Evaluation of a peer-led asthma self-management program and benefits of the program for adolescent peer leaders.
BACKGROUND
Asthma is the leading chronic condition in adolescents. Nonetheless, research efforts to address adolescent asthma morbidity by applying a developmentally appropriate self-management intervention have been limited. Recently a peer-led asthma self-management program has been developed and implemented for adolescents. The purpose of the study was to assess the acceptability of a peer-led asthma program for adolescents based on participant feedback and to examine the program's impact on asthma outcomes in peer leaders.


METHODS
Adolescents with persistent asthma (n = 91, 13-17 years) participated in a camp-based asthma program led by peer leaders (the intervention group) or healthcare professionals (the control group), and completed a set of program evaluation forms. Peer leaders (n = 14, 16-20 years) completed study questionnaires measuring asthma knowledge, self-efficacy, asthma control, and quality of life at baseline, immediately after camp, and 3, 6, and 9 months post-camp.


RESULTS
The peer-led group reported more positive experience with the program than the adult-led group (P = .01, Cohen's d = 0.53), particularly in its usefulness in dealing with asthma. Peer leaders were rated by participants highly on knowledge (98%), attitudes (93-96%), personal skills (91%), and perceived similarities (80-86%). Significant improvements were found in peer leaders' knowledge (P < .001, η(2) = 0.87), self-efficacy (P < .001, η(2) = 0.74), asthma control (P = .01, η(2) = 0.66), and quality of life in emotional functioning (P = .002, η(2) = 0.82) and activity (P = .003, η(2) = 0.62).


CONCLUSIONS
A peer-led asthma self-management program was successfully implemented and well received by adolescent learners. Asthma outcomes in peer leaders appear to have improved as a result of the program, although caution should be exercised in determining clinical meaningfulness, given the modest changes in mean scores. ClinicalTrials.gov registration NCT01161225.
School of Nursing, University of Rochester, Rochester, NY, USA. hyekyun_rhee@urmc.rochester.edu
Hyekyun
H
Rhee
Brenda E
BE
McQuillan
Michael J
MJ
Belyea
D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007857:Leadership; D008297:Male; D010379:Peer Group; D011788:Quality of Life; D012648:Self Care