A Family Approach to Managing Asthma in Early Teens

DESCRIPTION (provided by applicant): No reports provide evidence of the effects of asthma education in 11- to 14-year olds, or the advantages of parent training despite the significant asthma prevalence and morbidity in this age group and data indicating that parenting behaviors influence asthma management. The overall goal of this study is to test the efficacy of a program with two complementary components: (a) a school-based curriculum to empower middle school students to manage their asthma and (b) a parent training curriculum to teach childrearing skills that support the youth's growing autonomy and need to self-manage their disease. The specific aims are: (1) to implement screening to identify 6th - 8th grade students with persistent asthma;and (2) to provide health education and parent training to help children and parents manage asthma more effectively. The student program is based on Coping with Asthma at Home and at School, a successful program developed in Holland. The parent program is an adaptation of Thriving Teens, an effective parent training program developed by the investigators. Participants in this randomized control trial will be 384 children with asthma and their caregivers from 16 NYC public schools serving low-income, ethnic minorities. It is hypothesized that students randomized to the intervention will have, relative to controls, improvements in three primary outcomes: (1) reduced symptom severity;(2) improved quality of life;and (3) better asthma management skills. Also, when compared to controls, intervention students will show improvement in the following secondary outcomes: (4) urgent health care utilization;(5) days with activity restriction;and (6) parent-child interactions. Caregivers and children will complete comprehensive surveys assessing these outcomes at baseline, and immediately and 6- and 12-months after the intervention. This study is significant because: (1) it will be among the first to evaluate the impact of asthma education in middle school students;and (2) it is the first to couple asthma education with parent training as a means of enhancing asthma management.