title: Effects of a comprehensive school-based asthma program on symptoms, parent management, grades, and absenteeism.
abstract: OBJECTIVE
  This study assessed the impact of a comprehensive school-based asthma program on symptoms, grades, and school absences in children, and parents' asthma management practices.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Fourteen elementary schools in low-income neighborhoods in Detroit, MI.
  
  
  METHODS
  Eight hundred thirty-five children with asthma in grades 2 through 5 and their parents.
  
  
  METHODS
  The intervention entailed six components for children, their parents, classmates, and school personnel to encourage and enable disease management.
  
  
  RESULTS
  Parents completed telephone interviews and the schools provided data at baseline and 24 months after intervention. At follow-up, treatment children with persistent disease had significant declines in both daytime (14% fewer, p < 0.0001) and nighttime (14% fewer, p < 0.0001) symptoms. Among children with both mild intermittent and persistent disease, those in the treatment group had 17% fewer daytime symptoms (p < 0.0001) but 40% more nighttime symptoms. Treatment children had higher grades for science (p < 0.02) but not reading, mathematics, or physical education. No differences in school absences for all causes between groups were noted in school records. However, parents of treatment group children reported fewer absences attributable to asthma in the previous 3 months (34% fewer, p < 0.0001) and 12 months (8% fewer, p < 0.05). Parents of treatment children had higher scores (2.19 greater, p = 0.02) on an asthma management index. The program may have stimulated attention to symptoms at night by parents of children with mild intermittent disease. Overall, the intervention provided significant benefits, particularly for children with persistent asthma.
authors.affiliation: University of Michigan School of Public Health, Ann Arbor 48109-2029, USA. nmclark@umich.edu
authors.forename: Noreen M
authors.initials: NM
authors.lastname: Clark
authors.forename: Randall
authors.initials: R
authors.lastname: Brown
authors.forename: Christine L M
authors.initials: CL
authors.lastname: Joseph
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Anderson
authors.forename: Manlan
authors.initials: M
authors.lastname: Liu
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Valerio
mesh_terms: D000041:Absenteeism; D000124:Achievement; D001249:Asthma / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D015397:Program Evaluation; D012572:School Health Services; D012720:Severity of Illness Index