School-based asthma education program helps children and adolescents to better manage condition

Dec 3 2008

A new study has found that a school-based asthma education program conducted in the Oakland, California school district was shown to reduce symptoms and increase the number of days that children who suffered from asthma were able to go to school.

The study will be published this month in the Journal of School Health.

Nearly 10% or 6.8 million children have asthma in the U.S., according to the Centers for Disease Control and Prevention. The problem is most prevalent in urban areas, where children's symptoms are typically worse. In light of this, some schools in urban areas have been grappling with how best to help children cope with this chronic disease. Asthma can be deadly if not managed properly.

"This study demonstrates how schools can play an important role in the health and safety of children and adolescents coping with asthma," said Sheryl Magzamen, Ph.D., a Robert Wood Johnson Foundation® Health & Society Scholar at the University of Wisconsin and the lead author of the study. "We found that Kickin' Asthma is a good strategy for educating adolescents about their disease and helping them to take more control over it."

The study found that Kickin' Asthma demonstrated measurable and significant improvements for asthma symptoms, correct medication usage, and reduction in asthma morbidity for urban adolescent students during the first three years of the program. Days of activity limitations and days of school missed were significantly reduced (by one half day for every four weeks of intervention). The proportion of students who reported outpatient emergency care or hospitalization for asthma was significantly lower after participation during the first two years of the program. Frequency of daytime symptoms declined for the first three years of the program.

"The Kickin' Asthma program is specifically designed for an urban population and addresses the problem in children and adolescents during a potentially critical time, when they are starting to have more control over their own asthma care," said Adam Davis, Director of Programs and Research at the American Lung Association of California and Director of Oakland Kicks Asthma, which funded the Kickin' Asthma program.

Kickin' Asthma consists of a four-session curriculum developed by American Lung Association staff along with nurses and peer educators from the Oakland Unified School District. The program gives students the information and tools to better take care of their asthma by dispelling myths about the disease, educating students on the triggers, and instructing them about when and how to take their medication. The sessions were voluntary, although a small incentive was provided to students who completed the program during the first two years of the study.

Researchers surveyed 8,488 students during the first three years of the program (2003-2006) and 15.4% or 1,309 were identified as asthmatic. Of those, approximately 76% or 990 participated in the study. Participating students were in grades 7 to 10 from fifteen middle schools and three high schools.

"Effective asthma management programs can prevent costly and disruptive hospitalizations and ER visits, and decrease school absences," said Jo Ivey Boufford, M.D., co-director of the Robert Wood Johnson Foundation Health & Society Scholars National Program Office. "Programs like this, that put teenagers in charge of managing their asthma, are important for success and create good health habits for a lifetime."

The Oakland Unified School District is a public, K-12 school system with 42,000 predominantly low-income students. It is one of the most diverse school systems in the country with 45% African-American, 31% Latino, 17% Asian or Filipino, and 5% Caucasian students. Few schools in this district have a nurse or health aide.