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Asthma Health Outcomes Project

Overviews of Surveyed Asthma ProgramsSeptember 2005

Domestic Programs: California (cont'd) Back to Index

Evaluation of a School-Based Asthma Education Program for Inner-City Children

Scripps Research Institute

San Diego, CA

Sandra Christiansen, MD

The authors’ objective of this study was to assess the impact of a school-based education program on asthma outcomes.

In cooperation with the San Diego Unified Schools, the authors developed and implemented a school-based asthma education program. Based on the National Heart, Lung, and Blood Institute consensus guidelines for asthma, the five-session bilingual, interactive curriculum was conducted in 20-minute segments. Asthma knowledge was tested before and after the education program, and asthma severity was prospectively assessed at monthly intervals.

Outcome parameters were compared in educated and control (non-educated) fourth grade students with asthma by using nonparametric techniques.

After asthma education, students demonstrated improvement with increases in mean scores for: asthma knowledge quiz from 9.9 (SEM  = 0.44, n = 34) to 13.7 (SEM = 0.30); peak flow meter technique from 3.9 (SEM = 0.33, n = 32) to 6.4 (SEM = 0.29); and inhaler technique from 2.3 (SEM = 0.26, n = 32) to 4.3 (SEM = 0.26). All changes were highly significant (p  0.00001 as determined by Wilcoxon matched-pairs signed-rank test). Mean score comparisons for

asthmatic control students given paired examinations after a time interval matched with the educated students, did not reach statistical significance: quiz score of 11.3 (SEM = 0.80, n = 11) versus 10.9 (SEM = 0.68), peak flow meter technique score of 2.6 (SEM = 0.50, n = 18) versus 3.1 (SEM = 0.37) , and inhaler technique score of 2.5 (SEM = 0.37, n = 18) versus 2.2 (SEM = 0.31). Prospective monthly data were collected on 27 educated and 15 control asthmatic subjects. Severity of asthma was not significantly different between groups at entry to the study. Symptom questionnaires, validated for functional asthma severity, revealed a significant reduction in mean symptom scores at 180 days for the educated (2.87, SEM = 0.447) versus the control (4.36, SEM = 0.573) groups (p  = 0.0188 as determined by the Mann-Whitney U test).

In conclusion child-centered asthma education can be successfully conducted in the school setting, resulting in increased asthma knowledge, improved skills for peak flow meter and inhaler use, and a reduction in the severity of asthma symptoms.

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