Making a Difference in Rural Family Asthma Care

Abstract

Background: 87 of every 1000 children under 17 years have current asthma (ie, symptoms in past 12 months). Few intervention programs are tailored for rural populations. Purpose: To evaluate a family asthma management educational intervention, tailored for rural residents, on family asthma management (child self-management, parent management, inhaler skill, access to care) and children's health outcomes (absenteeism, ED visits, hospitalizations, quality of life). Methodology: An experimental design with randomization into treatment (asthma self-management) or attention-control (general health promotion) schools 183 children (108 boys, 75 girls) with a mean age of 878; a largely minority sample (47% Mexican American, 30% White, 22% African American) enrolled in the 12-month study. Findings: Repeated measures ANOVA showed the treatment group children had significantly greater improvements in asthma self-management (p=02), inhaler skill (p<001), asthma severity (p=002), and their parents had significantly greater improvements in asthma management (p=02) and access to care (p=01), than did the control group. Quality of life scores (p<001) improved and absenteeism decreased by 24% (p=001) for all children. ED visits decreased for the treatment group and increased for the control group and hospitalizations were reduced significantly for both groups. Logistical regression showed that access to care, SES, and ethnicity (White) accounted for 19% of the variance in ED visits; and child's grade level, self-management, access to care, and ethnicity (White) accounted for 24% of the variance in hospitalizations. Summary Concluding Statement: The use of a treatment intervention that incorporated population-focused scenarios (eg, rural situations, child situations) was shown to significantly impact the efforts of rural families, an underserved population, who were working to manage children's asthma – a significant health disparity of childhood.