BMJ 2001;322:583 ( 10 March )

Papers

Effect of peer led programme for asthma education in adolescents: cluster randomised controlled trial

Smita Shah, director, ^a Jennifer K Peat, associate professor, ^b Evalynn J Mazurski, research and evaluation officer, ^a Han Wang, statistician, ^a Doungkamol Sindhusake, statistician, ^c Colleen Bruce, research and evaluation officer, ^a Richard L Henry, professor, ^d Peter G Gibson, senior staff specialist. ^e

^a Primary Health Care Education and Research Unit, Auburn Hospital and Community Health Services, Auburn, NSW 2144, Australia, ^b Children's Hospital at Westmead, Westmead, NSW 2145, Australia, ^c Department of Public Health and Community Medicine, Westmead Hospital, ^d School of Paediatrics, University of New South Wales, Randwick, NSW 2031, Australia, ^e Airway Research Centre, Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW 2310, Australia

Correspondence to: S Shah, Department of Public Health and Community Medicine, Westmead Hospital, Westmead, NSW 2145, Australia Smita_Shah{at}wsahs.nsw.gov.au

Objective: To determine the effect of a peer led programme for asthma education on quality of life and related morbidity in adolescents with asthma.
Design: Cluster randomised controlled trial.
Setting: Six high schools in rural Australia.
Participants: 272 students with recent wheeze, recruited from a cohort of 1515 students from two school years (mean age 12.5 and 15.5 years); 251 (92.3%) completed the study.
Intervention: A structured education programme for peers comprising three steps (the "Triple A Program").
Main outcome measures: Quality of life, school absenteeism, asthma attacks, and lung function.
Results: When adjusted for year and sex, mean total quality of life scores showed significant improvement in the intervention than control group. Clinically important improvement in quality of life (>0.5 units) occurred in 25% of students with asthma in the intervention group compared with 12% in the control group (P=0.01). The number needed to treat was 8 (95% confidence interval 4.5 to 35.7). The effect of the intervention was greatest in students in year 10 and in females. Significant improvements occurred in the activities domain (41% v 28%) and in the emotions domain (39% v 19%) in males in the intervention group. School absenteeism significantly decreased in the intervention group only. Asthma attacks at school increased in the control group only.
Conclusion: The triple A programme leads to a clinically relevant improvement in quality of life and related morbidity in students with asthma. Wider dissemination of this programme in schools could play an important part in reducing the burden of asthma in adolescents.

---

© BMJ 2001
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Peer led programme for asthma education in adolescents

Tim J Peters, Anna Graham, Chris Salisbury, Laurence Moore, Martin Underwood, Sandra Eldridge, Peter G Gibson, Smita Shah, Doungkarnol Sindhusake, Han Wang, Jennifer K Peat, and Richard L Henry
BMJ 2001 323: 110. [Extract] [Full Text]

Peer led asthma education improves quality of life in teenagers with asthma
BMJ 2001 322: 0. [Full Text]

This article has been cited by other articles:

