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Effects of a school-based intervention for urban adolescents with asthma. A controlled trial.

AbstractRATIONALE:
Asthma prevalence and morbidity are especially elevated in adolescents, yet few interventions target this population.
OBJECTIVES:
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.
MEASUREMENTS AND MAIN 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.
AuthorsJean-Marie Bruzzese, Beverley J Sheares, Elisa J Vincent, Yunling Du, Hossein Sadeghi, Moshe J Levison, Robert B Mellins, David Evans
JournalAmerican journal of respiratory and critical care medicine (Am J Respir Crit Care Med) Vol. 183 Issue 8 Pg. 998-1006 (Apr 15 2011) ISSN: 1535-4970 [Electronic] United States
PMID21139088 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
Chemical References
  • Anti-Asthmatic Agents
Topics
  • Adolescent
  • Black or African American
  • Anti-Asthmatic Agents (therapeutic use)
  • Asthma (drug therapy, prevention & control, therapy)
  • Emergency Medical Services (statistics & numerical data)
  • Female
  • Hispanic or Latino
  • Humans
  • Male
  • Patient Education as Topic (methods)
  • Quality of Life
  • Schools
  • Self Care (methods, statistics & numerical data)
  • Treatment Outcome
  • Urban Population

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