title: An education intervention for childhood asthma by Aboriginal and Torres Strait Islander health workers: a randomised controlled trial.
abstract: 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.
authors.affiliation: Queensland Institute of Medical Research, and Australian Centre for International and Tropical Health, University of Queensland, Brisbane, QLD, Australia. Patricia.Valery@qimr.edu.au
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Valery
authors.forename: Ian B
authors.initials: IB
authors.lastname: Masters
authors.forename: Brett
authors.initials: B
authors.lastname: Taylor
authors.forename: Yancy
authors.initials: Y
authors.lastname: Laifoo
authors.forename: Peter K
authors.initials: PK
authors.lastname: O'Rourke
authors.forename: Anne B
authors.initials: AB
authors.lastname: Chang
mesh_terms: 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