Effectiveness of a multicomponent self-management program in at-risk, school-aged children with asthma.
BACKGROUND
Improving asthma knowledge and self-management is a common focus of asthma educational programs, but most programs have had little influence on morbidity outcomes. We developed a novel multiple-component intervention that included the use of an asthma education video game intended to promote adoption of asthma self-management behaviors and appropriate asthma care.


OBJECTIVE
To determine the effectiveness of an asthma education video game in reducing morbidity among high-risk, school-aged children with asthma.


METHODS
We enrolled 119 children aged 5 to 12 years from low-income, urban areas in and around San Francisco, CA, and San Jose, CA. Children with moderate-to-severe asthma and parental reports of significant asthma health care utilization were randomized to participate in the disease management intervention or to receive their usual care (control group). Patients were evaluated for clinical and quality-of-life outcomes at weeks 8, 32, and 52 of the study.


RESULTS
Compared with controls, the intervention group had significant improvements in the physical domain (P = .04 and P = .01 at 32 and 52 weeks, respectively) and social activity domain (P = .02 and P = .05 at 32 and 52 weeks, respectively) of asthma quality of life on the Child Health Survey for Asthma and child (P = .02 at 8 weeks) and parent (P = .04 and .004 at 32 and 52 weeks, respectively) asthma self-management knowledge. There were no significant differences between groups on clinical outcome variables.


CONCLUSIONS
A multicomponent educational, behavioral, and medical intervention targeted at high-risk, inner-city children with asthma can improve asthma knowledge and quality of life.
Shames
Richard S
RS
Department of Pediatrics, Stanford University School of Medicine, Stanford, California 94305, USA. rshames@pdl.com
Sharek
Paul
P
Mayer
Michelle
M
Robinson
Thomas N
TN
Hoyte
Elisabeth G
EG
Gonzalez-Hensley
Frances
F
Bergman
David A
DA
Umetsu
Dale T
DT
D001249:Asthma / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D010366:Peak Expiratory Flow Rate; D011788:Quality of Life; D012307:Risk Factors; D012648:Self Care / Q000379:methods*; D012923:Social Class