A trial of asthma self-management in Beijing schools

Abstract

Objectives: This study examined the effectiveness in children in China of an asthma education programme adapted from a model developed in the USA.

Methods: Six hundred and thirty-nine children in 21 elementary schools in one agricultural and one industrial area participated in a randomized, controlled trial. Data were collected at baseline and 1 year subsequently. The self-regulation-based programme addressed topics including preventing and managing symptoms, using medicines, and identifying and controlling triggers.

Results: Positive effects on treatment children v. control children were noted in school performance (0.21 v. -0.06, p=0.04), absences (-0.55 v . -0.32, p=0.02), and home environment (1.78 v. 4.75, p=0.009). Industrial-area children additionally benefited from fewer hospitalizations (odds ratio=1.96, p=0.05) and asthma-related concerns of parents (-0.63 v. -0.34, p=0.001). Agricultural-area parents showed greater improvement in asthma management (0.93 v. 0.26, p=0.0001), and expressed more negative feelings about asthma (-0.13 v. -0.58, p=0.04) and asthma concerns (-0.31 v. -0.63, p=0.0001).

Discussion: The programme provided overall benefits related to school performance, absences, and home environment. In the agricultural area, where fewer resources were available, benefits were fewer and concerns greater. In the industrial area, where education and income were higher, additional benefits related to healthcare use and parents' quality of life were realized.

Keywords

Asthma in schools Asthma self-management China Paediatric asthma

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References

Woolcock AJ Opportunities for Japanese— Australian cooperation in asthma research . Respirology 1999; 4: 409—11.

von Mutius E. The rising trends in asthma and allergic disease . Clin Exp Allergy 1998; 28(Suppl. 5): 45—9; discussion 50—1.

Hartert TV , Peebles RS Jr.Epidemiology of asthma: the year in review. Curr Opin Pulm Med 2000; 6: 4—9.

Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood (ISAAC). Eur Respir J 1998; 12: 315—35.

Weiss KB , Wagener DK Asthma surveillance in the United States. A review of current trends and knowledge gaps. Chest 1990; 98(5 Suppl.): 179S—84S.

Guevara JP , Wolf FM , Grum CM , Clark NM Effects of asthma self management educational interventions in children and adolescents: a systematic review and meta-analysis. BMJ 2003; 326: 1308—9.

Anderson E. , Valerio M. , Liu M. , et al. Schools capacity to assist low income minority children to manage asthma. J School Nursing (in press).

Clark NM , Brown R. , Joseph C. , et al. Issues in identifying asthma and estimating prevalence in an urban school population. J Clin Epidemiol 2002; 55: 870—81.

Evans D. , Clark NM , Feldman CH , et al. A school health education program for children with asthma aged 8—11 years. Health Educ Q 1987; 14: 267—79.

10.

Guidelines for the diagnosis and management of asthma. National (US) Asthma Education and Prevention Program Expert Panel Report II. National Asthma Education Program, Office of Prevention, Education, and Control. Bethesda, MD: National Heart, Lung, and Blood Institute, 1997.

11.

Hindi-Alexander MC , Cropp GJ Evaluation of a family asthma program . J Allergy Clin Immunol 1984; 74(4 Pt 1): 505—10.

12.

Clark NM , Brown R. , Joseph CL , Anderson EW , Liu M. , Valerio MA Effects of a comprehensive school-based asthma program on symptoms, parent management, grades, and absenteeism. Chest 2004; 125: 1674—9.

13.

Shah S. , Peat JK , Gibson P. , et al. Effect of peer led programme for asthma education in adolescents: cluster randomised controlled trial. BMJ 2001 ; 322: 583—5.

14.

Woolcock AJ Epidemiologic methods for measuring prevalence of asthma. Chest 1987; 91(6 Suppl.): 89S—92S.

15.

National Institutes of Health (NIH). Global Initiative for Asthma: global strategy for asthma management and prevention. NIH Publication No. 02-3659. Bethesda, MD: National Heart, Lung, and Blood Institute, 2002.

16.

Juniper EF , Guyatt GH Measuring quality of life in the parents of children with asthma. Qual Life Res 1996; 5: 27—34.

17.

Wang H. TCM treatment of asthma in children with yin hua wu mei tang — Professor Liu Bichen's experience in treating asthma. J Tradit Chin Med 2000; 20: 180—4.