School-based Asthma Education Research Articles

Student knowledge gains among first-time and repeat attendees of school-based asthma education program

BackgroundBecause children spend much of their time in schools, schools can play an important role in asthma education for the one in 12 affected children in the United States. School-based asthma education programs are commonly repeated annually, however few studies have evaluated the impact of repeated participation in asthma education in school-based programs.MethodsThis observational study evaluated the impact of Fight Asthma Now© (FAN), a school-based asthma education program for children in Illinois schools. Participants completed a survey at the start and end of the program, including demographics, prior asthma education, and 11 asthma knowledge questions (maximum knowledge score = 11).ResultsAmong 4,951 youth participating in the school-based asthma education program, mean age was 10.75 years. Approximately half were male and Black. Over half reported no prior asthma education (54.6%). At baseline, repeat attendees had significantly higher knowledge versus first-time attendees (mean: 7.45 versus 5.92; p < 0.001). After the program, both first-time and repeat attendees had significant knowledge improvements (first-time: mean = 5.92◊9.32; p < 0.001; repeat: mean = 7.45◊9.62; p < 0.001).ConclusionsSchool-based asthma education is effective for increasing asthma knowledge. Notably, repeated asthma education in school leads to incremental benefits for knowledge. Future studies are needed to understand the effects of repeated asthma education on morbidity.

School-Based Asthma Education Intervention is Associated with Improved Asthma Knowledge in Spanish bi-lingual children with asthma

A multicomponent school-nurse led intervention consisting of asthma education and asthma preventive therapy supervision is an innovative way to reduce asthma disparities in students with asthma attending a Spanish dual-language elementary school

Incorporating medical students into school-based asthma education improves asthma knowledge in children

Objectives Asthma affects 1.1 million children in the UK, substantially impacting quality of life and leading to significant morbidity and mortality. Effective asthma self-management, education and empowerment can lead to a reduction in asthma related morbidity and mortality. We hypothesized that medical students can significantly improve school children’s knowledge and awareness of asthma, at least in the short term. We sought to implement a medical student-led educational intervention program tailored to school-aged children, measure immediate improvements in asthma-related knowledge among participants, and determine if any population factors were associated with a difference in knowledge improvement. Methods Children were recruited from schools in Greater London. A 20-minute presentation was given by medical students which covered basic physiology of asthma, triggers, treatment, how to recognize a peer who is having an acute asthma attack and common misconceptions about asthma. The children’s knowledge was tested using questionnaires completed before and immediately after the presentation. Results Medical students taught 1711 children aged 5 to 11 both with and without asthma. The average questionnaire score was 4.67/13 (SD 2.82) at baseline and 10.15/13 (SD 2.92) following the program. An improvement in scores was observed in all age groups and was greatest in children aged 10 and 11 (p = 0.016 and 0.049 respectively). Conclusion We successfully implemented a medical student led asthma education program for school aged children in the UK. This novel approach was well received and led to a significant improvement in asthma knowledge amongst participants.

Impact of a novel asthma curriculum on knowledge and attitudes among schoolchildren

Background Asthma is the most common chronic pediatric disease, with rates of 8% among US children and 17% among African Americans. Traditionally, school-based asthma education has engaged students with asthma to improve their knowledge and outcomes. However, there is increasing recognition of the role of peers in fostering asthma-friendly school environments and assisting classmates with asthma. Few programs have addressed peer groups, and the impact of these programs on knowledge and behavior is largely unknown. We have piloted a novel curriculum to engage students with and without asthma and assess impact …

Results of an asthma education program delivered via telemedicine in rural schools

