Combined family, preschool asthma education programs may improve outcomes

Multilevel home and school asthma education improved asthma control and reduced oral corticosteroid use and hospitalizations among children in a low-income community setting, according to new data published in JAMA Pediatrics.

“Childhood asthma requires that all caregivers are trained to recognize symptoms of asthma, reduce exposure to triggers such as smoking and allergens, and be able to provide treatment as needed,” Michelle N. Eakin, PhD, associate professor in the division of pulmonary and critical care medicine at Johns Hopkins University, told Healio. “A multilevel education program teaches both families and school personnel about asthma to ensure that all of the caregivers in a child’s daily life know how to manage asthma.”

Eakin and colleagues conducted a randomized clinical trial to evaluate the effectiveness of a multilevel home-based and school-based asthma education program. The trial enrolled 398 children with asthma (mean age, 4.2 years; 62% boys; 95% Black; 90% had family income < $40,000 per year) who were enrolled in Head Start preschool programs in Baltimore and their primary caregivers. Families were randomly assigned to an intervention that included both Asthma Basic Care (ABC) family education combined with Head Start educational program (n = 199) or the Head Start educational program only (n = 199). The ABC program is a cultural- and literacy-tailored family asthma educational intervention. The Head Start asthma education program is a federally funded national program that provides preventive health services and screening for low-income preschool students.

The primary outcome was the Test for Respiratory and Asthma Control in Kids (TRACK) score to assess the degree of asthma control. The multilevel education program yielded improved asthma control scores (beta = 6.26; 95% CI, 1.77-10.75; P <.001), reduced oral corticosteroid courses (beta = –0.61; 95% CI, –1.13 to –0.09; P = .02) and reduced hospitalizations (OR = 0.36; 95% CI, 0.21-0.61; P < .001) over 12 months.

Moreover, a lower proportion of children in the combined education program had uncontrolled asthma at 3 months compared with the Head Start intervention alone (beta = –0.81; 95% CI, –1.32 to –0.31; P = .002).

Researchers observed an improvement in asthma-related quality of life at 12 months for both intervention groups (beta = 0.28; 95% CI, 0.19-0.38; P < .001).

“Preschool children benefit from multilevel home and school asthma education to ensure that all caregivers know how to manage the child’s asthma, identify symptoms, provide treatments and work on reducing exposure to triggers,” Eakin told Healio.

Further, “communities should consider partnering with the clinical community to ensure that evidence-based asthma education is provided to families who would benefit. This study included over 90% Black families who met low-income standards for Head Start,” Eakin said. “As we seek to identify and reduce health disparities, we need to support programs that broadly implement effective interventions to serve families at risk for poor health outcomes.”

For more information:

Michelle N. Eakin, PhD, can be reached at meakin1@jhmi.edu; Twitter: @mneakin.