The Effects of a School-Based Intervention on the Self-Care and Health of African-American Inner-City Children with Asthma Barbara Velsor-Friedrich, PhD, RN Therese D. Pigott, PhD Adrianne Louloudes, MSN, RN Asthma is a chronic illness that affects 5% to 10% or about 5 million children in this country. Morbidity and rising mortality rates are of particular concern in minority children. This study addresses a serious knowledge deficit about the management of asthma in minority children by testing the effect of a school-based asthma education program on psychosocial and health outcomes of 8-13-year-old inner-city minority students. Although the mean scores of the treatment group were higher than the control group on several of the psychosocial measures, these changes were not significant. However, significant differences were found between the groups on health outcomes. Recommendations for future research and clinical practice are discussed. © 2004 Elsevier Inc. All rights reserved. A STHMA IS A chronic condition that affects 15 million Americans, including 5 million chil- dren. Between 1980 and 1994, the prevalence of asthma increased 74% among children (National Center for Environmental Health, 2002). The prev- alence of asthma among urban African-American children in the United States is twice that of sub- urban white children. Pediatric morbidity and mor- tality rates are also particularly high in urban mi- nority populations (Joseph, Petersen, & Ownby, 1995; Gergen, Mullay, & Evans, 1998; National Center for Environmental Health, 2002). Costs associated with this disease are high, from both a health as well as a financial perspective. Childhood asthma accounts for 10 million school absences and annual heath care costs estimated at $1.9 billion (American Academy of Allergy, Asthma, and Immunology [AAAAI], 1999). The purpose of this article is to discuss the findings of a school-based intervention program on psychoso- cial and health outcomes of minority children with asthma. LITERATURE REVIEW Asthma Management The pharmacologic management of asthma has been modified in the last several years (National Heart Lung and Blood Institute [NHLBI], 1997; 2002; AAAAI, 1999). Anti-inflammatory drugs and inhaled steroids are the mainstay of treatment for patients with persistent asthma of mild, mod- erate, and severe types. Nonpharmacologic man- agement of asthma includes avoidance of allergens and irritants, the use of peak flow meters to mon- itor respiratory function, and patient and family education (Moffitt, Gerhart, & Yates, 1994; AAAAI, 1999). Over the past 20 years, several asthma education or “self-management” programs have been devel- oped to promote changes in behavior and to im- prove asthma health and quality of life (Velsor- Friedrich & Srof, 2000). Children who participated in these programs experienced fewer emergency department and unscheduled physician visits, im- provement in physical and social activities, better asthma self-management, enhanced self-efficacy, fewer school absences, and improved school per- formance (Evans et al., 1987; McNab, Wilson- Pessano, Hughes, & Scamagas, 1985; Schwartz, From the Department of Health Promotion, Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL. Address correspondence and reprint requests to Barbara Velsor-Friedrich, Department of Health Promotion, Marcella Niehoff School of Nursing, Loyola University Chicago, 6525 N. Sheridan Road, Chicago, IL 60626-5385. E-mail: bvelsor@ luc.edu 0882-5963/$ - see front matter © 2004 Elsevier Inc. All rights reserved. doi:10.1016/j.pedn.2004.05.007 247 Journal of Pediatric Nursing, Vol 19, No 4 (August), 2004