Evaluation of the Asthma Management Program to Promote Activity for Students in Schools (Asthma-PASS)

Evaluation of the Asthma Management Program to Promote Activity for Students in Schools (Asthma-PASS)

Physical activity (PA) is an important component of asthma management in children. Studies show that PA is associated with decreased severity of asthma symptoms, as well as improved disease control and quality of life. However, urban minority children with asthma face barriers to PA on multiple levels.The goal of this research project is to evaluate whether a multifaceted school-based intervention that addresses key barriers to physical activity reduces asthma morbidity among urban schoolchildren with asthma.

Investigators will conduct a cluster-randomized controlled trial with eligible children with persistent or uncontrolled asthma from 60 Bronx schools. Schools will be randomly assigned to either (1) the Asthma-PASS intervention or an asthma management (AM) comparison group. Both groups will participate in an existing classroom-based daily activity program. Enrollment will occur over 4 consecutive school years with 4-8 schools joining the study each year. The investigators will assess the effectiveness of Asthma-PASS in reducing asthma morbidity and improving PA as well as additional clinical and functional outcomes. The investigators will also identify potential mediators and moderators of the intervention effect. They will evaluate the process of intervention implementation by applying the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. The RE-AIM framework is a public health tool used for planning and evaluating programs to improve translation from research into practice and ensure sustainability in real-world settings.

Inclusion Criteria:

• Physician-diagnosed asthma (based on parent report with validation from the child's physician)
• Intermittent asthma (but with a report of asthma symptoms, such as coughing, wheezing, chest tightness, mucus/phlegm or shortness of breath, in the past 12 months)
• Mild persistent or more severe asthma based on prescribed controller medication (currently well-controlled) but with a report of asthma symptoms (as specified above) within the past 12 months [well-controlled due to taking controller medications in the past 12 months and without asthma symptoms (as specified above) within the past 12 months will qualify]
• Mild persistent or more severe asthma, or asthma that is uncontrolled despite therapy (based on age-specific guidelines)
• Attending pre-kindergarten through 5th grade in NYC (primarily Bronx) schools and also schools in lower Hudson Valley
• Parent is able to speak and understand either English or Spanish
• Consent from the primary caregiver, caregiver permission for child participation as well as assent from the child (for age 7 and above)

Exclusion Criteria:

• No access to a phone to conduct follow-up surveys
• Family plans to leave the school or city in less than 6 months
• The child has other significant medical conditions, such as congenital heart disease, cystic fibrosis, or other chronic lung disease
• Child is unable to participate in routine physical education (PE) classes as per physician-completed sports participation form
• Children in foster care or other situations in which consent cannot be obtained from a guardian
• Child is a participant in a concurrent asthma intervention study