BackgroundAsthma morbidity is high in low-income children living in rural US regions, yet few interventions have been designed to decrease the asthma burden in rural populations. ObjectiveTo examine the effect of a school-based asthma education program delivered by telemedicine in children living in an impoverished rural region. MethodsWe conducted a cluster randomized trial with rural children 7 to 14 years old by comparing a school-based telemedicine asthma education intervention with usual care. The intervention provided comprehensive asthma education by telemedicine to participants and provided evidence-based treatment recommendations to primary care providers. ResultsOf the 393 enrolled children, median age was 9.6 years, 81% were African American, and 47% lived in households with an annual income less than $14,999. At enrollment, 88% of children reported uncontrolled asthma symptoms. At the end of the intervention, there were no statistically significant differences in reported symptom-free days (primary outcome) for the intervention or usual-care group. Participants in the intervention group reported significantly higher use of peak flow meters to monitor asthma and reported taking their asthma medications as prescribed more frequently compared with the usual-care group. There were no changes in other outcome measures, including quality of life, self-efficacy, asthma knowledge, or lung function, between groups. ConclusionAlthough there was some evidence of behavior change among intervention participants, these changes were inadequate to overcome the significant morbidity experienced by this highly symptomatic rural impoverished population. Future interventions should be designed with a multifaceted approach that considers caregiver engagement, distance barriers, and inadequate access to asthma providers in rural regions. Trial RegistrationClinicalTrials.gov Identifier: NCT01167855.

A systematic review of school-based interventions that include inhaler technique education

Proper use of inhaled medication is essential for the successful treatment of childhood asthma; yet, improper inhaler technique among school-aged children is common. There are many schoolbased asthma education programs, but the extent to which these programs teach inhaler technique is unknown. We systematically reviewed the literature to identify schoolbased asthma interventions that included inhaler technique instruction. We searched several databases, including PubMed, for relevant articles. Studies were included if they were asthma interventions of any type (programs, curriculums, education) conducted at kindergarten through twelfth grade schools that taught inhaler technique and included inhaler technique as an outcome measure. Of the 285 citations identified, the final nine studies (selected from 71 full-text articles) met the inclusion criteria. Findings from this systematic review identified a very small number of school-based interventions that evaluated improvements in students' inhaler technique. Two of the nine studies (22%) used a validated measure of inhaler technique. Inhaler technique instruction varied in length, from 15min to 1h and nurses implemented inhaler technique instruction in six of the nine (67%) interventions. Existing studies offer mixed evidence for sustained technique improvements up to a 12-month follow-up period. Evidence suggests that students benefit from school-based inhaler technique education; however, inconsistencies in how technique was measured limit our ability to draw firm conclusions regarding the effectiveness of inhaler technique education on student outcomes. Future studies are needed to identify the most appropriate and feasible inhaler technique education components for use in comprehensive asthma self management interventions.

Effectiveness of school-based family asthma educational programs in quality of life and asthma exacerbations in asthmatic children aged five to 18: a systematic review.

Asthma is a common, chronic, non-communicable respiratory disease that affects millions of children worldwide. Asthma exacerbations can range from mild to severe and can have an unfavorable impact on the quality of life of children and their caregivers. Asthma exacerbations often result in absenteeism from school or work, activity intolerance and emergency hospital visits. One strategy to address this health issue in an attempt to improve health outcomes is school-based asthma educational programs. A review of the literature revealed that previous systematic reviews have examined similar topics on the effectiveness of school-based asthma educational programs that have included collaborative efforts between parents and schools. No systematic reviews were found that examined the effectiveness of school-based asthma educational programs that exclusively included children and their caregivers. Research has not been systematically reviewed to determine the effectiveness of a school-based asthma educational program within a familial context. To identify the best available evidence on the effectiveness of school-based family asthma educational programs that exclusively included both children and caregivers on the quality of life and number of asthma exacerbations of children aged five to 18 years with a clinical diagnosis of asthma. Children aged five to 18 years of any gender, race or ethnicity with a clinical diagnosis of asthma and their caregivers. School-based family asthma educational programs. Randomized controlled trials. Quality of life and the number of asthma exacerbations measured by either missed days from school or work, and/or physical activity intolerance, and/or emergency hospital visits. The search strategy aimed to find both published and unpublished studies from inception of the database to August 21, 2015. Quantitative papers selected for retrieval were assessed by two independent reviewers for methodological validity before inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute. Data were extracted from articles included in the review using the standardized data extraction tool from the Joanna Briggs Institute. The data extracted included specific details about the populations, interventions, study methods and outcomes of significance to the review question and its specific objectives. Due to the heterogeneity among the included studies, statistical pooling and meta-analysis was not possible. Results are presented in narrative form. Six studies examining the intervention were included in this review. All six of the included studies were randomized controlled trials (RCTs). All six studies compared the effects of school-based asthma education to no school-based asthma education/usual care on quality of life and number of asthma exacerbations. Three out of four RCTs showed that children who participated in school-based family asthma educational programs demonstrated a statistically significant improvement in overall quality of life (P < 0.05). All six studies showed improvement in the number of asthma exacerbations that resulted in one or all of the measured outcomes of either missed days from school or work, physical activity intolerance and/or decreased emergency hospital visits. School-based family asthma educational programs for children that include caregivers can have a positive impact on the quality of life and asthma management of children with asthma. Other outcomes that can be positively affected by school-based family asthma educational programs include absenteeism from school or work, physical activity intolerance and emergency hospital visits as result of asthma exacerbations.

