Do school-based asthma education programs improve self-management and health outcomes?
BACKGROUND
Asthma self-management education is critical for high-quality asthma care for children. A number of studies have assessed the effectiveness of providing asthma education in schools to augment education provided by primary care providers.


OBJECTIVE
To conduct a systematic review of the literature on school-based asthma education programs.


METHODS
As our data sources, we used 3 databases that index peer-reviewed literature: MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cumulative Index to Nursing and Allied Health Literature. Inclusion criteria included publication in English and enrollment of children aged 4 to 17 years with a clinical diagnosis of asthma or symptoms consistent with asthma.


RESULTS
Twenty-five articles met the inclusion criteria. Synthesizing findings across studies was difficult because the characteristics of interventions and target populations varied widely, as did the outcomes assessed. In addition, some studies had major methodologic weaknesses. Most studies that compared asthma education to usual care found that school-based asthma education improved knowledge of asthma (7 of 10 studies), self-efficacy (6 of 8 studies), and self-management behaviors (7 of 8 studies). Fewer studies reported favorable effects on quality of life (4 of 8 studies), days of symptoms (5 of 11 studies), nights with symptoms (2 of 4 studies), and school absences (5 of 17 studies).


CONCLUSIONS
Although findings regarding effects of school-based asthma education programs on quality of life, school absences, and days and nights with symptoms were not consistent, our analyses suggest that school-based asthma education improves knowledge of asthma, self-efficacy, and self-management behaviors.
Coffman
Janet M
JM
Philip R Lee Institute for Health Policy Studies and Department of bFamily and Community Medicine, University of California, San Francisco, California 94118, USA. janet.coffman@ucsf.edu
Cabana
Michael D
MD
Yelin
Edward H
EH
D000041:Absenteeism; D000293:Adolescent; D001249:Asthma / Q000523:psychology / Q000628:therapy*; D002648:Child; D018849:Controlled Clinical Trials as Topic; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D012572:School Health Services; D012648:Self Care / Q000379:methods* / Q000523:psychology; D020377:Self Efficacy