Asthma is the most common chronic childhood illness and disproportionately affects children who are ethnic minorities and poor. Few studies of childhood asthma have been conducted with children who live in rural areas or have included Mexican American children in their samples. In an NIH/NINR funded study (Enhancing Children's and Parents'Asthma Management, R01 NR00770), the Asthma Plan for Kids was used to teach rural school-age children how to manage their asthma and parents received an individualized educational session during a home visit. Study findings demonstrated the intervention could improve children's asthma self-management, asthma knowledge, metered dose inhaler skill, asthma severity, and parents'asthma management and access to care. In this competing continuation, we propose adding a third arm to the current research design with schools randomized into either an in-school asthma intervention, an in-school attention-control intervention, or an alternate intervention-delivery format of a single 5.5-hour asthma day camp. The tri-ethnic sample will be composed of 320 Mexican-American, African-American, and White rural school-aged children (grades 2-5) who have asthma and their parents. In addition, we propose adding a non-invasive measure of chronic airway inflammation (exhaled nitric oxide) to assess the impact of changes in asthma management on airway inflammation. Families will be followed for a full year with data collection at baseline and at 1-month, 4-months, and 7-months after the intervention to assess improvement in children's asthma morbidity, asthma severity, airway inflammation, family asthma management and quality of life. The proposed Camp-Workshop format may be a more efficient way to deliver the intervention and if it proves to be equally as effective as the School-Home format in improving asthma management and health outcomes it may have greater potential for translation to practice in that it increases the options for intervention delivery.

Public Health Relevance

Asthma is the most common chronic childhood illness. Asthma management occurs primarily in the context of the family and as such interventions that are effective in improving children's and parents'asthma management are needed.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Research Project (R01)
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Nursing Science: Children and Families Study Section (NSCF)
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Huss, Karen
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University of Texas Austin
Schools of Nursing
United States
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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 Garcia (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
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
Horner, Sharon D (2008) Childhood asthma in a rural environment: implications for clinical nurse specialist practice. Clin Nurse Spec 22:192-8;quiz 199-200
Horner, Sharon; Rew, Lynn; Torres, Rosamar (2006) Enhancing intervention fidelity: a means of strengthening study impact. J Spec Pediatr Nurs 11:80-9
Horner, Sharon D; Kieckhefer, Gail M; Fouladi, Rachel T (2006) Measuring asthma severity: instrument refinement. J Asthma 43:533-8
Horner, Sharon D (2006) Home visiting for intervention delivery to improve rural family asthma management. J Community Health Nurs 23:213-23