This paper presents the design, implementation and evaluation of a home based intervention targeting economically disadvantaged children to improve asthma clinical outcomes. The monitoring and intervention activities were delivered within an embedded astronaut-themed game to promote user acceptance and compliance to the clinical protocol. An iterative, user-centered design process was used to prototype the asthma home monitoring system (Aspira) involving a tablet application, digital spirometer and a particulate monitor linked to a data management server. Children of low socio-economic demographic populations were the main target group for this study as they have significantly high asthma rates and lack of condition awareness. Aspira is the first intervention of its kind that provides the target audience an easy to use and low-cost in-home monitoring application. Aspira's design is grounded in the principles of social cognitive theory and aims to increase use, participation and efficacy in the target population. We present the results of a pilot study to determine feasibility and preliminary efficacy of the resulting high-fidelity Aspira prototype among four families with asthmatic children living in the Seattle metropolitan area.