178508 Do School-based Asthma Education Programs Improve Self-Management and Health Outcomes

Monday, October 27, 2008: 10:50 AM

Janet M. Coffman, MPP, PhD , Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
Michael D. Cabana, MD, MPH , Department of Pediatrics, University of California, San Francisco, San Francisco, CA
Edward H. Yelin, PhD , Department of Medicine/Arthritis Research Group, University of California, San Francisco, San Francisco, CA, CA
Objective: To conduct a systematic review of the literature on effects of school-based asthma education programs on three intermediate outcomes (knowledge of asthma, self-efficacy, and self-management behaviors) and four health outcomes (days with symptoms, nights with symptoms, quality of life, and school absences). We hypothesized that asthma education would increase knowledge and self-efficacy which would improve self-management behaviors and health outcomes.

Methods: We searched PubMed, CINAHL, and the Cochrane Controlled Trials Register for controlled trials that assessed school-based asthma education programs. Inclusion criteria included publication in English and enrollment of children aged 4-17 years with a clinical diagnosis of asthma or symptoms consistent with asthma.

Results: Two investigators screened titles of 358 articles and retrieved 111 for further review. Twenty-five met the inclusion criteria. Most school-based asthma education programs provided comprehensive education consistent with national guidelines to groups of children. Eighty-three percent of studies that examined effects on knowledge, self-efficacy, and/or self-management behaviors found that school-based asthma education improved these intermediate outcomes. In contrast, only half of studies that assessed quality of life, days with symptoms, and/or nights with symptoms reported that education was associated with better outcomes. Only one third of studies that evaluated school absences found that children who received education had fewer absences.

Conclusion: School-based asthma education programs improve children's knowledge, self-efficacy, and self-management behaviors but are less effective in improving health outcomes. Greater collaboration between educators and health professionals and better access to appropriate care may be needed to improve the health of children with asthma.

Learning Objectives:
At the end of the presentation, participants will be able to articulate the major findings from a systematic review of school-based asthma education programs with regard to the characteristics of these programs and their impact on the health of children with asthma.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceptualized the project, completed the literature review, extracted data, analyzed data, and wrote all drafts of the paper described in this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.