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Breaking the Access Barrier^*

Evaluating an Asthma Center’s Efforts to Provide Education to Children With Asthma in Schools

^* From the Faculty of Nursing (Dr. Cicutto), University of Toronto, Toronto, ON, Canada; and the Asthma Centre (Mss. Murphy, Coutts, O’Rourke, Lang, and Chapman, and Dr. Coates), Credit Valley Hospital, Mississauga, ON, Canada.

Correspondence to: Lisa Cicutto, PhD, Associate Professor, University of Toronto, 50 St. George St, Toronto, ON, M5S 3H4 Canada; e-mail: lisa.cicutto{at}utoronto.ca

Objective: To evaluate an asthma education program for children with asthma that is delivered in their school by certified asthma educators from a local hospital-based asthma center.

Study design: Randomized controlled trial.

Setting: Twenty-six elementary schools located in a suburb of Toronto.

Participants: A total of 256 children in grades 2 to 5 with asthma and their parents were randomized to control and experimental groups.

Intervention: Children in the experimental group received the "Roaring Adventures of Puff" asthma education program over the course of six weekly 1-h sessions. Those in the control group continued receiving usual care.

Measurements and results: Data collection involved measuring asthma quality of life, self-efficacy for managing asthma, school absenteeism, days of interrupted activity, health services use, and parental loss of time from work. Quality of life and self-efficacy data were collected from the children at baseline and 2 months. Telephone parental interviews conducted over 1 year were used to collect data on the remaining variables. Unpaired t test, analysis of variance, and ² test were used to determine whether differences existed between the groups. The results are reported as the mean ± SD. The experimental group demonstrated higher scores than the control group for self-efficacy (3.6 ± 0.7 vs 3.8 ± 0.9, respectively; p < 0.05) and quality of life (5.0 ± 1.4 vs 5.5 ± 1.4, respectively; p < 0.05). At 1 year, the experimental group demonstrated fewer mean urgent health-care visits (2.5 ± 2.5 vs 1.7 ± 1.9 visits per year, respectively; p < 0.01), days of missed school (4.3 ± 5.7 vs 3.0 ± 4.4 days per year, respectively; p > 0.05), and days of interrupted activity (9.1 ± 10.5 vs 6.2 ± 7.3 days per year; p < 0.01) related to asthma than the control group. There were no differences between the groups for parental work absenteeism or scheduled asthma visits.

Conclusion: Providing an asthma education program to children in their school can significantly improve quality of life and reduce the burden of childhood asthma.

Key Words: asthma • asthma education • certified asthma educators • children • controlled-trial • school

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