Effects of a school-based intervention for urban adolescents with asthma. A controlled trial

Am J Respir Crit Care Med. 2011 Apr 15;183(8):998-1006. doi: 10.1164/rccm.201003-0429OC. Epub 2010 Dec 7.

Abstract

Rationale: Asthma prevalence and morbidity are especially elevated in adolescents, yet few interventions target this population.

Objectives: To test the efficacy of Asthma Self-Management for Adolescents (ASMA), a school-based intervention for adolescents and medical providers.

Methods: Three hundred forty-five primarily Latino/a (46%) and African American (31%) high school students (mean age = 15.1 yr; 70% female) reporting an asthma diagnosis, symptoms of moderate to severe persistent asthma, and asthma medication use in the last 12 months were randomized to ASMA, an 8-week school-based intervention, or a wait-list control group. They were followed for 12 months.

Measurements and main results: Students completed bimonthly assessments. Baseline, 6-month, and 12-month assessments were comprehensive; the others assessed interim health outcomes and urgent health care use. Primary outcomes were asthma self-management, symptom frequency, and quality of life (QOL); secondary outcomes were asthma medical management, school absences, days with activity limitations, and urgent health care use. Relative to control subjects, ASMA students reported significantly: more confidence to manage their asthma; taking more steps to prevent symptoms; greater use of controller medication and written treatment plans; fewer night awakenings, days with activity limitation, and school absences due to asthma; improved QOL; and fewer acute care visits, emergency department visits, and hospitalizations. In contrast, steps to manage asthma episodes, daytime symptom frequency, and school-reported absences did not differentiate the two groups. Most results were sustained over the 12 months.

Conclusions: ASMA is efficacious in improving asthma self-management and reducing asthma morbidity and urgent health care use in low-income urban minority adolescents.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • African Americans
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / drug therapy
  • Asthma / prevention & control*
  • Asthma / therapy
  • Emergency Medical Services / statistics & numerical data
  • Female
  • Hispanic or Latino
  • Humans
  • Male
  • Patient Education as Topic / methods
  • Quality of Life
  • Schools
  • Self Care / methods
  • Self Care / statistics & numerical data
  • Treatment Outcome
  • Urban Population

Substances

  • Anti-Asthmatic Agents