• Cates, C. (2009). Using education to improve control of asthma in children. CMAJ 181: 248-249 [Full text]  
• Watson, W. T.A., Gillespie, C., Thomas, N., Filuk, S. E., McColm, J., Piwniuk, M. P., Becker, A. B. (2009). Small-group, interactive education and the effect on asthma control by children and their families. CMAJ 181: 257-263 [Abstract] [Full text]  
• Coffman, J. M., Cabana, M. D., Yelin, E. H. (2009). Do School-Based Asthma Education Programs Improve Self-Management and Health Outcomes?. Pediatrics 124: 729-742 [Abstract] [Full text]  
• Bravata, D. M., Gienger, A. L., Holty, J.-E. C., Sundaram, V., Khazeni, N., Wise, P. H., McDonald, K. M., Owens, D. K. (2009). Quality Improvement Strategies for Children With Asthma: A Systematic Review. Arch Pediatr Adolesc Med 163: 572-581 [Abstract] [Full text]  
• Stegenga, K., Ward-Smith, P. (2009). On Receiving the Diagnosis of Cancer: The Adolescent Perspective. Journal of Pediatric Oncology Nursing 26: 75-80 [Abstract]  
• Clark, N. M., Mitchell, H. E., Rand, C. S. (2009). Effectiveness of Educational and Behavioral Asthma Interventions. Pediatrics 123: S185-S192 [Abstract] [Full text]  
• Ogrinc, G, Mooney, S E, Estrada, C, Foster, T, Goldmann, D, Hall, L W, Huizinga, M M, Liu, S K, Mills, P, Neily, J, Nelson, W, Pronovost, P J, Provost, L, Rubenstein, L V, Speroff, T, Splaine, M, Thomson, R, Tomolo, A M, Watts, B (2008). The SQUIRE (Standards for QUality Improvement Reporting Excellence) guidelines for quality improvement reporting: explanation and elaboration. Qual Saf Health Care 17: i13-i32 [Abstract] [Full text]  
• Bateman, E. D., Hurd, S. S., Barnes, P. J., Bousquet, J., Drazen, J. M., FitzGerald, M., Gibson, P., Ohta, K., O'Byrne, P., Pedersen, S. E., Pizzichini, E., Sullivan, S. D., Wenzel, S. E., Zar, H. J. (2008). Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 31: 143-178 [Abstract] [Full text]  
• Newbould, J, Francis, S-A, Smith, F (2007). Young people's experiences of managing asthma and diabetes at school. Arch. Dis. Child. 92: 1077-1081 [Abstract] [Full text]  
• Hutchinson, E., Hall, C. (2007). A phenomenological exploration of the patient learning J experiences of 16 19 year-old women accessing a young people's rheumatology service in the UK. Journal of Research in Nursing 12: 521-533 [Abstract]  
• Joseph, C. L. M., Peterson, E., Havstad, S., Johnson, C. C., Hoerauf, S., Stringer, S., Gibson-Scipio, W., Ownby, D. R., Elston-Lafata, J., Pallonen, U., Strecher, V., for the Asthma in Adolescents Research Team, (2007). A Web-based, Tailored Asthma Management Program for Urban African-American High School Students. Am. J. Respir. Crit. Care Med. 175: 888-895 [Abstract] [Full text]  
• McCann, D. C., McWhirter, J., Coleman, H., Calvert, M., Warner, J. O. (2006). A controlled trial of a school-based intervention to improve asthma management. Eur Respir J 27: 921-928 [Abstract] [Full text]  
• Cicutto, L., Murphy, S., Coutts, D., O'Rourke, J., Lang, G., Chapman, C., Coates, P. (2005). Breaking the Access Barrier: Evaluating an Asthma Center's Efforts to Provide Education to Children With Asthma in Schools. Chest 128: 1928-1935 [Abstract] [Full text]  
• Patterson, E E, Brennan, M P, Linskey, K M, Webb, D C, Shields, M D, Patterson, C C (2005). A cluster randomised intervention trial of asthma clubs to improve quality of life in primary school children: the School Care and Asthma Management Project (SCAMP). Arch. Dis. Child. 90: 786-791 [Abstract] [Full text]  
• Clark, N. M., Gong, M., Kaciroti, N., Yu, J., Guixian Wu, , Zhechun Zeng, , Zhaosu Wu, (2005). A trial of asthma self-management in Beijing schools. Chronic Illness 1: 31-38 [Abstract]  
• Suris, J-C, Michaud, P-A, Viner, R (2004). The adolescent with a chronic condition. Part I: developmental issues. Arch. Dis. Child. 89: 938-942 [Abstract] [Full text]  
• Main, D. S. (2002). Commentary: Understanding the Effects of Peer Education as a Health Promotion Strategy. Health Educ Behav 29: 424-426  
• Dinwiddie, R, Muller, W G (2002). Adolescent treatment compliance in asthma. JRSM 95: 68-71 [Full text]  
• Boulet, L.-P. (2001). A peer led asthma education programme in adolescents was more effective than no programme for improving quality of life. Evid. Based Med. 6: 148-148 [Full text]  
• Peters, T. J, Graham, A., Salisbury, C., Moore, L., Underwood, M., Eldridge, S., Gibson, P. G, Shah, S., Sindhusake, D., Wang, H., Peat, J. K, Henry, R. L (2001). Peer led programme for asthma education in adolescents. BMJ 323: 110-110 [Full text]  

Rapid Responses:

Read all Rapid Responses

Analysis should reflect the clustered study design.

William Plummer
bmj.com, 10 Mar 2001 [Full text]

Analysis reflects clustered study design

Smita Shah
bmj.com, 14 Mar 2001 [Full text]

Missing confidence interval.

W Plummer
bmj.com, 28 Mar 2001 [Full text]

Inadequate design and reporting of a cluster randomised controlled trial

Tim J Peters
bmj.com, 3 Apr 2001 [Full text]

" Missing the wood for the trees" OR "A Cluster of distracting comments"

Peter Gibson
bmj.com, 17 Apr 2001 [Full text]

Online poll

Find out more >>