A Randomized Trial of A.C.T. (Asthma Care Training) for Kids

Abstract

A randomized control trial of a curriculum, A.C.T. (Asthma Care Training) for Kids, was conducted. Seventy-six children between the ages of 8 and 12 years, whose asthma required treatment with medications at least 25% of the days per month, were randomly assigned to control and experimental groups. The control group received 4½ hours of lecture presentations on asthma and its management. The experimental groups (consisting of four to seven children and their parents) received five 1-hour sessions comprising "the treatment." Children and their parents were interviewed before the sessions and 3, 6, and 12 months after the completion of the experimental treatment. Use of emergency rooms and hospitals was determined by reviewing the records of these patients (all members of the Los Angeles Kaiser Permanente health care system) for the period of 1 year before and 1 year after the treatment. Results include (1) equivalent increases in knowledge and changes in beliefs in both groups, (2) significant changes in the self-reported compliance behaviors of the experimental group only, and (3) significant reductions in emergency room visits and days of hospitalization among those receiving the experimental treatment, compared with the control group. These changes represent an estimated savings of approximately $180 per child per year for those in the experimental group.

Teaching families to cope with childhood asthma.

“…The learning process was differentially fitted to adults and children. The learning method at the FAS was based on the principles of a self-management program as used at the Asthma Care Training (ACT) program (12). The intervention project was planned by a multidisciplinary team that consisted of two social workers, a pediatric pulmonologist, a psychiatrist, and a research psychologist.…”

“…Following the general approach and aims described above, the content and methods undertaken in the intervention program were based on the following specific criteria: The program was to be short, intensive, and goal-oriented. Only families in which both parents agreed to participate were to be included. The children and parents were to be addressed as active partners in the treatment of the child’s illness. At each stage of the program, three levels were to be addressed: the individual (child and each parent), the family, and the group. Expression of feelings by all family members was to be encouraged. The process of acquisition of knowledge and ideas was to involve active participation by all participants. The learning process was differentially fitted to adults and children. The learning method at the FAS was based on the principles of a self-management program as used at the Asthma Care Training (ACT) program (12). The intervention project was planned by a multidisciplinary team that consisted of two social workers, a pediatric pulmonologist, a psychiatrist, and a research psychologist.…”

“…The learning process was differentially fitted to adults and children. The learning method at the FAS was based on the principles of a self-management program as used at the Asthma Care Training (ACT) program (12).…”

A comprehensive graphic approach to peak flow "traffic light system" -interpretation

“…If the method itself seems to be good, but does not give convincing results, the method of interpreting PF results must be questioned. Interpretation of PF values has been simplified with the "traffic light system" [6,7]. Nevertheless, national guidelines are very inconsistent in this respect.…”