The present study investigated schools as an appropriate context for an intervention designed to produce clinical and psychological benefits for children with asthma.A total of 193 out of 219 (88.1%) children with asthma (aged 7-9 yrs) from 23 out of 24 (95.8%) schools completed the study. Intervention schools received a staff asthma-training session, advice on asthma policy, an emergency b 2 -agonist inhaler with spacer and whole-class asthma workshops. Nonintervention schools received no asthma-related input.Intervention children required less general practitioner-prescribed preventer medication despite no differences in symptom control compared with the nonintervention asthmatic group. Increased peer knowledge of asthma may have mediated improved active quality of life in the intervention group, together with increased self-esteem in young females. Those females not receiving the intervention, but identified as being asthmatic within the classroom, and thus possibly stigmatised, reported decreased self-esteem. Lower self-esteem in young males was associated with pet ownership. No change was found in staff knowledge, the establishment of asthma policies or school absences which were low even before intervention.In conclusion, a whole-school intervention can improve the health of children with asthma when followed with support for all children but effects are likely to be modified by sex and the home environment.
Eleven schools in the south of England took part in a trial of 'Safe in the Sun', a curriculum programme for primary school aged pupils. Case study methodology and the 'draw and write' technique were combined to evaluate changes in pupils' perceptions of the effects of the sun on their skin. Teachers were free to use the materials, consisting of a teacher's handbook and video, as they wished. Pupils in all schools showed higher levels of awareness of sun-safety measures in post-intervention studies compared with the levels recorded 4 months earlier. Chi-square analysis revealed that those pupils whose teachers had used the materials as recommended by the authors had significant increases in awareness and knowledge about keeping safe in the sun, compared with other levels of intervention. More pupils also appeared able to transfer their awareness to the context of the school playground, although the differences were not significant for any level of intervention. The discussion focuses on the value of the 'draw and write' technique as a tool for illuminative evaluation, on the factors which contributed to the pupils increased awareness of sun safety and on the importance of a whole school approach to sun safety.
This report describes the evaluation of a whole-school intervention to improve morbidity and psychosocial well-being in pupils with asthma. In all, 193 children with asthma (7-9 years) from 23 primary/junior schools in the south of England participated. Schools (n = 12) randomly assigned to the intervention group (IV) received a staff asthma training session, advice on asthma policy and practice and an emergency beta(2)-agonist inhaler with spacer. Pupils participated in an asthma lesson. Staff and pupils in non-intervention (NI) schools (n = 11) received no asthma-oriented input. While wheeze reports improved for all children with asthma, only the IV group showed lower requirement for medication (P = 0.01), clinically significant improvement (P < 0.05) in activity related quality of life (QOL) and increased self-esteem (SE: social P = 0.01; athletic P = 0.05; behaviour P = 0.001) in girls. SE decreased for NI girls but there was no change for non-asthmatic peers in NI or IV schools which had similar baseline levels of SE and QOL. There was a marginal improvement in the establishment of asthma policies/practices and no change in school absence or staff knowledge. The significantly increased peer group understanding of asthma seen in the intervention schools may have mediated increased well-being in the IV group. Primary schools are a potentially important context for improving asthma morbidity and psychosocial well-being of children with asthma.
A postal questionnaire survey of headteachers in 149 Infant, Junior and Primary schools (response rate: 63.8%) indicated poor asthma record keeping and a need for regular staff training in asthma. Dealing with an emergency was a major concern of headteachers. In 25 of the schools surveyed, an International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was distributed to parents of children in Years 3 and 4 (7-9 years). Headteacher-reported asthma prevalence was 11.9% in these schools, while ISAAC parental reports indicated a current or previous diagnosis of asthma in 24.3% children, with 17.8% receiving asthma treatment and 18.9% reporting wheeze in the previous 12 months. Of six wheezing children per Year 3/4 class, one was receiving no treatment for asthma, three had experienced four or more attacks of wheeze in the previous year with one wheezing child per two Year 3/4 classes experiencing more than 12 such attacks. Four in six children experienced exercise-related wheeze, while only one in five schools allowed asthma medication at Physical Education lessons. A whole school policy on asthma together with some regularly updated staff education and training by an asthma-trained nurse would address many of the issues raised in this study.
This study aimed to identify socio-cultural and reproductive health correlates of knowledge about AIDS among rural women using multivariate analysis of 1998-1999 National Family Health Survey (NFHS) data from two Indian states, Maharashtra and Tamil Nadu, where the urban HIV prevalence is relatively high. Analysis using multiple logistic regression was undertaken, modelling women's knowledge of AIDS, of whether the disease can be avoided, and of effective means of protection. Although 47% of all rural women in Maharashtra were aware of AIDS only about 28% knew that one can avoid it, and only about 16% possessed correct knowledge about its transmission. In Tamil Nadu, where overall 82% of rural women had awareness of AIDS, about 71% knew that one can avoid the disease but only about 31% possessed correct knowledge about its transmission. In both states, women from socially and economically backward groups had lower odds both of having awareness of AIDS and knowledge of ways to avoid getting the disease. Associations with socio-cultural and reproductive variables and the impact of contact with family planning services differed in the two states. The spread of the epidemic to rural areas presents a need actively to disseminate AIDS related knowledge for health protection rather than waiting for knowledge to follow the appearance of the disease in communities. Approaches to health promotion that do not consider differing contextual factors are unlikely to succeed. In particular, innovative strategies to disseminate knowledge among disadvantaged population groups are needed.
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