Effects of a school-based intervention for urban adolescents with asthma. A controlled trial.
BACKGROUND
Asthma prevalence and morbidity are especially elevated in adolescents, yet few interventions target this population.


OBJECTIVE
To test the efficacy of Asthma Self-Management for Adolescents (ASMA), a school-based intervention for adolescents and medical providers.


METHODS
Three hundred forty-five primarily Latino/a (46%) and African American (31%) high school students (mean age = 15.1 yr; 70% female) reporting an asthma diagnosis, symptoms of moderate to severe persistent asthma, and asthma medication use in the last 12 months were randomized to ASMA, an 8-week school-based intervention, or a wait-list control group. They were followed for 12 months.


RESULTS
Students completed bimonthly assessments. Baseline, 6-month, and 12-month assessments were comprehensive; the others assessed interim health outcomes and urgent health care use. Primary outcomes were asthma self-management, symptom frequency, and quality of life (QOL); secondary outcomes were asthma medical management, school absences, days with activity limitations, and urgent health care use. Relative to control subjects, ASMA students reported significantly: more confidence to manage their asthma; taking more steps to prevent symptoms; greater use of controller medication and written treatment plans; fewer night awakenings, days with activity limitation, and school absences due to asthma; improved QOL; and fewer acute care visits, emergency department visits, and hospitalizations. In contrast, steps to manage asthma episodes, daytime symptom frequency, and school-reported absences did not differentiate the two groups. Most results were sustained over the 12 months.


CONCLUSIONS
ASMA is efficacious in improving asthma self-management and reducing asthma morbidity and urgent health care use in low-income urban minority adolescents.
NYU Child Study Center, 215 Lexington Avenue, New York, NY 10016, USA. Jean-Marie.Bruzzese@nyumc.org
Jean-Marie
JM
Bruzzese
Beverley J
BJ
Sheares
Elisa J
EJ
Vincent
Yunling
Y
Du
Hossein
H
Sadeghi
Moshe J
MJ
Levison
Robert B
RB
Mellins
David
D
Evans
D000293:Adolescent; D001741:Black or African American; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000517:prevention & control* / Q000628:therapy; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods; D011788:Quality of Life; D012574:Schools; D012648:Self Care / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014505:Urban Population
D018927:Anti-Asthmatic Agents