Breaking the Access Barrier

ObjectiveTo 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.Study designRandomized controlled trial.SettingTwenty-six elementary schools located in a suburb of Toronto.ParticipantsA total of 256 children in grades 2 to 5 with asthma and their parents were randomized to control and experimental groups.InterventionChildren 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 resultsData 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.ConclusionProviding an asthma education program to children in their school can significantly improve quality of life and reduce the burden of childhood asthma.