A trial of asthma self-management in Beijing schools

Abstract

Objectives: This study examined the effectiveness in children in China of an asthma education programme adapted from a model developed in the USA. Methods: Six hundred and thirty-nine children in 21 elementary schools in one agricultural and one industrial area participated in a randomized, controlled trial. Data were collected at baseline and 1 year subsequently. The self-regulation-based programme addressed topics including preventing and managing symptoms, using medicines, and identifying and controlling triggers. Results: Positive effects on treatment children v. control children were noted in school performance (0.21 v. -0.06, p=0.04), absences (-0.55 v . -0.32, p=0.02), and home environment (1.78 v. 4.75, p=0.009). Industrial-area children additionally benefited from fewer hospitalizations (odds ratio=1.96, p=0.05) and asthma-related concerns of parents (-0.63 v. -0.34, p=0.001). Agricultural-area parents showed greater improvement in asthma management (0.93 v. 0.26, p=0.0001), and expressed more negative feelings about asthma (-0.13 v. -0.58, p=0.04) and asthma concerns (-0.31 v. -0.63, p=0.0001). Discussion: The programme provided overall benefits related to school performance, absences, and home environment. In the agricultural area, where fewer resources were available, benefits were fewer and concerns greater. In the industrial area, where education and income were higher, additional benefits related to healthcare use and parents' quality of life were realized.