Asthma affects 4.8 million children under 18 years of age. Since 1985, asthma prevalence has increased 84% among children 5-14 years of age. Their utilization of health care resources have increased 128% for office visits and 13% for hospitalizations. School absences have increased more than 50% from 1980 to 1996 among children with asthma, and the economic impact of asthma is estimated to be $10.7 billion with half attributed to the indirect costs associated with caring for children with asthm. The purpose of this study is to: 1) Evaluate the effectiveness of an asthma education program in improving child health outcomes (ED visits, hospitalizations, absenteeism); 2) Evaluate the effectiveness of an asthma education program in improving parents' asthma knowledge and management behaviors, self-efficacy and perceptions of access to care, and children's asthma knowledge, asthma management, metered dose inhaler (MDI) technique, self-efficacy, and coping; and 3) Explore the effects of background variables (socioeconomic status, ethnicity, gender, knowledge, self-efficacy, asthma severity, school) and intervening process factors (access to care, coping, asthma management behaviors, MDI technique) on health outcomes. An asthma education intervention is proposed with a tri-ethnic sample of 276 Mexican American, African American, and Anglo American rural school-aged children (8-11 years) who have asthma and their parents. The quasi-experimental design will include random assignment to control and experimental conditions at the school level to prevent intra-school contamination. After study enrollment and collection of baseline data (Time 1), asthma classes will be provided to the experimental group in 16 classes with small groups of 4-6 children (12-18 children per school). At the same time, the control group will receive an attention control intervention with 16 general health classes. One month (Time 2) after the asthma classes, a home visit will be made to (1) collect data from all participants and (b) provide individualized family education to the experimental group. Family education includes (a) completing the Home Asthma Plan; (b) clarifying asthma medication use; and (c) reducing environmental asthma triggers with specific strategies for rural homes. Follow-up data will be collected 4 months (Time 3) and 8 months (Time 4) later and analyzed.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR007770-04
Application #
7062104
Study Section
Special Emphasis Panel (ZRG1-NURS (02))
Program Officer
Huss, Karen
Project Start
2003-08-01
Project End
2008-04-30
Budget Start
2006-05-01
Budget End
2008-04-30
Support Year
4
Fiscal Year
2006
Total Cost
$318,808
Indirect Cost
Name
University of Texas Austin
Department
Type
Schools of Nursing
DUNS #
170230239
City
Austin
State
TX
Country
United States
Zip Code
78712
Horner, Sharon D; Timmerman, Gayle M; McWilliams, Bennie C (2018) Feasibility study of a combined lifestyle behaviors and asthma self-management intervention for school-aged children. J Spec Pediatr Nurs 23:e12224
Walker, Verónica García (2017) Exploration of the Influence of Factors Identified in the Literature on School-aged Children's Emotional Responses to Asthma. J Pediatr Nurs 33:54-62
Horner, Sharon D; Brown, Adama; Brown, Sharon A et al. (2016) Enhancing Asthma Self-Management in Rural School-Aged Children: A Randomized Controlled Trial. J Rural Health 32:260-8
Horner, Sharon D; Brown, Adama (2015) An exploration of parent-child dyadic asthma management influences on quality of life. Issues Compr Pediatr Nurs 38:85-104
Horner, Sharon D; Brown, Adama (2014) Evaluating the effect of an asthma self-management intervention for rural families. J Asthma 51:168-77
Walker, Veronica García (2013) Minority caregivers' emotional responses and perceptions of the emotional responses of their children to asthma: comparing boys and girls. Issues Ment Health Nurs 34:325-34
Walker, Veronica García (2012) Factors related to emotional responses in school-aged children who have asthma. Issues Ment Health Nurs 33:406-29
Horner, Sharon D; Brown, Sharon A; Walker, Veronica Garcia (2012) Is rural school-aged children's quality of life affected by their responses to asthma? J Pediatr Nurs 27:491-9
Horner, Sharon D (2012) Best practices for improving intervention fidelity that every nurse should know. J Spec Pediatr Nurs 17:171-4
Horner, Sharon D; Fouladi, Rachel T (2008) Improvement of rural children's asthma self-management by lay health educators. J Sch Health 78:506-13

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