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ADVANCE Perspective: Respiratory Views

School-Based Program Helps Urban Teens Manage Asthma

Published December 14, 2010 1:59 PM by Valerie Newitt

Guess what! Students can learn a lot more than history and math in school. Researchers in New York City studied the effects of Asthma Self-Management for Adolescents (ASMA), a program aimed at urban youth and their medical providers. They concluded the school-based intervention program was successful in significantly improving asthma management and quality of life, and reducing asthma morbidity for students who participated. The findings were published online and distributed by Newswise ahead of the print edition of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

Program researchers enlisted 345 students with moderate to severe persistent asthma and asthma medication use in the previous 12 months, and randomized them to ASMA or a wait-list control group. Forty-six percent identified themselves as Latino and 31 percent identified themselves as African-American.

Those in the ASMA program underwent an eight-week program aimed at helping students manage symptoms through three educational group sessions and individual coaching sessions, held at least one each week for five weeks.

Students learned how to work with their medical provider to more effectively control their asthma. In addition, their providers were contacted to inform them of the study, and were given written materials and telephone consultations with pediatric pulmonologists or adolescent medicine specialists about the program's concepts and National Heart, Lung, and Blood Institute guidelines for treatment of asthma.

Providers were encouraged to give students written treatment plans and to prescribe anti-inflammatory medicines for students with persistent asthma. Students without medical providers were given a referral to a primary care provider in their neighborhood, or to a school-based health center, when available.

The good news? The researchers found students enrolled in ASMA took significantly more steps to prevent asthma symptoms from occurring and had improved self-confidence in managing their asthma compared to the control group. In addition, at six months, the odds of appropriately using a controller medication were twice as high in the ASMA group, compared to the control group.

Morbidity was also decreased in the ASMA group compared to control. ASMA participants reported a 31 percent reduction in night awakenings and a 42 percent reduction in activity restriction due to asthma, as well as a 28 percent reduction in acute medical visits, a 49 percent reduction in emergency department visits and a 76 percent reduction in hospitalizations compared with controls.

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