No reports provide evidence of the effects of asthma education in 11- to 14-year olds, or the advantages of parent training despite the significant asthma prevalence and morbidity in this age group and data indicating that parenting behaviors influence asthma management. The overall goal of this study is to test the efficacy of a program with two complementary components: (a) a school-based curriculum to empower middle school students to manage their asthma and (b) a parent training curriculum to teach childrearing skills that support the youth's growing autonomy and need to self-manage their disease.
The specific aims are: (1) to implement screening to identify 6th - 8th grade students with persistent asthma;and (2) to provide health education and parent training to help children and parents manage asthma more effectively. The student program is based on Coping with Asthma at Home and at School, a successful program developed in Holland. The parent program is an adaptation of Thriving Teens, an effective parent training program developed by the investigators. Participants in this randomized control trial will be 384 children with asthma and their caregivers from 16 NYC public schools serving low-income, ethnic minorities. It is hypothesized that students randomized to the intervention will have, relative to controls, improvements in three primary outcomes: (1) reduced symptom severity;(2) improved quality of life;and (3) better asthma management skills. Also, when compared to controls, intervention students will show improvement in the following secondary outcomes: (4) urgent health care utilization;(5) days with activity restriction;and (6) parent-child interactions. Caregivers and children will complete comprehensive surveys assessing these outcomes at baseline, and immediately and 6- and 12-months after the intervention. This study is significant because: (1) it will be among the first to evaluate the impact of asthma education in middle school students;and (2) it is the first to couple asthma education with parent training as a means of enhancing asthma management.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL079953-05
Application #
7612029
Study Section
Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
Smith, Robert A
Project Start
2005-05-01
Project End
2012-04-30
Budget Start
2009-05-01
Budget End
2012-04-30
Support Year
5
Fiscal Year
2009
Total Cost
$762,500
Indirect Cost
Name
New York University
Department
Type
Organized Research Units
DUNS #
121911077
City
New York
State
NY
Country
United States
Zip Code
10016
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Jay, Melanie; Stepney, Cesalie; Wijetunga, N Ari et al. (2013) Accuracy of weight perception among urban early adolescents with uncontrolled asthma and their caregivers. Ann Behav Med 45:239-48
Bruzzese, Jean-Marie; Stepney, Cesalie; Fiorino, Elizabeth K et al. (2012) Asthma self-management is sub-optimal in urban Hispanic and African American/black early adolescents with uncontrolled persistent asthma. J Asthma 49:90-7
Bruzzese, Jean-Marie; Unikel, Lynne H; Shrout, Patrick E et al. (2011) Youth and Parent Versions of the Asthma-Related Anxiety Scale: Development and Initial Testing. Pediatr Allergy Immunol Pulmonol 24:95-105
Bruzzese, Jean-Marie; Sheares, Beverley J; Vincent, Elisa J et al. (2011) Effects of a school-based intervention for urban adolescents with asthma. A controlled trial. Am J Respir Crit Care Med 183:998-1006
Stepney, Cesalie; Kane, Katelyn; Bruzzese, Jean-Marie (2011) My child is diagnosed with asthma, now what?: motivating parents to help their children control asthma. J Sch Nurs 27:340-7
Bruzzese, Jean-Marie; Unikel, Lynne H; Evans, David et al. (2010) Asthma knowledge and asthma management behavior in urban elementary school teachers. J Asthma 47:185-91
Bruzzese, Jean-Marie; Fisher, Paige H; Lemp, Nadia et al. (2009) Asthma and social anxiety in adolescents. J Pediatr 155:398-403
Bruzzese, Jean-Marie; Unikel, Lynne; Gallagher, Richard et al. (2008) Feasibility and impact of a school-based intervention for families of urban adolescents with asthma: results from a randomized pilot trial. Fam Process 47:95-113