TABLE 4

Findings From Studies of School-Based Asthma Education Programs

StudyKnowledge of AsthmaSelf-EfficacySelf-Management BehaviorsQuality of LifeDays of SymptomsNights of SymptomsSchool Absences
Bartholomew et al14 (2006)Greater knowledge (P < .0001)Greater self-efficacy (P = .0027)Daily self-management: higher score (P = .001); exercise pretreatment: higher score (P = .0049); self-management of exacerbations at home: higher score (P = .0128); self-management of exacerbations away from home: NS; trigger management: higher score (P < .0001)NSNS
Butz et al15 (2005)Grades 1–2: 1.70 points (maximum score: 15) (P < .0001); grades 3–5: 0.48 points (maximum score: 15) (P = .18)2.73 points (maximum score: 27) (P = .005)0.06 points (maximum score: 7), NSFewer days (P = .007)Chest tightness/discomfort: fewer nights (P = .02); shortness of breath: fewer nights (P = .03); wheezing: fewer nights (P = .02)
Christiansen et al16 (1997)a4.20 points (maximum score: 17) (P < .00001)Inhaler: 2.30 points (maximum score: 7) (P < .00001); peak flow meter: 2.00 points (maximum score: 8) (P < .00001)−1.49 points (maximum score: 15) (P = .0188)−0.59 absences over 1 y (P = .6439)
Cicutto et al17 (2005)0.20 points (maximum score: 5) (P < .05)0.50 points (maximum score: 7) (P < .05)−1.30 absences over 1 y (P < .05)
Clark et al18 (2004)−17.00% (P < .0001)40.00% (P < .0001)−8.00% over 1 y (P < .05)
Clark et al19 (2005)−2.83 d over 1 y (P = .13)−0.23 absences over 1 wk (P = .02)
Evans et al20 (1987)a3.00% (P = .04)11.00% (P = .05)−15.80 d over 1 y (P = .004)−0.80 absences over 1 y, NS
Gerald et al21 (2006)0.15 absences, NS
Gibson et al22 (1998)Greater knowledge (P < .05)Activity: 0.46 points (maximum score: 7), NS; emotional: −0.20 points (maximum score: 7), NS; environmental: 0.15 points (maximum score: 7), NS; symptoms: −0.16 points (maximum score: 7), NS
Henry et al23 (2004)Greater knowledge (P = .0001)0.27 points (maximum score: 7) (P = .003)
Homer24 (2004)Child's responses: −0.20 points (maximum score: 5), NS; parents' responses: 0.37 points (maximum score: 5) (P = .003)0.68 absences over 1 y, NS
Joseph et al25 (2007)Availability of rescue inhaler: 6.60 percentage points (P = .01); controller medication adherence: 7.80 percentage points (P = .09); smoking cessation/reduction: 0.01 percentage points (P = .89)1.20 relative risk of increase in quality of life (P = .35)0.50 relative risk of having any days with symptoms over 2 wk (P = .003)0.40 relative risk of having any nights with symptoms over 2 wk (P = .009)0.30 relative risk of having any absences over 30 d (P = .006)
Levy et al26 (2006)−3.80 d over 8 mo (P < .05)
McCann et al27 (2006)b15.80 percentage points in percent with improvement ≥ 2 points (P = .02)NSNS
MeGhan et al28 (2003)Appropriate use of preventive medications: 28 percentage points (P < .001); appropriate use of reliever medications: 3 percentage points, NS; takes steps to avoid triggers: 2 percentage points, NS; uses a peak flow meter: 11 percentage points (P = .08)Chest tightness: −3 percentage points over 2 wk, NS; coughing: −11 percentage points over 2 wk, NS; shortness of breath: −7 percentage points over 2 wk, NS; wheezing: 3 percentage points over 2 wk, NS−5 percentage points over 2 wk, NS−17 percentage points over 12 mo (P = .07)
Parcel et al29 (1980)aGrades kindergarten through 2: 0.94 points (P < .05); grades 3–5: 1.62 points (P < .05)0.80 points (P < .05)
Patterson et al30 (2005)41.00% with correct technique (P < .001)0.20 points (maximum score: 7) (P = .32)
Persaud et al31 (1996)a−0.10 points (maximum score: 20) (P = .9)1.4 points (P = .17)−1.2 absences over 20 wk, NS
Shah et al32 (2001)13.7 percentage points in % with clinically significant improvement (0.5 points) (P = .01)−1.50 absences (P < .05)
Toelle et al33 (1993)a0.30 points, NS−0.01 percentage points in percentage with ≥1 d per 3 mo, NS−35.50 percentage points in percentage with ≥1 night per 3 mo (P < .05)−0.75 absences over 6 mo, NS
Velsor-Friedrich et al34 (2004)0.70 points (maximum score: 25), NS0.08 points (maximum score: 5), NS−0.54 percentage points, NS−0.23 d over 2 wk (P = .047)−5.37 absences over 1 y, NS
Velsor-Friedrich et al35 (2005)2.40 points (maximum score: 25) (P = .03)0.27 points (maximum score: 5) (P = .01)8.14 percentage points (P = .01)−4.00 percentage points in percentage with ≥1 d over 2 wk, NS4.49 absences over 1 y, NS
Yawn et al36 (2000)b
Young et al37 (2001)0.58 points (maximum score: 7), NSNS
Summary
    No. of studies1089c9c12c5c18c
  • Reported are the differences in mean outcomes for intervention and control groups. Where both preintervention and postintervention data were available, the “difference in difference” in mean outcomes was calculated (ie, difference in scores, days with symptoms, etc, for the intervention group minus difference for the control group). If only postintervention data were available, differences in mean outcomes after the intervention were estimated. In some cases, no numerical data on outcomes were available. Sig indicates statistically significant difference between the intervention and comparison groups (P < .05); NS, no statistically significant difference between the intervention and comparison groups; —, not assessed.

  • a Indicates that the study was included in the Wolf et al7 (2002) meta-analysis on pediatric asthma education.

  • b Study was omitted from analysis of effects of school-based asthma education on knowledge of asthma because responses of children with asthma were combined with responses of classmates who did not have asthma.

  • c Includes both studies that compared asthma education to usual care and studies that compared 2 different asthma education interventions.