PROJECT SUMMARY Asthma is prevalent among World Trade Center (WTC) rescue and recovery workers (responders). Moreover, this population exhibits poorly controlled disease with high health care utilization costs, particularly among responders affected by mental health conditions. Evidence from the general population supports that asthma self-management programs can improve asthma outcomes, including asthma control and health care utilization. However, asthma self- management is not currently part of the WTC Health Program (WTCHP). That asthma morbidity and mortality are higher in older adults compared to younger adults is particularly salient for the aging WTC cohort, underscoring the potential for asthma self- management programs to become vital to meeting the unique needs of this population. To address this need, we developed an innovative approach to optimizing asthma care: the Telehealth Enriched Asthma Management (TEAM) program. This intervention will utilize the existing clinical infrastructure of the WTCHP, including partnering with the WTC Mental Health Program, to provide asthma self-management to enhance current asthma care. The TEAM program will also leverage the recently augmented telehealth capabilities in the WTCHP (implemented in response to the SARS-CoV-2 pandemic) by delivering a series of virtual visits to provide asthma self-management education. Within this robust telehealth and clinical infrastructure, TEAM will provide care coordinated with other components of the WTCHP— Treatment Program, Mental Health Program, smoking cessation services, and social work— via a multifactorial approach that will promote uptake and adherence. The specific aims of the TEAM program are to: 1) develop an intervention that will expand telehealth capabilities to improve asthma care; 2) collect and analyze a variety of subjective and objective asthma outcome measures to evaluate the effectiveness of the TEAM intervention; 3) evaluate current barriers to telehealth platform utililzation as well as satisfaction with virtual encounters to understand how to improve WTCHP telehealth delivery. Our proposal is evidence-based and responds to the specific needs of those most significantly impacted by the WTC disaster. We anticipate that this program will improve asthma care for this vulnerable population, while optimizing telehealth capabilities that can be implemented for other health conditions affecting WTC responders.