Evaluation of a School-Based Asthma Education Protocol

School-based asthma education offers an opportunity to reach low-income children at risk for poor asthma control. Iggy and the Inhalers (Iggy) is an asthma education program that was implemented in a Midwest metropolitan school district. The purpose of this evaluation was to conduct a comprehensive program evaluation. Objectives included increasing children's asthma-related knowledge and families' awareness of asthma management, while cultivating collaboration between school nurses and asthma providers. A total of 173 students participated in Iggy education, with 147 completing both initial and 1-month posttests. Thirty-one parents and seven school nurses provided qualitative feedback. Iggy was well received by children, parents, and school nurses. Asthma knowledge increased significantly ( p < .001) between pretest and posttest, and this increase was retained at 1-month follow-up. This program evaluation suggests that our program had a significant, sustained impact on students' asthma knowledge. It also supports the value of collaboration between asthma providers and school nurses.

Improving School Attendance through Asthma Education: A Systematic Literature Review of School-Based Asthma Education Programs

Improving School Attendance through Asthma Education: A Systematic Literature Review of School-Based Asthma Education Programs

The school environment and asthma in childhood.

In this article, we discuss the relationship between environmental exposures within the school environment and pediatric asthma morbidity. This article will conclude by reviewing novel school based asthma education and therapeutic programs and environmental interventions designed to help mitigate pediatric asthma morbidity.

The effectiveness of school-based family asthma educational programs on the quality of life and number of asthma exacerbations of children aged five to 18 years diagnosed with asthma: a systematic review protocol.

REVIEW QUESTION / OBJECTIVE The objective of this review is to identify the best available quantitative evidence related to the effectiveness of school-based family asthma educational programs on the quality of life and number of asthma exacerbations of children aged five to18 years with a diagnosis of asthma. INCLUSION CRITERIA Types of participants This review will consider studies that include children, five to 18 years of age, of any gender, race, or ethnicity with a clinical diagnosis of asthma, who has participated in school-based asthma education programs that include their caregivers. Studies that include children younger than age five and older than age 18, with respiratory diseases other than asthma, who have not participated in school-based asthma education programs that include their caregivers will be excluded. Types of intervention(s) This review will consider studies that evaluate the effectiveness of school-based family asthma education interventions on the quality of life and number of asthma exacerbations of children with asthma compared to absence of school-based family asthma education programs. Types of outcomes This review will consider studies that include the following outcome measures: primary outcomes of quality of life and asthma exacerbations, and secondary outcomes of absences from school or work, physical activity intolerance, and emergency hospital visits as a result of asthma exacerbations. Quality of life can be measured by a valid and reliable tool such as the Pediatric Asthma Quality of Life Questionnaire. The number of asthma exacerbations can be measured by valid and reliable tools such as the TRUNCATED AT 250 WORDS

Cigarette smoking in adolescents with asthma in Jordan: Impact of peer-led education in high schools

