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Effects of a school-based intervention for urban adolescents with asthma. A controlled trial.
Am J Respir Crit Care Med. 2011 Apr 15; 183(8):998-1006.AJ

Abstract

RATIONALE

Asthma prevalence and morbidity are especially elevated in adolescents, yet few interventions target this population.

OBJECTIVES

To test the efficacy of Asthma Self-Management for Adolescents (ASMA), a school-based intervention for adolescents and medical providers.

METHODS

Three hundred forty-five primarily Latino/a (46%) and African American (31%) high school students (mean age = 15.1 yr; 70% female) reporting an asthma diagnosis, symptoms of moderate to severe persistent asthma, and asthma medication use in the last 12 months were randomized to ASMA, an 8-week school-based intervention, or a wait-list control group. They were followed for 12 months.

MEASUREMENTS AND MAIN RESULTS

Students completed bimonthly assessments. Baseline, 6-month, and 12-month assessments were comprehensive; the others assessed interim health outcomes and urgent health care use. Primary outcomes were asthma self-management, symptom frequency, and quality of life (QOL); secondary outcomes were asthma medical management, school absences, days with activity limitations, and urgent health care use. Relative to control subjects, ASMA students reported significantly: more confidence to manage their asthma; taking more steps to prevent symptoms; greater use of controller medication and written treatment plans; fewer night awakenings, days with activity limitation, and school absences due to asthma; improved QOL; and fewer acute care visits, emergency department visits, and hospitalizations. In contrast, steps to manage asthma episodes, daytime symptom frequency, and school-reported absences did not differentiate the two groups. Most results were sustained over the 12 months.

CONCLUSIONS

ASMA is efficacious in improving asthma self-management and reducing asthma morbidity and urgent health care use in low-income urban minority adolescents.

Authors+Show Affiliations

NYU Child Study Center, 215 Lexington Avenue, New York, NY 10016, USA. Jean-Marie.Bruzzese@nyumc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

21139088

Citation

Bruzzese, Jean-Marie, et al. "Effects of a School-based Intervention for Urban Adolescents With Asthma. a Controlled Trial." American Journal of Respiratory and Critical Care Medicine, vol. 183, no. 8, 2011, pp. 998-1006.
Bruzzese JM, Sheares BJ, Vincent EJ, et al. Effects of a school-based intervention for urban adolescents with asthma. A controlled trial. Am J Respir Crit Care Med. 2011;183(8):998-1006.
Bruzzese, J. M., Sheares, B. J., Vincent, E. J., Du, Y., Sadeghi, H., Levison, M. J., Mellins, R. B., & Evans, D. (2011). Effects of a school-based intervention for urban adolescents with asthma. A controlled trial. American Journal of Respiratory and Critical Care Medicine, 183(8), 998-1006. https://doi.org/10.1164/rccm.201003-0429OC
Bruzzese JM, et al. Effects of a School-based Intervention for Urban Adolescents With Asthma. a Controlled Trial. Am J Respir Crit Care Med. 2011 Apr 15;183(8):998-1006. PubMed PMID: 21139088.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of a school-based intervention for urban adolescents with asthma. A controlled trial. AU - Bruzzese,Jean-Marie, AU - Sheares,Beverley J, AU - Vincent,Elisa J, AU - Du,Yunling, AU - Sadeghi,Hossein, AU - Levison,Moshe J, AU - Mellins,Robert B, AU - Evans,David, Y1 - 2010/12/07/ PY - 2010/12/9/entrez PY - 2010/12/9/pubmed PY - 2011/6/23/medline SP - 998 EP - 1006 JF - American journal of respiratory and critical care medicine JO - Am. J. Respir. Crit. Care Med. VL - 183 IS - 8 N2 - RATIONALE: Asthma prevalence and morbidity are especially elevated in adolescents, yet few interventions target this population. OBJECTIVES: To test the efficacy of Asthma Self-Management for Adolescents (ASMA), a school-based intervention for adolescents and medical providers. METHODS: Three hundred forty-five primarily Latino/a (46%) and African American (31%) high school students (mean age = 15.1 yr; 70% female) reporting an asthma diagnosis, symptoms of moderate to severe persistent asthma, and asthma medication use in the last 12 months were randomized to ASMA, an 8-week school-based intervention, or a wait-list control group. They were followed for 12 months. MEASUREMENTS AND MAIN RESULTS: Students completed bimonthly assessments. Baseline, 6-month, and 12-month assessments were comprehensive; the others assessed interim health outcomes and urgent health care use. Primary outcomes were asthma self-management, symptom frequency, and quality of life (QOL); secondary outcomes were asthma medical management, school absences, days with activity limitations, and urgent health care use. Relative to control subjects, ASMA students reported significantly: more confidence to manage their asthma; taking more steps to prevent symptoms; greater use of controller medication and written treatment plans; fewer night awakenings, days with activity limitation, and school absences due to asthma; improved QOL; and fewer acute care visits, emergency department visits, and hospitalizations. In contrast, steps to manage asthma episodes, daytime symptom frequency, and school-reported absences did not differentiate the two groups. Most results were sustained over the 12 months. CONCLUSIONS: ASMA is efficacious in improving asthma self-management and reducing asthma morbidity and urgent health care use in low-income urban minority adolescents. SN - 1535-4970 UR - https://www.unboundmedicine.com/medline/citation/21139088/Effects_of_a_school_based_intervention_for_urban_adolescents_with_asthma__A_controlled_trial_ L2 - http://www.atsjournals.org/doi/full/10.1164/rccm.201003-0429OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -