To design, develop, implement, and test the effectiveness of a three component health services and health education intervention for primarily Hispanic inner-city elementary school students at high risk for asthma morbidity and mortality.

BACKGROUND:

The study was part of an initiative "Interventions to Improve Asthma Management and Prevention at School". The Broad Agency Announcement was released in June, 1994.

DESIGN NARRATIVE:

The study used a randomized intervention trial to test the effectiveness of a comprehensive school-based asthma program to increase linkages with primary care physicians, to increase self-management activities, and to reduce morbidity associated with asthma. The study used a nested design in which the schools were the unit of design, allocation, and analysis. Effects were measured from aggregate data about students and data from school measures to control asthma. There were three components to the intervention. First, case finding for asthma through screening in both intervention and control schools. Second, a linkage management system that connected the child with a source of primary care and enhanced communication among the school nurse, the primary care physician, and parents. Third, the development and implementation of interactive multimedia and decision support system techniques to tailor individualized learning opportunities for children with asthma. The interventions occurred in the school setting and included tailored feedback for children, teachers, nurses, primary care providers, and the family. Assessments were made of the potential for diffusion of the components to target audiences.

Inclusion:

School-aged children enrolled at participating schools