JM Bruzzese et al. Effects of a School-based Intervention for Urban Adolescents with Asthma: A Controlled Trial. American Journal of Respiratory & Critical Care Medicine, December 7, 2010.

Asthma prevalence and morbidity is especially elevated in adolescents, yet few interventions target this population. Bruzzese and colleagues tested the efficacy of Asthma Self-Management for Adolescents (ASMA), a school-based intervention for adolescents and medical providers. A total of 345 primarily Latino/a (46%) and African American (31%) high school students (mean age=15.1; 70% female) reporting an asthma diagnosis, symptoms of moderate to severe persistent asthma, and asthma medication use in the last 12 months were randomized to ASMA, an 8-week school-based intervention, or a wait-list control group. They were followed for 12 months. Students completed bimonthly assessments. Baseline, 6-month, and 12-month assessments were comprehensive; the others assessed interim health outcomes and urgent health care utilization. Primary outcomes were asthma self-management, symptom frequency, and quality of life (QOL); secondary outcomes were asthma medical management, school absences, days with activity limitations, and urgent health care utilization. Relative to controls, ASMA students reported significantly: (a) more confidence to manage their asthma; (b) taking more steps to prevent symptoms; (c) greater use of controller medication and written treatment plans; (d) fewer night awakenings, days with activity limitation, and school absences due to asthma; (e) improved QOL; and (f) fewer acute care visits, ED visits, and hospitalizations. In contrast, steps to manage asthma episodes, daytime symptom frequency, and school-reported absences did not differentiate the two groups. Most results were sustained over the 12 months.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that ASMA is efficacious in improving asthma self-management, and reducing asthma morbidity and urgent health care use in low-income urban minority adolescents.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE CONSUMER: This is yet another example of a program that shows that adolescents can learn and perform self-management skills over a period of time.