EVALUATION OF A SCHOOL-BASED ASTHMA EDUCATION-PROGRAM FOR INNER-CITY CHILDREN

Background: We have previously reported a high prevalence of current a sthma-related symptoms affecting predominantly Hispanic, socioeconomic ally disadvantaged schoolchildren in Southeast San Diego. Objective: W e sought to assess the impact of a School-based education program on a sthma outcomes. Methods: In cooperation with the San Diego Unified Sch ools, we developed and implemented a school-based asthma education pro gram. Based on the National Heart, Lung, and Blood Institute consensus guidelines for asthma, the five-session bilingual, interactive curric ulum was conducted in 20-minute segments. Asthma knowledge was tested before and after the education program, and asthma severity was prospe ctively assessed at monthly intervals, Outcome parameters were compare d in educated and control (noneducated) fourth grade students with ast hma by using nonparametric techniques. Results: After asthma education , students demonstrated improvement with increases in mean scores for: asthma knowledge quiz from 9.9 (SEM = 0.44, n = 34) to 13.7 (SEM = 0. 30); peak flowmeter technique from 3.9 (SEM = 0.33, n = 32) to 6.4 (SE M = 0.29); and inhaler technique from 2.3 (SEM = 0.26, n = 32) to 4.3 (SEM = 0.26). All changes were highly significant (p less than or equa l to 0.00001 as determined by Wilcoxon matched-pairs signed-rank test) , Mean score comparisons for asthmatic control students given paired e xaminations after a time interval matched with the educated students, did not reach statistical significance: quiz score of 11.3 (SEM = 0.80 , n = 11) versus 10.9 (SEM = 0.68), peak flowmeter technique score of 2.6 (SEM = 0.50, n = 18) versus 3.1 (SEM = 0.37), and inhaler techniqu e score of 2.5 (SEM = 0.37, n = 18) versus 2.2 (SEM = 0.31). Prospecti ve monthly data were collected on 27 educated and 15 control asthmatic subjects. Severity of asthma was not significantly different between groups at entry to the study. Symptom questionnaires, validated for fu nctional asthma severity, revealed a significant reduction in mean sym ptom scores at 180 days for the educated (2.87, SEM = 0.447) versus th e control (4.36, SEM = 0.573) groups (p = 0.0188 as determined by the Mann-Whitney U test). Conclusion: Child-centered asthma education can be successfully conducted in the school setting, resulting in increase d asthma knowledge, improved skills for peak flowmeter andinhaler use, and a reduction in the severity of asthma symptoms.