Background: Peer-led smoking prevention programs focus on teaching adolescents—especially those with asthma- who are affected most by cigarettes, refusal skills to lower their intention to smoke. The purpose of this study was to determine the impact of a peer-led asthma education program on students who were smokers in terms of self-efficacy to resist smoking, asthma knowledge and asthma-related quality of life. Methods: This study is a secondary analysis of a cluster-randomized controlled trial of students with asthma (n = 259) in 4 randomly-selected high schools, stratified for gender in Northern Jordan, using a closed-envelope technique. Trained bilingual health workers facilitated the implementation of the peer-led program, which uses a three-step cascade process to train peers from year 11 and 10 over a three week period to deliver asthma education for the school community, with the aid of well-established resources. Students with asthma (n = 261) in grades 8, 9 and 10 were surveyed at baseline in December 2006 and three months post-intervention on the main outcomes, which were asthma-related quality of life, knowledge of asthma management, and self-efficacy to resist smoking. For the purpose of this paper, we assessed the impact on the intervention only on students who were smokers (n = 72). Results: The prevalence of smoking among students with asthma was 29%. Male students (44%) were more likely to smoke than females (6%) ( p <0.001). Compared to the control group, the peer-led intervention improved self-efficacy to resist smoking, understand asthma and asthma-related quality of life. Smokers within the intervention schools improved their self-efficacy to resist smoking by 83% ( p =0.001), asthma knowledge by 60% ( p =0.001) and demonstrated benefits within all the sub-domains of asthma related quality of life when compared to controls ( p =0.001). Conclusion: The prevalence of smoking among high school Jordanian students with asthma, especially males, is alarmingly high, highlighting the need for early intervention. A school-based peer-led asthma and smoking education approach can be effective in motivating students to not smoke. Therefore, nurse educators worldwide, especially who work in youth centers, community, and school health fields, need to be aware of the effectiveness, availability, and possible adoption of such innovative interventions in order to improve overall well-being for adolescents in general and for smokers in specific.

Asthma-Related School Absenteeism and School Concentration of Low-Income Students in California

IntroductionAsthma is one of the leading causes of school absenteeism. Previous studies have shown that school absenteeism is related to family income of individual students. However, there is little research examining whether school absenteeism is related to school-level concentration of low-income students, independent of family income. The objective of this study was to examine whether the proportion of low-income students at a school was related to school absenteeism due to asthma.MethodsUsing data from the 2007 California Health Interview Survey, a population-based survey of California households, we examined the association between attending schools with high concentrations of low-income students and missing school because of asthma, adjusting for demographic characteristics, asthma severity, and health insurance status. Schools with high concentrations of low-income students were identified on the basis of the percentage of students participating in the free and reduced-price meal program, data publicly available from the California Department of Education.ResultsStudents attending schools with the highest concentrations of low-income students were more likely to miss school because of asthma. Students from low-income families, younger students, those with more frequent asthma symptoms, or those taking prescription asthma medications also were more likely to miss school because of asthma.ConclusionThe use of school-level interventions to decrease school absenteeism due to asthma should be explored, especially in schools with high concentrations of low-income students. Potential interventions could include school-based asthma education and disease management or indoor and outdoor air pollution control.

468 Feasibility of a peer-led, school-based asthma education programme for adolescents in Jordan

The Adolescent Asthma Action programme (Triple A) has been used successfully to promote asthma knowledge, awareness and quality of life in adolescents with asthma in Australia. We describe the feasibility and acceptability of an adaptation of this English-language, peer-led, asthma education programme in a girls' high school in Northern Jordan. The pilot was conducted by bilingual health workers. Feasibility, acceptability and adaptability were measured through participation rates, open-ended questionnaires completed by peer leaders, a focus group for junior students and reflective journal notes. The programme was well-received by staff and students, with high levels of participation. The peer-led approach was viewed positively. Students reported that they enjoyed the interactive learning activities and the opportunity to practise English. The students reported increased asthma knowledge and awareness, with students with asthma reporting receiving more support from peers. A peer-led asthma education programme is feasible and acceptable in the Jordanian school context.

Reducing Health Disparities For Asthma With a School Based Asthma Education Program

Reducing Health Disparities For Asthma With a School Based Asthma Education Program

Enhancing School-Based Asthma Education Efforts Using Computer-Based Education for Children

Background. Schools are an important site for delivery of asthma education programs. Computer-based educational programs are a critical component of asthma education programs and may be a particularly important education method in busy school environments. Objective. The objective of this brief report is to review and critique computer-based education efforts in schools. Results. The results of our literature review indicated that school-based computer education efforts are related to improved knowledge about asthma and its management. In some studies, improvements in clinical outcomes also occur. Data collection programs need to be built into games that improve knowledge. Many projects do not appear to last for periods greater than 1 year and little information is available about cultural relevance of these programs. Conclusions. Educational games and other programs are effective methods of delivering knowledge about asthma management and control. Research about the long-term effects of this increased knowledge, in regard to behavior change, is needed. Additionally, developing sustainable projects, which are culturally relevant, is a goal for future research.

