Enhancing Childrens' and Parents' Asthma Management

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DESCRIPTION (provided by applicant): Asthma affects 4.8 million children under 18 years of age. Since 1985, asthma prevalence has increased 84% among children 5-14 years of age. Their utilization of health care resources have increased 128% for office visits and 13% for hospitalizations. School absences have increased more than 50% from 1980 to 1996 among children with asthma, and the economic impact of asthma is estimated to be $10.7 billion with half attributed to the indirect costs associated with caring for children with asthm. The purpose of this study is to: 1) Evaluate the effectiveness of an asthma education program in improving child health outcomes (ED visits, hospitalizations, absenteeism); 2) Evaluate the effectiveness of an asthma education program in improving parents' asthma knowledge and management behaviors, self-efficacy and perceptions of access to care, and children's asthma knowledge, asthma management, metered dose inhaler (MDI) technique, self-efficacy, and coping; and 3) Explore the effects of background variables (socioeconomic status, ethnicity, gender, knowledge, self-efficacy, asthma severity, school) and intervening process factors (access to care, coping, asthma management behaviors, MDI technique) on health outcomes. An asthma education intervention is proposed with a tri-ethnic sample of 276 Mexican American, African American, and Anglo American rural school-aged children (8-11 years) who have asthma and their parents. The quasi-experimental design will include random assignment to control and experimental conditions at the school level to prevent intra-school contamination. After study enrollment and collection of baseline data (Time 1), asthma classes will be provided to the experimental group in 16 classes with small groups of 4-6 children (12-18 children per school). At the same time, the control group will receive an attention control intervention with 16 general health classes. One month (Time 2) after the asthma classes, a home visit will be made to (1) collect data from all participants and (b) provide individualized family education to the experimental group. Family education includes (a) completing the Home Asthma Plan; (b) clarifying asthma medication use; and (c) reducing environmental asthma triggers with specific strategies for rural homes. Follow-up data will be collected 4 months (Time 3) and 8 months (Time 4) later and analyzed.