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A randomized pilot trial of a school-based psychoeducational intervention for children with asthma
Anna L Marsland1, Deborah Gentile2, Amanda Hinze-Crout1
1University of Pittsburgh, Pittsburgh, Pennsylvania.
Insights
A school-based stress management program, "I Can Cope," was feasible and acceptable for children with asthma. It improved asthma control and reduced psychological distress, suggesting potential for addressing health disparities.
Area of Science:
- Pediatric Pulmonology
- Child Psychology
- Public Health Interventions
Background:
- Asthma disproportionately affects minority and low-income children, leading to significant health disparities.
- Psychological stress is a key factor contributing to poor asthma control in children.
- Existing interventions often fail to reach vulnerable populations effectively.
Purpose of the Study:
- To evaluate the feasibility and acceptability of the "I Can Cope" (ICC) school-based intervention for children with asthma.
- To assess the preliminary efficacy of ICC in improving asthma control and psychological well-being.
- To explore the potential of school-based programs in addressing asthma-related health disparities.
Main Methods:
- A randomized pilot trial involving 104 low-income children with persistent asthma.
- Participants were recruited from urban schools and randomized to ICC, an asthma education control (OAS), or no treatment.
- Feasibility was assessed by participation and dropout rates; acceptability by child and parent ratings.
Main Results:
- The ICC intervention demonstrated high acceptability among children and parents.
- Compared to no treatment, ICC significantly reduced depression symptoms, perceived stress, and child-reported asthma symptoms.
- Improvements were noted in sleep quality and child-reported asthma control, with no changes in objective asthma morbidity measures.
Conclusions:
- School-based interventions like ICC are feasible and acceptable for reaching children with asthma, including hard-to-reach populations.
- Preliminary findings support the use of ICC to target psychological factors contributing to asthma disparities.
- Further large-scale efficacy studies are warranted to confirm the benefits of school-based stress management interventions for pediatric asthma.
Background:
Asthma is a common childhood illness with high morbidity and mortality among minority and socio-economically disadvantaged children. Disparities are not fully accounted for by differences in asthma prevalence, highlighting a need for interventions targeting factors associated with poorer asthma control. One such factor is psychological stress.
Objective:
Here, we examine the feasibility and acceptability of "I Can Cope (ICC)," a school-based stress management and coping intervention for children with asthma.
Methods:
A parallel randomized pilot trial was conducted. One hundred and four low-income children (mean age 10 years; 54% male; 70% African American) with persistent asthma were recruited from 12 urban schools and randomized to the following: (a) ICC or one of two control conditions: (b) "Open Airways for Schools (OAS)"-an asthma education intervention or (c) no treatment.
Results:
Seventy one percentage of eligible children participated in the study, with a dropout rate of 12%. ICC was rated as highly acceptable by participating children and parents. Preliminary efficacy data suggest that when compared with no treatment, ICC resulted in decreased symptoms of depression, perceived stress and child-reported symptoms of asthma, and improvements in sleep quality and child-reported asthma control. There were no intervention-related changes in objective measures of asthma morbidity. The magnitude of intervention effects on psychological function did not differ between the ICC and OAS groups.
Conclusions:
Results support the feasibility and acceptability of utilizing school-based interventions to access hard to reach children with asthma. Preliminary findings offer support for future, large-scale efficacy studies of school-based interventions designed to target multiple factors that contribute to asthma disparities.
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