Canadian Respiratory Journal / 2016 / Article / Tab 2

Review Article

The Impacts of Educational Asthma Interventions in Schools: A Systematic Review of the Literature

Table 2

Educational asthma interventions carried out in the school environment and their achieved outcomes.

Author/yearInterventionConduction of the interventionMain outcomes
Knowledge of asthmaQuality of lifeVisits to the emergency departmentHospitalizationSchool absenteeismUse of medications

Butz et al. (2005) [16]Educational asthma intervention, for students, with the use of coloring books, inhalers, and peak flow meters Workshop on asthma for the parents or caregiversHealth educators/nursesStudents: IG, = 10.4 (after), versus CG, = 9.9 () Parents: IG, = 17.5, versus CG, = 16.3 ()There was no change in quality of life ()IG, 13.4%, versus CG, 18% ()IG, 3.6%, versus CG, 5.6% ()Use of maintenance medication:
IG, 52.7%, versus CG, 62.9% ()

Patterson et al. (2005) [28]Intervention based on the theoretical model Predisposing, Reinforcing and Enabling Causes in Educational Diagnosis and Evaluation (PRECEDE) NursesIG,   ±  SD = 0.30 ± 1.19, versus CG,   ±  SD = 0.23 ± 0.98 ()Correct inhalation technique: IG, 56%, versus CG, 15% ()

Cicutto et al. (2005) [22]Intervention based on the program Roaring Adventures of Puff (RAP)Health educators/asthma certifiedIG,   ±  SD = 5.5 ± 1.4, versus CG,   ±  SD = 5.0 ± 1.4 ()IG,   ±  SD = 1.7 ± 1.9, versus CG,   ±  SD = 2.5 ± 2.5 ()IG,   ±  SD = 3.0 ± 4.4, versus CG,   ±  SD = 4.3 ± 5.7 ()

Clark et al. (2005) [34]Adaptation of the curricular educational program Open Airways for Schools for students with asthma and their parentsHealth educatorsRural area: IG, = −0.132, versus CG, = −0.577 () Industrial area: IG, = −0.628, versus CG, = −0.340 ()There was no difference between the IG and the CG ()Schools in industrial areas: larger reduction in hospitalization instances (OR: 1.96, )CG, = −0.55, versus IG, = −0.32 ()

Gerald et al. (2006) [17]Curricular educational programs Open Airways for Schools (for students with asthma; main focus), Managing Asthma: A Guide for Schools (for school staff), and Asthma Awareness: A Curriculum for the Elementary School Classroom (for all students)Health professionalsDifference of 3 points in the IG (0.23–4.09) ()IG,   ±  SD = 0.09 ± 0.28, versus CG,   ±  SD = 0.10 ± 0.31 ()IG,   ±  SD = 0.04 ± 0.19,versus CG,   ±  SD = 0.02 ± 0.14 ()IG,   ±  SD = 3.88 ± 3.5, versus CG,   ±  SD = 3.21 ± 3.2 ()

Levy et al. (2006) [18]Intervention based on curricular program Open Airways for SchoolsNursesIG: 40% (before) versus 87% (after) () Increased knowledge also observed among the parents of the IG ()IG,   ±  SD = 1.36 ± 0.49, versus CG,   ±  SD = 1.59 ± 1.0 ()IG,   ±  SD = 0.18 ± 0.73, versus CG,   ±  SD = 0.45 ± 1.06 ()IG,   ±  SD = 4.38, versus CG,   ±  SD = 8.18 ()

Joseph et al. (2007) [29]Online and interactive program based on National Asthma Education and Prevention ProgramsEducational software on asthmaThere was no difference between the IG and the CG ()There was no difference between the IG and the CG ()IG: < hospitalization instances ()IG < school absenteeism
()
Comprehension of relief medication: IG, 38.8%, versus CG, 32.2% ()

Bruzzese et al. (2008) [35]Intervention based on curricular programs Open Airways for Schools and Asthma Self-Management for Adolescents (ASMA)NursesIG,   ±  SD = 3.0 ± 0.9, versus CG,   ±  SD = 2.2 ± 0.8 ()

Kintner and Sikorskii (2009) [19]Interactive program, using educational books and curriculum SHARP (Staying Healthy-Asthma Responsible and Prepared)Health professionalsIG,   ±  SD = 10.18 ± 0.43, versus CG,   ±  SD = 7.96 ± 0.47 ()IG,   ±  SD = 2.13 ± 0.10, versus CG,   ±  SD = 1.70 ± 0.11 ()

Clark et al. (2010) [12]Intervention composed of two programs: (i) adaptation of Open Airways for schools and (ii) orientation on self-management with participation of classmatesHealth studies undergraduates, community leaders, and students of previously trained primary educationThere was no difference between the IG and the CG ()

McGhan et al. (2010) [30]Program based on Roaring Adventures of Puff (RAP)Health professionalsIG, = 5.9, versus CG, = 4.9 ()IG, = 0.2, versus CG, = 0.072 ()IG, = 4.0,
versus CG, = 2.5 ()
Use <3 puffs B2 of short action: IG, 77.4%, versus CG, 70% ()

Bruzzese et al. (2011) [14]Educational and clinical intervention incorporated into school hours: ASMA (Asthma Self-Management for Adolescents)Nurses and medical specialistsIncrease in quality of life in the IG ()IG:   ±  SD = 0.64 ± 1.51 CG:   ±  SD = 1.46 ± 3.69 ()IG:   ±  SD = 0.05 ± 0.30
CG:   ±  SD = 0.24 ± 1.18 ()
IG:   ±  SD = 0.43 ± 0.69
CG:   ±  SD 0.78 ± 1.09 ()
IG:   ±  SD = 46.04 ± 76 CG:    ±  SD 43.66 ± 64 ()

Mosnaim et al. (2011) [31]Educational curricular intervention on asthma using focus groups and technical inhaler trainingNurses, medical specialists, and health educatorsAdolescents increase of 0.85 points ()Better use of inhalers by the adolescents (IG),

Pike et al. (2011) [20]Curricular intervention integrating the theme of asthma in 3 primary education subjectsPreviously trained primary education teachersBefore versus after test >33% in the IG ()

Al-sheyab et al. (2012) [21]“Triple A” intervention aimed at the training of peersBilingual nurses trained by the people responsible for “Triple A”IG,   ±  SD = 7.14 ± 0.20, versus CG,   ±  SD = 5.52 ± 0.20
()
IG,   ±  SD = 5.42 ± 0.14, versus CG,   ±  SD = 4.07 ± 0.14 ()

Bowen (2012) [32]Adaptation of the program Open Airways for Schools integrated into the school curriculum and school hoursHealth professionalsIG (70–90%) versus CG (50%) (, )

Joseph et al. (2013) [33]Online interactive program Puff CityHealth professionals/educational software on asthmaIG,   ±  SD = 5.3 ± 7.4, versus CG,   ±  SD = 7.1 ± 7.6 ()IG:   ±  SD = 1.5 ± 3.4 versus 1.7 ± 3.7 ()IG,   ±  SD = 0.3 ± 0.8, versus CG,   ±  SD = 0.5 ± 1.1 ()

Note. Open Airways for Schools is a program that educates and empowers children in the self-management of asthma through an interactive approach. Roaring Adventures of Puff (RAP) is an educational program on asthma for children and health professionals, with a view to addressing the lack of educational activities on asthma for the self-management of the disease. IG: intervention group; CG: control group.
The age of participants of the selected studies in this review was limited from 10 to 19 years old considering that the World Health Organization defines this period of life as adolescence.
Children grades 3–5.
Parent asthma knowledge scores.

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