Asthma is the most prevalent chronic illness in childhood, affecting 9 million youth under the age of 17 years. Approximately 19 percent of all U.S. high school students have been diagnosed with asthma at some point in their lives. Asthma disproportionately affects minority populations. Hospitalization and death rates for African- Americans are nearly triple those of whites. Asthma is responsible for 14 million lost school days and $14 billion in health care and lost productivity costs. Adolescents with asthma are particularly at risk for poor control of this life-threatening disease due to tumultuous changes of adolescence and their concerns of normalcy, approval, and feelings of invincibility. Educational materials and programs that specifically target adolescents are virtually non-existent. This study, implemented by a multi-disciplinary team, will address these issues by providing a comprehensive asthma program that is developmental^ appropriate for urban African-American adolescents with asthma. The objective of this study is to evaluate the efficacy of the school-based program TEAM (Teen Educational Asthma Management) on the self care and quality of life of urban African-American teens with asthma. The TEAM program is composed of: 1) asthma education, 2) coping skills training and 3) nurse practitioner re-enforcement visits.
The specific aims are to evaluate the efficacy of this intervention on:
AIM 1 - asthma self care and asthma-related quality of life;
and AIM 2 - asthma knowledge, asthma self-efficacy, coping and asthma health outcomes (FEV1, mean peak flow reading, symptom days, asthma-related ED visits, hospitalization and school absences). A total of 134 African-American adolescents with persistent asthma will be enrolled in the study. Two groups, the intervention and control group, will be compared at three posttest times: 2, 6 &12 months. End of program interviews will be conducted with a sub-sample of teens and parents/guardians to explore the experience of the intervention and the potential difference in teens'asthma management strategies. Hierarchial linear regression modeling will be using to test the hypotheses about temporal change in outcomes. Processing and analysis of the qualitative data will be based on guidelines by Patton, Miles, &Knafl. The findings of this study will improve care to this underserved population of urban African-American teens with asthma and will have significant implications for health care providers, researchers, and policy makers.
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