Asthma in Central Texas Project

Asthma is the most common chronic childhood illness and disproportionately affects children
who are ethnic minorities and poor. Few studies of childhood asthma have been conducted with
children who live in rural areas or have included Mexican American children in their
samples. This study builds on the original R01NR007770 with findings that demonstrated the
intervention could improve children's asthma self-management, asthma knowledge, metered dose
inhaler skill, asthma severity, and parents' asthma management and access to care. In this
competing continuation, the investigators added a third arm to the current research design
with schools randomized into either an in-school asthma intervention, an in-school
attention-control intervention, or an alternate intervention-delivery format of a single
5.5-hour asthma day camp. The tri-ethnic sample will be composed of 320 Mexican-American,
African-American, and White rural school-aged children (grades 2-5) who have asthma and
their parents. In addition, the investigators propose adding a non-invasive measure of
chronic airway inflammation (exhaled nitric oxide) to assess the impact of changes in asthma
management on airway inflammation. Families will be followed for a full year with data
collection at baseline and at 1-month, 4-months, and 7-months after the intervention to
assess improvement in children's asthma morbidity, asthma severity, airway inflammation,
family asthma management and quality of life. Hypotheses (H): Children in the Camp-Workshop
group and the School-Home group will demonstrate equivalent improvements, but greater
improvements than the Attention-Control group in:(H1.1) their asthma severity and airway
inflammation from the Time 1 assessment when compared to Time 4 assessment; (H1.2) office
visits, ED visits, and hospitalizations for asthma, and absenteeism for the study year (Time
4) when compared to the pre-study year (Time 1); and (H1.4) Parents in the intervention arms
will demonstrate sustained improvements in asthma caregiver's quality of life (QOL0 from the
pre-study year (Time 1) to the end of the study year (Time 4) measurement, when compared to
the Attention-Control group.