Asthma program helps school children improve grades

Detroit public school children living with asthma may have fewer absences and improve their grades with the help of a new comprehensive asthma program.

In a study published in the May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians, Detroit children with asthma participating in a school-based asthma program had 34 percent fewer absences than children with asthma not enrolled in the program. Children in the program also received significantly higher science grades and experienced fewer daytime symptoms than students with asthma not involved in the program.

“Asthma and its symptoms can greatly impact the school life of a child,” said Noreen M. Clark, PhD, University of Michigan School of Public Health, Ann Arbor, MI. “Our new asthma program shows that by involving the child, parents, and school system in asthma management, children with asthma can experience substantial physical and academic benefits.”

Researchers from the University of Michigan Medical School and School of Public Health, and Henry Ford Health System, Detroit, MI, introduced an interventional asthma program into 14 Detroit elementary schools with the intention of evaluating the program’s effects on symptom management and school attendance and performance. Participating schools were randomly selected to either receive the program or serve as the study control group with the option of receiving the program at a later date. A total of 835 students with asthma (98 percent African-American), grades 2 to 5, were included in the study, with 416 students receiving the asthma program and 419 students in the control group. The program was implemented over a period of 24 months and involved asthma education for students with asthma and their classmates, asthma education and management training for school personnel and parents, and communication to the asthmatic child’s physician encouraging the completion of an asthma action plan for the child.

At the completion of the program, parents reported that children in the treatment group had 34 percent fewer asthma-related absences than children in the control group. However, school absence records, which do not account for the cause of absences, showed no significant difference in absences between the groups. In addition, science grades for treatment children were significantly higher than grades for control children, while all other academic grades remained similar between the groups. Results were based on school records and parent and caregiver interviews at the beginning of the program and at 12 and 24 months after intervention.

“Our intervention techniques included age-appropriate lessons related to physiology and lung function, which may have helped to improve science grades for treatment children,” said Dr. Clark. “It also is possible that the deductive nature of the program activities may have enhanced the ability of the children to address science problems in general.”

In regard to asthma symptoms, children in the treatment group experienced 17 percent fewer days with asthma symptoms than the control group. In addition, children in the treatment group with persistent asthma had 15 percent fewer nighttime symptoms than the control group; however, children in the treatment group with mild periodic asthma showed a 40 percent increase in nighttime symptoms. Results also showed that parents whose children were participating in the program took additional and more frequent steps to manage their child’s asthma than parents of children in the control group.

“Asthma symptoms that are mild and sporadic may be less noticeable to family members,” said Dr. Clark. “Families involved in the asthma program may have been more aware of their child’s nighttime symptoms and therefore more likely to report them.”

“As health-care providers, we are constantly striving to find more effective ways of managing asthma in children,” said Paul A. Kvale, MD, FCCP, President-Elect of the American College of Chest Physicians. “With a support network of community and school-based asthma programs combined with physician intervention, children with asthma and their families may be better prepared to manage asthma-related symptoms.”

CHEST is a peer-reviewed journal published by the ACCP. It is available online each month at https://journal.chestnet.org/. ACCP represents more than 15,700 members who provide clinical respiratory, critical care, and cardiothoracic patient care in the United States and throughout the world. ACCP's mission is to promote the prevention and treatment of diseases of the chest through leadership, education, research, and communication.