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PEDIATRICS Vol. 106 No. 1 Supplement July 2000, pp. 210-215

An Evaluation of an Innovative Multimedia Educational Software Program for Asthma Management: Report of a Randomized, Controlled Trial

Received May 19, 1999; accepted Mar 17, 2000.

Charles Homer*, Dagger , §, Oded Susskind, Hillel R. Alpert, MPM§; Celestina Owusu§, Lynda Schneider*, Dagger , Leonard A. Rappaport*, Dagger , and David H. Rubinparallel

From the * Department of Medicine, Children's Hospital, Dagger  Department of Pediatrics, Harvard Medical School, § Clinical Effectiveness Program, Children's Hospital, Boston, Massachusetts; parallel  Departments of Pediatrics, St Barnabas Hospital, Bronx, New York; and Department of Pediatrics, New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, New York.

Background.  Asthma continues to be a substantial cause of morbidity in pediatric populations. New strategies are needed to provide cost-effective educational interventions for children with asthma, particularly those in the inner city.

Objective.  To assess the effectiveness of a multimedia educational software program about asthma.

Setting.  A hospital-based primary care clinic and an affiliated neighborhood health center.

Design.  Randomized, controlled trial.

Population.  Children 3 to 12 years old with physician-diagnosed asthma.

Intervention.  An interactive educational computer program, Asthma Control, designed to teach children about asthma and its management. Using a graphic display of a child going through simulated daily events, the game emphasizes: 1) monitoring; 2) allergen identification; 3) use of medications; 4) use of health services; and 5) maintenance of normal activity. Control group participants reviewed printed educational materials with a research assistant.

Outcomes.  Acute health care use (emergency department and outpatient) was the primary outcome. Secondary outcome measures included maternal report of asthma symptom severity, child functional status and school absences, satisfaction with care, and parental and child knowledge of asthma.

Results.  A total of 137 families were enrolled in the study (76 intervention, 61 control). Both intervention and control groups showed substantial improvement in all outcomes during the 12-month follow-up period. Aside from improvement in knowledge after use of the computer program, no differences were demonstrated between the 2 groups in primary or secondary outcome measures. Children reported enjoyment of program use.

Conclusions.  This trial of an educational software program found that it did not produce greater improvement than occurred with review of traditional written materials. Because both groups showed substantial improvement over baseline, computer-based education may be more cost-effective. Alternatively, improvements in illness severity over time may overshadow the effects of such interventions. Rigorous comprehensive evaluations such as this are necessary to assess new interventions intended to improve management and outcomes of asthma.  Key words:  asthma management, randomized, controlled trial, computers.




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