Nine million (12%) U.S. children under 18 years of age have been diagnosed with asthma at some point in their lives and more than 4 million (6%) children have had an asthma attack in the last 12 months. School-aged children diagnosed with asthma are restricted from participating in normal life activities, absent from school more than their peers, and admitted to hospitals in life-threatening situations. Health care professionals attribute these adverse outcomes to poor self-management. Although children and parents exhibiting poor self-management are usually referred for health education, few programs report significant long-term changes in behaviors or decreased morbidity. Perhaps this is because education programs rarely address the psychosocial issues, concerns, and needs of the children. Health care professionals commonly assume that children and parents are unwilling to assume responsibility for managing the condition due to rebellion and denial, and believe that acceptance of the condition and the need for ongoing monitoring and treatment would greatly reduce problems. Children/adolescents have verbalized and demonstrated difficulty in accepting their chronic condition. They report experiencing a barrage of negative emotions, facing numerous psychosocial challenges, and worrying about the stigmatization of this chronic condition, especially in situations where the disease symptoms and treatments conflict with the normative behavior of healthy peers. This study is part of a program of research designed to foster acceptance of asthma by increasing long-term responsibility for maintaining and promoting health, and preventing complications. Cognitive, behavioral, and psychosocial needs of older school-age children and early adolescents with asthma are explored from a lifespan development perspective. An innovative, comprehensive, theory-driven, research-guided, school-based education and counseling program for diverse, students, parents/family caregivers, and school personnel has been developed: The SHARP Program: Staying Healthy-Asthma Responsible & Prepared. The purpose of this study is to evaluate the feasibility, benefits, and efficacy of the program.
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