COPE for Children With Asthma: Intervention for Children With Asthma

The Interventionist was trained on the implementation of the COPE intervention and will
deliver the COPE for Asthma intervention. The intervention, delivered by Colleen McGovern
-the Interventionist, will take place in a room within the school separate from other
students. The room will include a door for privacy. The intervention will be once/week, 30
minute sessions, for 7 weeks - during lunch and/or recess time. Groups during lunch and
recess, or "lunch bunch" groups, are routinely held in the school system by the social
workers, guidance counselors, and school nurses. Participants will be given weekly tickets
allowing them to get in line first to pick up their lunch to maximize the allotted time. If
the material for a session is not covered (i.e., school-wide fire drill, lock down, or other
unforeseen event), the session will be moved to the following week.

In the event a participant has severely elevated t-scores, >=70, on the anxiety or depression
screening tools or expresses feelings or intent to harm self or others (at any time point or
otherwise), the principal, school nurse and/or guidance counselor/social worker will be
notified for follow-up per the school district's protocol. A form letter will be sent to the
child's CG that day. If child discloses accounts of abuse or neglect, Franklin County
Children's Services will be notified and the principal, school nurse and/or guidance
counselor/social worker.

Consent/assent of the CG and child and initial screening for anxiety/depression:SCARED and
PROMIS measures; will be completed by the Interventionist and a research assistant, RA, from
Dr. Melnyk's research team. Data collection and the intervention will start when >=5 child/CG
dyads have been consented/assented in a school.

Week 1 at baseline. To avoid bias, the Interventionist will serve as the interventionist and
the RA will complete the data gathering. The measures for the child participants will be
explained, then self-administered, and checked for completeness by the RA. The RA will
conduct phone interviews with the CGs to gather data on demographics, controller medication
adherence, and the Asthma Control Test. If phone contact is not possible, the surveys will be
sent home with the child with sealable envelopes for the return.

Weeks 2 - 8. COPE for Asthma will be delivered in small groups (Interventionist may need to
implement the intervention at several schools on different days; this is expected). Lessons
include 30 minutes of didactic teaching and activities.

Post-Intervention Assessment, after the 7-week intervention. After the last COPE for Asthma
session has been implemented in a group, a member of Dr. Melnyk's research team will
administer the post-intervention follow-up surveys. CGs will be contacted to complete the
parent/CG survey.

6-Week Post-Intervention Assessment. The same procedure as for the post-intervention
assessment will be conducted for this time period for the children and CGs.

Inclusion Criteria:

- Children age 8-12 years enrolled in Columbus City Schools

- Diagnosis of persistent asthma requiring daily inhaled controller medication use at
some point (medical condition form on file with the school/CG report)

- Have symptoms depression or anxiety per the PROMIS/SCARED measures

- Have written consent to participate provided by care giver and child assent

- The participating care giver has primary or at least equal responsibility for the
day-to-day management of the child's asthma

- care givers provide written consent for their own participation

- Be able to speak, read, and write in English (care giver and child).

Exclusion Criteria:

- has other significant pulmonary conditions (e.g., pulmonary fibrosis, cystic fibrosis)

- currently receiving treatment from a mental health professional

- child or CG has cognitive learning disability that could interfere with the ability to
comprehend the interview questions.