Asthma is a common chronic health condition affecting about 9 million children under the age of 18, and more than 4 million children in the U.S. have suffered current asthma episodes. Despite improvement in treatments, asthma morbidity and mortality in children and adolescents continues to be a major issue due to inadequate self-management. As an essential part of asthma treatment, self-management requires individuals' active commitment to the process of overall care to minimize asthma episodes, to optimize daily functioning and to enhance overall well-being. Adolescents are at particular risk for poor self-management that has led to high asthma morbidity. Nonetheless, intervention studies addressing adolescents' poor asthma self-management are scarce. Peer relationships play an increasingly important role in adolescents' psychosocial functioning and in influencing their health-related behaviors. Using peer leaders has been found effective in improving health decisions and behaviors in both adolescent leaders and participants. Camp programs increase cognitive capability for asthma self-management and psychosocial wellbeing through interactions with peers with similar health conditions. This study is to test an asthma self- management program led by peer leaders at a day camp for adolescents. Development of the intervention and an evaluation scheme was based on Social Cognitive Theory that underscores the interactions between environments and persons, and advocates observational learning in determining behaviors.
Study aims are: (1) to determine the feasibility of implementing the intervention using a peer-assisted asthma day camp for adolescents with asthma; (2) to examine patterns of change in knowledge, attitude, self-efficacy, perception of barriers and self-management behaviors and asthma control and quality of life in peer leaders; (3) to test the hypothesis that adolescents participating in a peer-assisted asthma camp program will report improved knowledge, attitudes, self-efficacy, self-management behaviors, decreased perception of barriers and increased asthma control and quality of life over time compared with the adult-led camp group; (4) to examine the moderating effect of personal traits (e.g., age, sex, SES, race) on intervention outcomes such as self-management behaviors, asthma morbidity and quality of life in adolescents; and (5; to conduct cost analysis to examine the effect of the intervention on self-reported health care utilization by comparing baseline data with 9-months post-camp data and the peer-led camp with the adult-camp programs. Data will be collected from 116 teens ages 13-20 with mild to severe persistent asthma, living in Central Virginia. The teens will be randomly assigned to either peer-led (intervention) or adult-led camp group. Data will be collected at baseline, immediately after the camp, and 3-, 6- and 9-months post-camp. Feasibility of the intervention program will be determined using descriptive statistics of data from program evaluation instruments. General linear models will be used to examine the effectiveness of the program. ? ? ? ?
