title: Small-group, interactive education and the effect on asthma control by children and their families.
abstract: BACKGROUND
  Effective approaches to education about asthma need to be identified. We evaluated the impact on asthma control by children and their caregivers of an intervention involving small-group, interactive education about asthma.
  
  
  METHODS
  We randomly assigned children who visited an emergency department for an exacerbation of asthma (n = 398) to either of 2 groups. Children assigned to the control group followed the usual care recommended by their primary care physician. Those assigned to the intervention group participated in a small-group, interactive program of education about asthma. We examined changes in the number of visits to the emergency department during the year after the intervention.
  
  
  RESULTS
  During the year after enrolment, children in the intervention group made significantly fewer visits to the emergency department (0.45 visits per child) compared with those in the control group (0.75 visits per child) (p = 0.004). The likelihood of a child in the intervention group requiring emergency care was reduced by 38% (relative risk [RR] 0.62, 95% confidence interval CI 0.48-0.81, p = 0.004). Fewer courses of oral corticosteroids (0.63 per child) were required by children in the intervention group than by those in the control group (0.85 per child) (p = 0.006). We observed significant improvements in the symptom domain of the questionnaire on pediatric asthma quality-of-life (p = 0.03) and the activity domain of the questionnaire on caregivers' quality of life (p = 0.05). Parents of children in the intervention group missed less work because of their child's asthma after participating in the educational program (p = 0.04). No impact on hospital admissions was observed.
  
  
  CONCLUSIONS
  Education about asthma, especially in a small-group, interactive format, improved clinically important outcomes and overall care of children with asthma.
authors.affiliation: Children's Asthma Education Centre, Dalhousie University, IWK Health Centre, Halifax, NS. wade.watson@iwk.nshealth.ca
authors.forename: Wade T A
authors.initials: WT
authors.lastname: Watson
authors.forename: Cathy
authors.initials: C
authors.lastname: Gillespie
authors.forename: Nicola
authors.initials: N
authors.lastname: Thomas
authors.forename: Shauna E
authors.initials: SE
authors.lastname: Filuk
authors.forename: Judy
authors.initials: J
authors.lastname: McColm
authors.forename: Michelle P
authors.initials: MP
authors.lastname: Piwniuk
authors.forename: Allan B
authors.initials: AB
authors.lastname: Becker
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001249:Asthma / Q000453:epidemiology / Q000628:therapy*; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005190:Family; D005260:Female; D006126:Group Processes; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D018582:Sick Leave / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology
chemical_list: D000305:Adrenal Cortex Hormones
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