School-based self-management interventions for asthma among primary school children: a systematic review

Abstract

A Cochrane review of school-based asthma interventions (combining all ages) found improved health outcomes. Self-management skills, however, vary according to age. We assessed effectiveness of primary school-based self-management interventions and identified components associated with successful programmes in children aged 6–12 years. We updated the Cochrane search (March 2020) and included the Global Health database. Two reviewers screened, assessed risk-of-bias and extracted data. We included 23 studies (10,682 participants); four at low risk-of-bias. Twelve studies reported at least one positive result for an outcome of interest. All 12 positive studies reported parental involvement in the intervention, compared to two-thirds of ineffective studies. In 10 of the 12 positive studies, parental involvement was substantial (e.g. attending sessions; phone/video communication) rather than being provided with written information. School-based self-management intervention can improve health outcomes and substantial parental involvement in school-based programmes seemed important for positive outcomes among primary school children.

Stakeholders’ views of supporting asthma management in schools with a school-based asthma programme for primary school children: a qualitative study in Malaysia

“…Similar community-wide programmes have been implemented in other contexts 31 32. Education for staff and children is a common component,14 15 and could correct common misperceptions about asthma and asthma medication. Involvement of school health teams could improve the accessibility of healthcare for children with asthma 19 33–35.…”

“…3 12 13 School-based asthma self-management educational interventions that were theory-driven, involved parent, included children's satisfaction and done outside children's free time have been shown to improve asthma control, reduce school absenteeism and asthma attacks, [14][15][16] though few were conducted in LMICs. 14 15 These programmes are complex interventions that can be successful if tailored to the target population, 17 18 and adapted to the context. 19 The WHO has also highlighted the importance of policy and organisation-level collaboration and engagement with parents, students and teachers.…”

“…The WHO endorses the role of school in supporting children with asthma and recommends that asthma should be an essential school health service in all countries 3 12 13. School-based asthma self-management educational interventions that were theory-driven, involved parent, included children’s satisfaction and done outside children’s free time have been shown to improve asthma control, reduce school absenteeism and asthma attacks,14–16 though few were conducted in LMICs 14 15. These programmes are complex interventions that can be successful if tailored to the target population,17 18 and adapted to the context 19.…”

Social Determinants of Health in Asthma Through the Life Course

“…Systematic reviews of effective SBAP interventions consistently show that programs with substantial parental involvement resulted in successful interventions in both school-age and adolescent populations. 62,65 Asthma navigators can improve parental involvement through providing individualized care tailored to student/parental concerns, improving parental confidence, and assisting families in navigating complex health care settings. 61,65,66 In addition, poor communication between members in the home, school, and health care system is a gap in current asthma care-contributing to insufficient SDOH management and inconsistent asthma management.…”

“…62,65 Asthma navigators can improve parental involvement through providing individualized care tailored to student/parental concerns, improving parental confidence, and assisting families in navigating complex health care settings. 61,65,66 In addition, poor communication between members in the home, school, and health care system is a gap in current asthma care-contributing to insufficient SDOH management and inconsistent asthma management. 61,64 SBAPs may fill this gap by using school nurses and asthma navigators in establishing formal communication channels between these sectors.…”