“The Roaring Adventures of Puff” (RAP) – a school based asthma education program for children with asthma

Background Asthma guidelines recognize asthma education as “an essential component of asthma therapy”. The Children’s Asthma Education Centre (CAEC)’s small group interactive sessions for children and families does not meet the needs of all families. Schools provide an opportunity for asthma education. The “Roaring Adventures of Puff” (RAP) is an effective, previously validated asthma education program.

Evaluation of the Fight Asthma Now (FAN) program to improve asthma knowledge in urban youth and teenagers

School-based asthma education programs targeting disadvantaged youth and teens with asthma are lacking. To assess the impact of the Fight Asthma Now (FAN) educational program among 2 populations of predominantly low-income minority students: youth (3(rd)-6(th) graders) and teens (7(th)-8(th) graders). Chicago-area elementary schools were invited to participate in this stratified 2-arm study. Eligible schools were assigned to participate either in the intervention or in the control arm. Within each participating school, eligible students were recruited and grouped (stratified by grade and age) to form teen or youth classes. Participants completed a pre- and post-intervention asthma knowledge questionnaire and observation for spacer technique competency. The treatment group received the FAN curriculum between the evaluations. A sample of 26 low-income, predominantly minority-serving schools was recruited. Most participating schools were randomized in a 3:1 ratio to form 25 youth classes (19 intervention and 6 control group) and 16 teen classes (11 intervention and 5 control group), resulting in 275 vs 69 youth and 141 vs 51 teens in the intervention and control groups, respectively. Stratified analyses were performed, and clustering within the school and class was taken into consideration in analyses. Multilevel models adjusting for school, class, ethnicity, sex, and pretest score indicate that the FAN intervention significantly increased both knowledge and spacer competency test scores, among both the youth and teen participants (P = .011 with respect to knowledge score among teen students, P < .0001 for all other cases). This study suggests that FAN significantly increases asthma knowledge and spacer technique competency within this high-risk population.

The Effects of Self-Management Education for School-Age Children on Asthma Morbidity

The effects of asthma self-management education for school-age children on number of school days missed, emergency department visits and hospital admissions were evaluated through a systematic review of the published research. A total of 9 studies on asthma education programs that were conducted in schools by school nurses and health educators and targeted children 5-18 years of age were reviewed. The studies were all published between 1998 and 2009. The school-based asthma education programs delivered interventions in multiple sessions over short consecutive time periods of about a month to a month and a half. Follow-up data were collected in varying intervals from 1 month to 1 year postinterventions. Results indicated that a decrease in school days missed can be expected from such programs. The data regarding emergency department visits and hospital admissions was less definitive.

Knowledge and Attitudes of Adolescents towards Asthma: Questionnaire Results before and after a School-Based Education Program

Background: Previous studies on school-based education programs have reported that asthmatic and nonasthmatic adolescents, teachers and school personnel do not have enough information on asthma. However, the number of education programs including adolescents without asthma is not sufficient. The aim of the present study was to determine the knowledge of school children about asthma and to investigate whether their knowledge of asthma can be increased by an education program through a booklet distributed as a handout. Methods: This cross-sectional prospective questionnaire survey was carried out in a private school in Ankara, Turkey, between February and April 2006. 720 adolescents in grades 6, 7 and 8 were included. Knowledge about asthma was evaluated by a scoring system before and after the education offered by means of a booklet. Results: The final analysis was conducted on 642 students in total. The number of right answers in 5 categories, percentage of right answers and total questionnaire score improved significantly after the education received (p < 0.001). The total questionnaire scores of the girls (p = 0.002), those students with a university graduate mother (p = 0.006) and those with a physician parent (p = 0.041) were higher than those of the other pupils. Conclusion: Theoretical material in the form of a booklet can be used in a school-based asthma education program in order to improve the knowledge of adolescents about asthma.