Evaluation of an Education Program for Elementary School Children with Asthma

Abstract

To evaluate the effectiveness of a comprehensive asthma management education program for 7- to 12-year-old children with asthma, entitled Roaring Adventures of Puff (RAP), 18 elementary schools in Edmonton were randomized to intervention and control groups. Participating in the program were 76 students with asthma in the intervention schools and 86 in the control schools. Children in the intervention schools had statistically significant improvements in unscheduled doctor visits, missed school days, moderate-to-severe parent rating of severity, severity of shortness of breath, limitations in the kind of play, and correct use of medications. Unscheduled doctor visits and missed school days were the only significant improvements in the control group; however, improvements were about half that of the intervention group. The results showed that a comprehensive, school-based asthma education program is feasible and improves outcomes.

A controlled trial of a school-based intervention to improve asthma management

“…A number of controlled intervention studies have now failed to find a significant intervention effect on absences in children of this age [16,20], with a further study finding a reduction in both intervention and control groups [19]. This measure may now not be a good marker of asthma morbidity and may be more related to socioeconomic factors.…”

“…However, it has been more difficult to demonstrate that they have a direct impact on disease outcome measures. Programmes focusing on school-based treatment, asthma management education and peer-led initiatives have had some success [18][19][20], but limited progress has been made in encouraging schools to set up asthma policies [13,15,21].…”

Developing, Implementing, and Evaluating a School-Centered Asthma Program: Step-Up Asthma Program

“…Many studies describe successful school-centered interventions, including education for students and parents, 15,16,[21][22][23][24][25][26][27][28] case management, 25,27 enhanced communication with providers, 15,21,26,27 access to providers in school-based health centers 27,29,30 or as consults, 31,32 provision of asthma action plans, 15,23 directly observed therapy, 32,33 and home visits. 27 These programs have shown improvements in asthma control and have different strengths, but many have small numbers and lack sustainability mechanisms.…”

Small-group, interactive education and the effect on asthma control by children and their families

“…Post-education outcomes that have been identified by researchers include reductions in the numbers of visits to emergency departments, admissions to hospitals and unscheduled visits to physicians, and in costs related to health care. 8,10,26,[44][45][46][47] From 2005 onward, an increasing number of randomized control trials have been performed. [48][49][50][51][52][53][54][55] Some have focused on schools with children as the target learners [50][51][52] or included a multifaceted approach with education as one component.…”