Evaluation of the feasibility of a school-based asthma management programme in Taiwan

Aims and objectives. To investigate the feasibility of a school-based asthma management programme for middle school children. Background. Asthma rates are increasing among school-aged children. Successful asthma treatment in children depends in part on clear communication and effective education. Design. This feasibility study employed a one-group only longitudinal design with four time points over 18 months. Methods. Nineteen female and twelve male (n = 31) seventh-grade children with asthma (13 SD 0 center dot 71 years) were identified using a six-stage asthma case-finding approach. Teachers and school staff were trained in the principles and methods of the proposed school-based asthma management programme. An individualised guided asthma self-management programme was developed for each child by a clinical team at a major academic medical centre. We assisted teachers in implementing the school programme; building a support network and monitoring children's activities. Outcome measures included lung function tests (at 0, six, 12 and 18 months), disease-related symptoms, psychosocial status and impact of asthma on learning (at 0 and 18 months). School provided data on academic achievement and school absences at 0, six, 12 and 18 months. Results. Significant improvements were noted at six, 12 and 18 months on forced vital capacity (FVC)% of predicted (p = 0 center dot 001, 0 center dot 015, 0 center dot 015, respectively), forced expiratory volume in one second (FEV1)% of predicted (p = 0 center dot 001, 0 center dot 006, 0 center dot 088, respectively) and FEV1/FVC% of predicted (p = 0 center dot 001, 0 center dot 015, 0 center dot 099, respectively). There was a trend towards improved asthma symptoms (p = 0 center dot 050) and a significant decrease in positive perception of curriculum (p = 0 center dot 017) at 18 months after adjustment for covariates. Conclusions. This programme was associated with respiratory benefits on physiological asthma markers commonly, with a trend for symptom control. Academic and psychosocial outcomes are subject of further inquiry. Relevance to clinical practice. School-based asthma management holds promise as a feasible clinical option for middle school children with asthma in the Taiwanese school system.