Chest
Volume 128, Issue 4, October 2005, Pages 1928-1935
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Clinical Investigations
Breaking the Access Barrier

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Objective

To evaluate an asthma education program for children with asthma that is delivered in their school by certified asthma educators from a local hospital-based asthma center.

Setting

Twenty-six elementary schools located in a suburb of Toronto.

Participants

A total of 256 children in grades 2 to 5 with asthma and their parents were randomized to control and experimental groups.

Intervention

Children in the experimental group received the “Roaring Adventures of Puff” asthma education program over the course of six weekly 1-h sessions. Those in the control group continued receiving usual care.

Measurements and results

Data collection involved measuring asthma quality of life, self-efficacy for managing asthma, school absenteeism, days of interrupted activity, health services use, and parental loss of time from work. Quality of life and self-efficacy data were collected from the children at baseline and 2 months. Telephone parental interviews conducted over 1 year were used to collect data on the remaining variables. Unpaired t test, analysis of variance, and χ2 test were used to determine whether differences existed between the groups. The results are reported as the mean ± SD. The experimental group demonstrated higher scores than the control group for self-efficacy (3.6 ± 0.7 vs 3.8 ± 0.9, respectively; p < 0.05) and quality of life (5.0 ± 1.4 vs 5.5 ± 1.4, respectively; p < 0.05). At 1 year, the experimental group demonstrated fewer mean urgent health-care visits (2.5 ± 2.5 vs 1.7 ± 1.9 visits per year, respectively; p < 0.01), days of missed school (4.3 ± 5.7 vs 3.0 ± 4.4 days per year, respectively; p > 0.05), and days of interrupted activity (9.1 ± 10.5 vs 6.2 ± 7.3 days per year; p < 0.01) related to asthma than the control group. There were no differences between the groups for parental work absenteeism or scheduled asthma visits.

Conclusion

Providing an asthma education program to children in their school can significantly improve quality of life and reduce the burden of childhood asthma.

Section snippets

Materials and Methods

A randomized controlled trial of an elementary school-based asthma education program was conducted with children with asthma in a large suburb of Toronto. Approval for conducting the study was received by the participating school board and the Ethics Review Committee of the Credit Valley Hospital (Mississauga, ON, Canada). Parents and children provided informed consent and assent, respectively. Children were eligible for inclusion if they were enrolled in grades 2 through 5 in a participating

Results

Of the 256 children with asthma and their parents who were recruited into the study, 239 completed it (control group, 118 children; experimental group, 121 children). Eight children and their parents were lost to follow-up after the 6-month data collection interview (control group, six children; experimental group, two children). For the experimental group, nine children withdrew from the study prior to receiving the educational program because of conflicts with other activities during the

Discussion

Children with asthma experience an unnecessary burden of illness, which can be mitigated through the known benefits of asthma education programs. The school is an excellent environment in which to educate children with asthma and to learn about their approach to managing the condition. The provision of asthma education to patients is often suboptimal, and the health-care system can pose access barriers. The purpose of the current study was to determine whether the provision of an asthma

Conclusion

The current study demonstrates that a school-based asthma education program delivered by certified asthma educators from a local asthma center can lead to benefits for the children affected by asthma. Specifically, children who attended the education program demonstrated increases in self-efficacy and quality of life, and reductions in urgent health-care use, school absenteeism, and number of days of interrupted activity. It is important to note that this project was performed in a suburban

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    Partnership funding was received from The Change Foundation, Credit Valley Hospital, Asthma Society, University of Toronto, and the Ontario Lung Association. Dr. Lisa Cicutto was supported by a Career Scientist Award from the Ontario Ministry of Health and Long Term Care.

    The results and conclusions of this research are those of the authors; no official endorsement by the Ministry is intended or should be inferred.

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

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