Enhancing Asthma Self-Management in Rural School-Aged Children: A Randomized Controlled Trial

• Published in: The Journal of rural health 2016-06, Vol.32 (3), p.260-268
• Main Authors: Horner, Sharon D., Brown, Adama, Brown, Sharon A., Rew, D. Lynn
• Format: Article
• Language: English
• Subjects: Asthma; Asthma - prevention & control; Asthma - therapy; Attention; Child; child health; Child Welfare - statistics & numerical data; Children; Children & youth; Data analysis; Disease Management; Educational programs; Elementary schools; Emergency medical services; Emergency services; Enrollments; Female; Health care policy; Health education; Health Education - organization & administration; health promotion; Health status; Humans; Intervention; Longitudinal Studies; Low income groups; Male; Management; Medical diagnosis; Medical treatment; Parents & parenting; Participation; Questionnaires; Retention; Rural areas; rural children; Rural communities; Rural health care; Rural Population - statistics & numerical data; School Health Services - organization & administration; Schools; Schools - organization & administration; Self Care; Selfmanagement; Severity; Severity of Illness Index; Socioeconomic factors; Socioeconomic status; Socioeconomics; Visits
• ISSN: 0890-765X; 1748-0361
• DOI: 10.1111/jrh.12150

Purpose To test the effects of 2 modes of delivering an asthma educational intervention on health outcomes and asthma self‐management in school‐aged children who live in rural areas. Methods Longitudinal design with data collected 4 times over 12 months. The target sample was composed of children in grades 2‐5 who had a provider diagnosis of asthma. Elementary schools were stratified into high or low socioeconomic status based on student enrollment in the free or reduced‐cost lunch program. Schools were then randomly assigned to 1 of 3 treatment arms: in‐school asthma class, asthma day camp, or the attention‐control group. Findings Sample retention was good (87.7%) and equally distributed by study arm. Improvements in emergency department visits and office visits were related to attending either the asthma class or asthma day camp. Asthma severity significantly decreased in both asthma treatment groups. Other factors such as hospitalizations, parent asthma management, and child asthma management improved for all groups. Conclusions Both asthma class and asthma day camp yielded significant reductions in asthma severity. There were reductions in the emergency department and office visits for the 2 asthma arms, and hospitalizations declined significantly for all groups. Asthma self‐management also improved in all groups, while it was somewhat higher in the asthma arms. This may be due to the attention being drawn to asthma management by study participation and the action of completing questionnaires about asthma management, asthma symptoms, and health outcomes.