Center for Managing Chronic Disease - Putting People at the Center of Solutions

Detroit Middle School Asthma Project

Asthma is the most prevalent chronic disease in children and a significant public health concern, particularly in large urban centers. While the national rate in children under 18 years is about 6-8%, in Detroit, Michigan, rates have been shown to be as high as 20%. In the fall of 2003 an NHLBI funded asthma study began in 19 middle schools across Detroit. Partnering organizations for this project include the University of Michigan Schools of Public Health and Medicine, Henry Ford Health Systems, American Lung Association of Michigan, and the Detroit Public Schools (DPS) Offices of Research and Evaluation and of Physical Education and Health.

The project's overall goal is to evaluate asthma education interventions for young adolescents that combine aspects of peer influence and mastery of disease management by the student with asthma.  A previous study to evaluate an asthma education program (Open Airways) with elementary age children in Detroit demonstrated reduced symptoms of asthma, improved academic performance and improved disease management behavior. The target population of this study is 11-12 year middle school students.  In addition to dealing with the changing social environment of middle school, older children with asthma also have fuller responsibility for managing their own disease, assuming tasks previously undertaken or overseen by parents.

Schools have been randomized into three groups for evaluation of the programs; 1292 students with symptoms of asthma and their parents are participating. The basic intervention is the Open Airways for Middle Schools program (for 6th graders with asthma) adapted to pre-teens' decision-making ability and for urban African-American youth. We have also adapted for this population a highly successful peer education program called Peer Asthma Action (PA2) that was developed and first evaluated in Australia.1,2  This three-step, peer-led program blends social influence with active learning methods in a cascading asthma awareness strategy that touches the whole school.  Evaluation data have been collected from each enrolled student, the parent/guardian and school records at baseline, one year later (as 7th graders), and two years later (as 8th graders).   Data analysis is in progress.

1. Shah, S., Mamoon, H.A., Gibson, P.G. (1998)  Peer-led asthma education for adolescents: Development and formative evaluation.  Health Promotion Journal of Australia; 8(3): 177-182.

2. Shah, S., Peat, J.K., Mazurski, E.J., Wang, H., Sindhusake, D., Bruce, C., Henry, R.L., Gibson, P.G. (2001) Effect of peer led programme for asthma education in adolescents: Cluster randomized controlled trial. BMJ; 322: 583-585.

Project-related Presentations:

Dodge, J.A., Joseph, C.L.M., Garrity, C.R., Thomas, L.J., et al. "Development of a Program for Pre-teen Students with Asthma," presented at the National Asthma Conference in Atlanta, GA, April 14-16, 2004. (Poster)

Clark, N.M., Dodge, J.A., Nelson, B.W., Thomas, L.J., et al. "Asthma in Low-Income Minority Children in Head Start Programs and Middle Schools in Detroit," presented at the 61st Annual Meeting of the American Academy of Allergy, Asthma and Immunology in San Antonio, TX, March 18-22, 2005. (Poster)

Clark, N.M., Dodge, J.A., Roberts, R.H., Awad, D.F., et al.  "Congruence of Parent and Preteen Reports of the Preteen's Experience with Asthma," presented at the American Thoracic Society International Conference in San Diego, CA, May 20-25, 2005. (Poster)

Thomas, L.J., Dodge, J.A., Clark, N.M.  "Open Airways for Middle School (OASMS) Program: Development and process evaluation" presented at the 133rd Annual Meeting of the American Public Health Association in New Orleans, LA, November 5-9, 2005.  (Poster)

Clark, N.M., Dodge, J.A., Shah, S., Valerio, M.A., Awad, D.F., Thomas, L.J. "Understanding of asthma in adolescent girls" presented at the International Conference of the American Thoracic Society in San Francisco, CA, May 18-23, 2007. (Poster)

Project-related Publications:

In Preparation
 

For more information, please contact Lara Thomas at ljthomas@umich.edu

Did you know

The annual economic impact on the U.S. economy of the most common chronic diseases is calculated to be more than $1 trillion, which could balloon to nearly $6 trillion by the middle of the century (from the Milken Institute)