in numerous settings including clinical settings, homes, schools, child care, and outdoor environments and that, to reduce asthma disparities, organizations need to understand and address the environmental and social inequities that contribute to those disparities. RAMP has also seen firsthand the importance of community asthma coalitions in addressing the problem of asthma and the way that these coalitions benefit from the support of an organization like RAMP. RAMP has created a framework for reducing the burden of asthma that ties together the knowledge gained over 15 years and provides a model for other organizations.

Regional Asthma Management and Prevention describes its collaborative approach to address a social determinant of health--air quality--and the associated inequities that have led to asthma disparities impacting African American and Latino communities in the San Francisco Bay Area. The strategies, aimed at decreasing diesel pollution in disproportionately impacted communities, span the levels of the socioecological model, with an emphasis on policy outcomes. Regional Asthma Management and Prevention describes how this work fits within a larger comprehensive approach to address asthma disparities encompassing several components, ranging from clinical management to environmental protection.

Racial and ethnic disparities in the health of Americans are widespread and persistent in the United States despite improvements in the health of Americans overall. Increasingly, strategies for reducing disparities have focused on addressing the factors that contribute to - if not fundamentally underlie - health disparities: social, economic, and environmental inequities, which limit access to resources and cause unhealthy exposures. As public health shifts to interventions that seek to improve the circumstances of disproportionately affected populations and achieve equity through policy change, alternative methods to evaluate these efforts are also required. This paper presents an example of such approaches to addressing asthma disparities through Regional Asthma Management and Prevention's (RAMP) programmatic efforts and an evaluation of these activities. The paper describes RAMP's targets and strategies, as well as the specific evaluation methods applied to each, including activity tracking, observations, surveys, key informant interviews, and case studies. Preliminary evaluation findings are presented, as are lessons learned about the efficacy of the evaluation design features - both its strengths and shortcomings. Findings discussed are intended to contribute to the growing literature that provides evidence for the application of emerging approaches to evaluation that reflect non-traditional public health and support others interested in expanding or replicating this work.