Dec 27, 2010


This school-based program uses several components to improve outcomes for
children with asthma and involves students with asthma, their classmates, their
caretakers, their physicians, school principals and counselors, and custodial
personnel. An evaluation of the program found positive impacts for daytime
symptoms, asthma management, asthma-related absences, and science grades. There
was also a positive impact on nighttime symptoms, but only for students with
persistent and not intermittent asthma. No impacts were found for asthma
medications, grades other than science, and overall school absences.


Target population:
Elementary school children with asthma

This intervention is a comprehensive school-based program involving several
components: Open Airways for Schools disease management training for children,
which is adapted to fit local needs; two classroom sessions of Environmental
Detective to help classmates understand factors that influence respiratory
health and develop empathy for children with asthma; orientation to asthma and
control strategies for principals and school counselors; briefings and building
walk-throughs for custodial personnel on potential environmental triggers and
means of remediation; school fairs for children and caretakers, including
question and answer sessions on asthma care for caretakers; and letters to
children’s clinicians with information on the program and requesting a copy of
children’s asthma action plan for the school.


Evaluated population:
835 children with asthma from fourteen public elementary schools in Detroit. The
sample was 98 percent African American, and 45 percent came from families with
incomes below $15,000.

Schools were randomly assigned to the treatment or control condition. Caretakers
were interviewed at baseline, 12 month follow-up, and 24 month follow-up on
children’s asthma symptoms and asthma management. Data were also collected on
school absences and grades.

By the 24-month follow-up, treatment students had fewer daytime symptoms.
Treatment students with persistent asthma also had fewer nighttime symptoms
compared with control students with persistent asthma, but among students with
mild, intermittent asthma, those who received the intervention had more
nighttime symptoms than controls. Parents of students in the treatment schools
took more steps by the 24 month follow-up to manage their children’s asthma.
Treatment students also had fewer asthma-related absences and their science
grades declined less than control students. No impact was found for asthma
medications, grades other than science, and general school absences.

Analyses did not adjust for the fact that random assignment was implemented at
the school level, while analyses were conducted at the student level.



Clark, N.M., Brown, R., Joseph, C.L.M., Anderson, E.W., Liu, M., & Valerio, M.A.
(2004). Effects if a comprehensive school-based asthma program on symptoms,
parent management, grades, and absenteeism. Chest, 125,1674-1679.

Contact Information

Noreen M. Clark, PhD

University of Michigan school of Public Health

1420 Washington Heights

Ann Arbor, MI 48109-2029

Children (3-11), Elementary, Males and Females (Co-ed),Black/African American, Urban, School-based,
Attendance, Academic Achievement/Grades, Health Status/Conditions

Program information last updated on 12/27/10.