School asthma program improves health and grades

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A comprehensive school-based asthma management program improved health status and school performance of children with asthma, particularly those with persistent disease, according to a new study.

The findings, which appear in the medical journal Chest, are based on a study of 835 asthmatic children in grades 2 through 5 in 14 schools in low-income communities in Detroit, Michigan.

School-based asthma programs, “can help children with asthma experience fewer symptoms and do better at school,” Dr. Noreen M. Clark from the University of Michigan School of Public Health told Reuters Health. “Since resources are always scarce, focusing such a program on children with persistent disease can produce the best results,” she added.

The aim of the program is education of the asthmatic child to improve their skills in managing the disease. A series of components targets key people in the child’s social environment—parents, classmates, and school personnel—who can also assist.

Seven schools (416 children) were randomly assigned to the intervention program and another 7 schools (419 children) were wait-listed for the program and served as the “controls.” Interviews were conducted with parents and school personnel at the start of the program and two years later.

The results showed that children with persistent asthma who were assigned to the school-based program had significant declines in both daytime and night-time symptoms (14 percent fewer episodes for both).

Among children with both mild intermittent and persistent disease, those in the intervention group had 17 percent fewer daytime asthma symptoms, but 40 percent more night-time symptoms. The authors believe that the intervention program “may have stimulated attention to symptoms at night by parents of children with mild intermittent disease.”

Intervention children also posted higher grades in science, but not in reading, math, or physical education. School absenteeism rates did not differ between the groups, however, parents of intervention children reported 34 percent fewer asthma-related absences in the previous 3 months and 8 percent fewer in the preceding 12 months.

In conclusion, Clark emphasized that “implementing such a program is not difficult, especially if a group like the American Lung Association can provide volunteers who can be trained to work in the school.”

SOURCE: Chest, May 2004.

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