title: Evaluating the effect of an asthma self-management intervention for rural families.
abstract: OBJECTIVE
  To present outcomes of an asthma self-management educational intervention delivered to children (grades 2-5) at school and to parents in a home visit.
  
  
  METHODS
  The intervention effectiveness was tested in a 12-month longitudinal study with randomization by elementary schools into treatment and attention-control groups with 183 children who had a diagnosis of asthma. Data were collected at four time points. Change over time was examined with linear mixed models.
  
  
  RESULTS
  Quality of life (QOL), hospitalizations, and emergency department visits improved significantly for all the children. African American and Mexican American children had worse asthma-related QOL than did White children. Asthma management behaviors, asthma self-efficacy, and coping likewise improved with girls improving significantly more than the boys. Significant improvements in inhaler skill and asthma severity were seen in the treatment group children when compared to the control group. Treatment group parents showed significant improvements in home asthma management and self-efficacy.
  
  
  CONCLUSIONS
  The improvement in inhaler skill is an important finding for practitioners as this is a behavior that can be addressed in the clinical setting. The reduction in the treatment group's asthma severity scores may reflect the improvement in medication delivery as their inhaler skill improved. The differential improvement between boys and girls points to the need for testing other formats in asthma education that can address different learning styles. The individualized parent asthma education enabled the intervener to incorporate neighborhood and home environmental information thereby allowing for tailoring of parental instruction.
authors.affiliation: School of Nursing, The University of Texas at Austin , Austin, TX , USA.
authors.forename: Sharon D
authors.initials: SD
authors.lastname: Horner
authors.forename: Adama
authors.initials: A
authors.lastname: Brown
mesh_terms: D001249:Asthma / Q000628:therapy*; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005190:Family; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D036501:Metered Dose Inhalers / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D063868:Patient Outcome Assessment; D011788:Quality of Life; D012424:Rural Population; D012648:Self Care; D012720:Severity of Illness Index