Asthma: It’s a Family Affair! is a school-based intervention that involves a six-week behavioral intervention for adolescents and five weeks of parent training for their caregivers. An evaluation of the intervention found positive impacts at the two-month follow-up for nighttime symptoms and caregiver problem solving, as well as a change from caregivers being responsible for the child’s asthma medication to the adolescents being responsible for their own medication. No impacts were found for daytime symptoms, caregiver communication, or caregiver warmth.
DESCRIPTION OF PROGRAM
Target population: Adolescents with asthma and their caregivers
Asthma: It’s a Family Affair! is a school-based intervention that combines a behavioral intervention on asthma management for adolescents and parent training for their caregivers that focuses on child rearing skills to support their child’s autonomy and need to self-manage asthma. The adolescent behavioral intervention involves six weekly 75-minute interactive group sessions. The curriculum is based on the phase model of asthma self-regulation and uses techniques from several other youth asthma interventions, including Coping with Asthma at Home and at School, Open Airways for Schools, and Asthma Self-Management for Adolescents. The sessions are administered by a developmental psychologist and cover information and feelings about asthma, asthma medications, prevention and management of symptoms, problem solving and coping with negative feelings about asthma, relaxation exercises, healthy behaviors, and communicating about asthma to peers and teachers. Adolescents are also given homework assignments that allow them to practice the skills they learned and are instructed to share what they learned with their caregivers.
The parent training is based on behavior family systems theories, and the training curriculum is adapted from the substance use prevention program Thriving Teens. The training involves five weekly 90-minute sessions that are administered by a developmental psychologist and a clinical psychologist and cover asthma facts and medication, preventing and managing asthma symptoms, maintaining a positive relationship with teenage children, balancing positive relationships with discipline and guidance, understanding the changes and challenges that occur when children become adolescents, communicating and problem solving effectively, and building communication and problem solving skills in teenage children. Caregivers are given weekly homework assignments and encouraged to practice the skills they learned and discuss the child’s homework.
EVALUATION OF PROGRAM
Evaluated population: This pilot study included 24 students with asthma from a public middle school in New York City and their caregivers. Students’ average age was 12.9, and 54 percent of the students were male. The student sample was 41 percent Hispanic, 17 percent white, 8 percent African American, and 34 percent other. The caregiver sample was 46 percent Hispanic, 17 percent white, 13 percent African American, and 24 percent other. Seventy-nine percent of the caregivers were biological mothers, 13 percent were biological fathers, and 8 percent were mother surrogates.
Approach: Caregivers of all students in the school were asked to complete a survey to determine eligibility for the study. Forty-nine percent did, and of those, 14 percent were eligible, and 31 percent of those who were eligible chose to participate. Students and caregivers completed baseline assessments on asthma management, asthma symptoms, and caregiver-child interactions and were then randomly assigned to the intervention or a no-treatment control condition. Assessments were repeated following the intervention and at the two-month follow-up.
Results: Positive impacts were found at follow-up for caregiver reports of problem solving with children, the number of steps the adolescents take to prevent symptoms, and nighttime symptoms. There was also a change from caregivers primarily being responsible for the child’s asthma medication at baseline, to the adolescents being responsible for their own medication at follow-up. There was no impact on daytime symptoms, caregiver communication, or caregiver warmth.
SOURCES FOR MORE INFORMATION
Bruzzese, J-M., Unikel, L., Gallagher, R., Evans, D., & Colland, V. (2008). Feasibility and impact of a school-based intervention for families of urban adolescents with asthma: Results from a randomized pilot trial. Family Process, 47,95-113.