No abstract

Most children in this study were not accurately classified by their providers as having mild persistent to severe persistent asthma and had not been prescribed maintenance medications. When providers were aware of their patient's asthma symptoms, most of the children were prescribed maintenance medications. Attempts to improve adherence to asthma guidelines should take into consideration provider underestimations of asthma severity.

This Campbell systematic review sought to answer the following questions with the available high quality experimental studies of programs that combined academic programming with other activities such as youth development or recreation: To what extent and in what ways does access to after‐school programs impact student context (i.e., student location, supervision, and safety), participation in enriching activities, behaviors, social and emotional development, and academic outcomes for youth? Do the effects of after‐school programs vary among subgroups of youth defined by their baseline characteristics? Among the program models and settings evaluated, do some seem more beneficial to youth than others? What are the distinguishing characteristics of those more and less successful programs? This review only included well‐implemented experimental design studies. An extensive search of the literature uncovered only five studies that met the inclusion criteria for this review. The five evaluated programs were fairly homogenous along many dimensions, including their target populations and settings–primarily elementary youth living in lower‐ income, urban settings. Notably, looking across the 97 impacts measured by the five studies included in this review reveals primarily null findings–84 percent showed no significant differences between the program and control youth. Also, not one of these studies reported impacts for parents. In this era of welfare reform, it might be important to understand how this type of intervention targeting low‐income youth may impact parents' job attendance and retention or parental levels of stress while balancing the demands of work and child care. Such parental outcomes could arguably mediate student social and emotional, behavioral, and academic outcomes.

School-based provision of inhaled corticosteroids significantly improved symptoms, quality of life, and absenteeism among urban children with mild persistent to severe persistent asthma. This effect was seen only among children not exposed to secondhand smoke.