School-Based Asthma Education Can Benefit Everyone, Even Those With Prior Knowledge

A school-based asthma education program for children in Illinois schools was effective for increasing asthma knowledge for first-time participants and those with prior asthma education.

The study found that repeated education is expected to further existing asthma knowledge by offering better self-management strategies and reducing asthma morbidity.

“While children with prior asthma education have higher baseline knowledge than first-time participants, the repeat attendees still showed significant knowledge gains at the end of the program,” wrote the researchers.

The full observational study is published in BMC Pulmonary Medicine.

One in 12 children in the United States is affected by asthma. Asthma is associated with morbidity risk, especially among Black and Puerto Rican children, and has accounted for 767,000 emergency visits and 13.8 million missed days in school annually.

While prior studies have found positive effects of asthma education programs, few have examined the impact of repeated asthma education for school-aged children. In the current study, the researchers aimed to evaluate the potential incremental effects of asthma education programs for children in school.

The study evaluated Fight Asthma Now (FAN), a school-based education program in Illinois between 2017 to 2020. FAN helps children with asthma identify and avoid triggers, manage episodes, and long-term asthma control. The program is administered as 3 sessions lasting 60 minutes, or 4 sessions lasting 45 minutes, depending on the school’s schedule and preference.

Before and after completing the program, participants were asked to complete questionnaires based on asthma knowledge, practice, and self-efficacy. Students were also asked to note if they had previous asthma education in addition demographic information, including grade, gender, and race/ethnicity.

Eleven questions assessed the students’ knowledge of signs or symptoms, triggers, treatment, and disease course of asthma, 2 questions assessed knowledge of practices, and 1 question assessed self-efficacy.

The researchers classified children into 2 groups based on prior asthma education. Scores across groups were compared, with pre and post-test scores compared for each student.

A total of 200 schools across 52 districts in Illinois participated in FAN, including a total of 4951 students.

The mean (SD) age of participants was 10.75 (2.05) years, with most children located in Chicago (68.1%, n = 2348) and 74% participated in the youth program (n = 2553). Furthermore, 50.9% of participants identified as Black (n = 1755) and 14.7% identified as Hispanic (n = 508). More than half (54.6%) of children reported no prior asthma education (n = 1882).

At baseline, students with repeated education had significantly higher knowledge compared with first-time participants (SD, 7.45 vs 5.92; P < .001). After completing the program, first-time and repeat attendees both showed significant knowledge improvements. In the first-time group, knowledge improved from an SD of 5.92 to 9.32, while knowledge improved SD from 7.45 to 9.62 in the repeat group (P < .001 for both).

Although this study was based in Illinois and has limited generalizability, the researchers believe the study shows that asthma education leads to improved knowledge and has incremental gains for children who previously received education.

“Given the findings of our study, schools should continue to, or begin to, implement school-based asthma education programs and leverage resources to create repeated programming so children can experience the incremental benefits of repeat asthma education,” wrote the researchers.

“Specific consideration should be given to implementing such programs in schools that serve primarily minority and impoverished populations given the disproportionate effects of asthma within these communities.”

Reference

Volerman A, Kappel N, Tayal A, Rosenwinkel M, Salem E, Vipond L. Student knowledge gains among first-time and repeat attendees of school-based asthma education program. BMC Pulm Med. 2023;23(1):249. doi:10.1186/s12890-023-02544-y