Dec 15, 2010


The Triple A Program is a school-based peer-led asthma education program in
which 11th grade students teach 10th grade students about
asthma and asthma management, and the 10th grade students then teach
7th grade students. An evaluation of the program found that there
were positive impacts on quality of life, days absent from school, and asthma
attacks in school for the 10th grade students, and a marginal
positive impact on quality of life for the 7th grade students. The
improvement in quality of life was significant for girls, but not for boys.
There was no impact on lung function.


Target population:
High school students

The intervention consists of having 11th grade students complete a
six-hour asthma peer leader training workshop, in which they learn to educate
their peers on asthma and asthma management using games, videos, worksheets, and
discussion. These students then conduct three 45-minute lessons in groups of
three to four peer leaders, for 10th grade students. The peer leaders
use the teaching tools that they learned to help the 10th grade
students examine the barriers to asthma management. The 10th grade
students then present the key messages from those lessons to 7th
grade students in the schools in the form of short acts, dramas, and songs.


Evaluated population:
1,379 7th and 10th grade students from six high schools
completed the screening, and of those, the 272 who reported recent wheezing and
gave consent completed baseline measurements. Of this sample, 75 percent had
been diagnosed with asthma. The average age for 7th grade
participants was 12.5, and the average age for 10th grade
participants was 15.5. Sixty-five percent of the intervention participants were
female, while 46 percent of the control participants were female.

Schools were randomly assigned to the treatment or control condition. All 7th
and 10th grade students who were present on test day (91 percent of
the total student enrollment) completed the screening. Of these students, 325
reported recent wheezing, and 272 of those students consented and subsequently
completed baseline measurements of lung function, school absenteeism, asthma
attacks during school, and asthma quality of life, which is comprised of
symptoms, activities, and emotional impact. Measurements were completed again by
251 of the participants following the intervention.

There was a positive impact of the intervention on days absent from school and
asthma attacks for 10th grade students, but not for 7th
grade students. There was a positive impact on quality of life overall, and for
the activities domain. However, there was only a marginal change in overall
quality of life for 7th grade students, and there was no impact on
the activities domain for 10th grade students. In addition, subgroup
analyses by gender found that there was a positive impact on overall quality of
life for females only, and that there was a positive impact in the emotions
domain for males only. There was no intervention impact on lung function.



Shah, S., Peat, J.K., Mazurski, E.J., Wang, H., & Sindhusake, D. (2001). Effect
of peer led programme for asthma education in adolescents: Cluster randomised
controlled trial. British Medical Journal, 322,1-5.

Contact Information:

Smita Shah

Department of Public Health and Community Medicine

Westmead Hospital

Westmead, NSW

2145, Australia

Adolescents (12-17), High School, Males and Females (Co-ed), School-based,
Health Status/Conditions

Program information last updated on 12/15/10.

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