Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

School-based program helps adolescents cope with asthma

08.12.2010
A school-based intervention program designed for adolescents with asthma significantly improves asthma management and quality of life for the students who participate, and reduces asthma morbidity, according to researchers in New York City, who studied the effect of the program aimed at urban youth and their medical providers.

The Asthma Self-Management for Adolescents (ASMA) program is an eight-week intervention geared toward helping adolescents learn more effective ways of managing their symptoms and controlling their asthma.

The findings were published online ahead of the print edition of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

"We found that, relative to controls, ASMA students reported significantly more confidence in managing their asthma, greater use of their controller medication and written treatment plans, fewer days with asthma-related activity restrictions and fewer emergency department visits and hospitalizations, as well as an improved quality of life," said Jean-Marie Bruzzese, PhD, assistant professor of child and adolescent psychiatry at NYU School of Medicine. "Our findings indicate ASMA is effective in improving asthma self-management and in reducing asthma morbidity and urgent health-care use in low-income, urban minority adolescents."

Collaborating with Robert B. Mellins, MD and David Evans, PhD of Columbia University College of Physicians and Surgeons, and the NYC Department of Education, the researchers enrolled 9th and 10th graders from five New York City high schools. To aid in selection, students in these grades were asked to complete a case detection survey, which asked students if they had been diagnosed asthma and gathered information about the frequency of symptoms and the use of prescribed asthma medication. Following parental consent, researchers enlisted 345 students who reported an asthma diagnosis, symptoms of moderate to severe persistent asthma and asthma medication use in the previous 12 months, and randomized them to ASMA or a wait-list control group. Of the enrolled students, 46 percent identified themselves as Latino and 31 percent identified themselves as African-American.

During the study period, trained staff performed assessments of the students every two months over a 12-month period, in addition to the more detailed interviews that occurred at the start of the study and at 6 and 12 months following enrollment. Comprehensive surveys assessed self-management and medical management of asthma, including symptom management and use of written management plans and controllers; health outcomes, including symptom days and asthma-related school absences; and urgent health-care use, including medical visits and hospitalizations.

Those randomized to participate in the ASMA program underwent an eight-week, intensive program aimed at helping students manage their symptoms through three educational group sessions and individual coaching sessions, held at least one each week for five weeks. Students received coaching about medical visits and how to work with their medical provider to more effectively control their asthma. In addition, the students' medical providers were contacted to inform them of the study, and were given written materials and telephone consultations with pediatric pulmonologists or adolescent medicine specialists about the program's concepts and National Heart, Lung, and Blood Institute (NHLBI) guidelines for treatment of asthma. Providers were encouraged to give students written treatment plans and to prescribe anti-inflammatory medicines for students with persistent asthma. Students without medical providers were given a referral to a primary care provider in their neighborhood, or to a school-based health center, when available.

"Research has shown adolescents are less likely to receive regular medical care compared to younger children, and minority adolescents are less likely to use preventive medicine than white, non-Hispanic youth," Dr. Bruzzese said. "The ASMA program helps teach these children, and inform their caregivers, of the steps they can take to gain control of their symptoms and their treatment program. The cognitive and psychosocial developments of adolescence make this period an ideal time to teach these skills."

The researchers found that, at each follow-up interview, students enrolled in ASMA took significantly more steps to prevent asthma symptoms from occurring and had improved self-confidence in managing their asthma compared to the control group. In addition, at six months, the odds of appropriately using a controller medication were twice as high in the ASMA group, compared to the control group.

Morbidity was also decreased in the ASMA group compared to control. ASMA participants reported a 31 percent reduction in night awakenings and a 42 percent reduction in activity restriction due to asthma, as well as a 28 percent reduction in acute medical visits, a 49 percent reduction in emergency department visits and a 76 percent reduction in hospitalizations compared with controls.

"ASMA addresses an illness with high public health significance and, as such, can serve as a model for other populations of adolescents, including those in rural and suburban communities, or for adolescents with other chronic illnesses," said Dr. Bruzzese.

Schools or districts that lack resources to implement the program may consider partnerships with insurance providers or local medical schools with pediatric pulmonologists or allergists on staff, the researchers noted.

"Adoption of ASMA by schools would contribute to reducing the burden of asthma on adolescents, as well decreasing the health-care burden of the community at large," said Dr. Bruzzese.

Brian Kell | EurekAlert!
Further information:
http://www.thoracic.org

More articles from Health and Medicine:

nachricht NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures
17.11.2017 | National Institute of Standards and Technology (NIST)

nachricht High speed video recording precisely measures blood cell velocity
15.11.2017 | ITMO University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

Im Focus: Novel Nano-CT device creates high-resolution 3D-X-rays of tiny velvet worm legs

Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.

During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....

Im Focus: Researchers Develop Data Bus for Quantum Computer

The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.

Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...

Im Focus: Wrinkles give heat a jolt in pillared graphene

Rice University researchers test 3-D carbon nanostructures' thermal transport abilities

Pillared graphene would transfer heat better if the theoretical material had a few asymmetric junctions that caused wrinkles, according to Rice University...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

NASA detects solar flare pulses at Sun and Earth

17.11.2017 | Physics and Astronomy

NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures

17.11.2017 | Health and Medicine

The importance of biodiversity in forests could increase due to climate change

17.11.2017 | Studies and Analyses

VideoLinks
B2B-VideoLinks
More VideoLinks >>>