To date, no data provide information on the effects of middle school based interventions for pre-teens with asthma or the advantages of an approach that recognizes the importance of peer influence on pre-teen's asthma behavior. Interventions to reach low-income minority populations are particularly needed. This random trial will deploy 2 interventions and a control group with 972 eleven and twelve year old, low income, African American students in middle schools. The goals are to determine if (1) a self-management program focused on pre-teen capabilities designed for middle schools produces desired outcomes, and (2) if the program enhanced by a peer component, improves upon outcomes. Outcomes of interest are symptom experience, quality of life, self-management, and school grades. The first intervention will be Open Airways, a proven self-management program adapted for pre-teen self-regulation capacity and the middle school setting. The second intervention will combine intervention one with a highly successful peer led asthma program assessed with multi ethnic urban students. The peer program blends aspects of social influence with active learning methods. The peer component aims to modify the social environment of the school to create support for pro-teens managing asthma. The interventions will be tested in a trial where 18 middle schools in Detroit, Michigan will be randomized into a control, intervention 1 or intervention 2 group. Data to assess outcomes will be collected at baseline, and 12 and 24 months post program through parent interviews, student surveys, and review of school records. Asthma rates for this age group continue to rise and the problems associated with the disease are especially difficult in poor communities. This study will assess innovative interventions for low-income minority preteens with asthma.
