An education intervention for childhood asthma by Aboriginal and Torres Strait Islander health workers: a randomised controlled trial.
OBJECTIVE
To assess the outcomes of an education intervention for childhood asthma conducted by Australian Indigenous health care workers (IHCWs).


METHODS
Randomised controlled trial in a primary health care setting on Thursday Island and Horn Island, and in Bamaga, Torres Strait region of northern Australia, April 2005 to March 2007.


METHODS
88 children, aged 1-17 years, with asthma diagnosed by a respiratory physician (intervention group, 35; control group, 53; 98% Indigenous children).


METHODS
Children were randomly allocated to: (i) three additional asthma education sessions with a trained IHCW, or (ii) no additional asthma education. Both groups were re-assessed at 12 months.


METHODS
Primary endpoint: number of unscheduled visits to hospital or a doctor caused by asthma exacerbation.


RESULTS
measures of quality of life (QoL) and functional severity index; asthma knowledge and understanding of asthma action plans (AAPs); and school days missed because of wheezing.


RESULTS
The groups were comparable at baseline (except for asthma severity, which was adjusted for in the analysis). There were no significant differences in the primary outcome (number of unscheduled medical visits for asthma). School children in the intervention group missed fewer school days because of wheezing (100% < 7 days v 21% of those in the control group missed 7-14 days). Significantly more carers in the intervention group could answer questions about asthma medication, knew where their AAP was kept (84% v 56%), and were able to describe the plan (67% v 40%). In both the intervention and control groups (before-and-after comparison), there was a significantly reduced frequency of asthma exacerbations, as well as an improved QoL score and functional severity index, with no significant differences between the groups.


CONCLUSIONS
A community-based asthma education program conducted by trained IHCWs improves some important asthma outcomes in Indigenous children with asthma.


BACKGROUND
Australian Clinical Trials Registry ACTRN012605000718640.
Valery
Patricia C
PC
Queensland Institute of Medical Research, and Australian Centre for International and Tropical Health, University of Queensland, Brisbane, QLD, Australia. Patricia.Valery@qimr.edu.au
Masters
Ian B
IB
Taylor
Brett
B
Laifoo
Yancy
Y
O'Rourke
Peter K
PK
Chang
Anne B
AB
D000041:Absenteeism; D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D001315:Australia; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D006801:Humans; D007223:Infant; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods; D000078329:Workforce; D000095283:Australian Aboriginal and Torres Strait Islander Peoples