Multicomponent intervention for schoolchildren with asthma: Pilot cluster randomized controlled trial
Background: Physical activity (PA) is an important factor in asthma management. However, studies report low PA in children with asthma living in underserved communities. Objective: We assessed preliminary effectiveness of a pilot multicomponent asthma intervention that includes classroom-based PA, a...
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| Format: | Article |
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Elsevier
2025-05-01
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| Series: | Journal of Allergy and Clinical Immunology: Global |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772829325000190 |
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| author | Marina Reznik, MD, MS Florinda Islamovic, MD Jill S. Halterman, MD, MPH Cheng-Shiun Leu, PhD Jiaqing Zhang, PhD Philip O. Ozuah, MD, PhD |
| author_facet | Marina Reznik, MD, MS Florinda Islamovic, MD Jill S. Halterman, MD, MPH Cheng-Shiun Leu, PhD Jiaqing Zhang, PhD Philip O. Ozuah, MD, PhD |
| author_sort | Marina Reznik, MD, MS |
| collection | DOAJ |
| description | Background: Physical activity (PA) is an important factor in asthma management. However, studies report low PA in children with asthma living in underserved communities. Objective: We assessed preliminary effectiveness of a pilot multicomponent asthma intervention that includes classroom-based PA, asthma education to increase knowledge and reduce stigma, and care coordination to facilitate guideline-based care, on PA and symptom-free days (SFD) in urban, historically marginalized children with asthma. Methods: Children aged 7-10 years with asthma and their caregivers were recruited from 4 Bronx, NY, schools. We randomly assigned 2 schools as intervention and 2 as control sites. Child PA (primary outcome) was measured by accelerometers at 4 time points, and caregivers completed surveys on asthma symptoms. Analyses used generalized linear mixed models with generalized estimating equation adjusting for clustering. Clinical Trial Registration: ClinicalTrials.gov NCT01873755. Results: We included 107 children (53% male participants, 82% Hispanic, mean [standard deviation] age 9.0 [1.0] years, 76% with persistent or uncontrolled asthma). Children in the intervention group had a significantly greater increase in total moderate-to-vigorous PA and step counts at 12 months after intervention in the entire sample (β = 6.05, P < .0001; β = 579.11, P = .008, respectively) and in those with persistent or uncontrolled asthma compared to controls (β = 6.20, P < .001; β = 639.08, P = .004, respectively). Similar beneficial intervention effects were found in improvement in SFD over 2 weeks in the entire sample (β = 1.38, P = .018) and in children with persistent or uncontrolled asthma (β = 1.82, P = .011) compared to controls. Conclusion: A pilot intervention addressing multiple barriers to PA, including stigma, teacher confidence in asthma management, access to PA, and in-school medication, improved PA levels and SFD in students with asthma. |
| format | Article |
| id | doaj-art-e383a8bf83da475b88203e69bc798ee1 |
| institution | Kabale University |
| issn | 2772-8293 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Allergy and Clinical Immunology: Global |
| spelling | doaj-art-e383a8bf83da475b88203e69bc798ee12025-02-08T05:01:45ZengElsevierJournal of Allergy and Clinical Immunology: Global2772-82932025-05-0142100418Multicomponent intervention for schoolchildren with asthma: Pilot cluster randomized controlled trialMarina Reznik, MD, MS0Florinda Islamovic, MD1Jill S. Halterman, MD, MPH2Cheng-Shiun Leu, PhD3Jiaqing Zhang, PhD4Philip O. Ozuah, MD, PhD5Department of Pediatrics, Albert Einstein College of Medicine, Children’s Hospital at Montefiore Einstein, Bronx, NY; Corresponding author: Marina Reznik, MD, MS, Department of Pediatrics, Albert Einstein College of Medicine, Children’s Hospital at Montefiore Einstein, 3411 Wayne Ave, 8th Fl, Bronx, NY 10467.Department of Pediatrics, Albert Einstein College of Medicine, Children’s Hospital at Montefiore Einstein, Bronx, NYDepartment of Pediatrics, University of Rochester, Rochester, NYDepartment of Biostatistics, Columbia University, New York, NYAdobe Inc, Waltham, MassAlbert Einstein College of Medicine, Montefiore Einstein Health System, Bronx, NYBackground: Physical activity (PA) is an important factor in asthma management. However, studies report low PA in children with asthma living in underserved communities. Objective: We assessed preliminary effectiveness of a pilot multicomponent asthma intervention that includes classroom-based PA, asthma education to increase knowledge and reduce stigma, and care coordination to facilitate guideline-based care, on PA and symptom-free days (SFD) in urban, historically marginalized children with asthma. Methods: Children aged 7-10 years with asthma and their caregivers were recruited from 4 Bronx, NY, schools. We randomly assigned 2 schools as intervention and 2 as control sites. Child PA (primary outcome) was measured by accelerometers at 4 time points, and caregivers completed surveys on asthma symptoms. Analyses used generalized linear mixed models with generalized estimating equation adjusting for clustering. Clinical Trial Registration: ClinicalTrials.gov NCT01873755. Results: We included 107 children (53% male participants, 82% Hispanic, mean [standard deviation] age 9.0 [1.0] years, 76% with persistent or uncontrolled asthma). Children in the intervention group had a significantly greater increase in total moderate-to-vigorous PA and step counts at 12 months after intervention in the entire sample (β = 6.05, P < .0001; β = 579.11, P = .008, respectively) and in those with persistent or uncontrolled asthma compared to controls (β = 6.20, P < .001; β = 639.08, P = .004, respectively). Similar beneficial intervention effects were found in improvement in SFD over 2 weeks in the entire sample (β = 1.38, P = .018) and in children with persistent or uncontrolled asthma (β = 1.82, P = .011) compared to controls. Conclusion: A pilot intervention addressing multiple barriers to PA, including stigma, teacher confidence in asthma management, access to PA, and in-school medication, improved PA levels and SFD in students with asthma.http://www.sciencedirect.com/science/article/pii/S2772829325000190Physical activityurban youthasthmainterventionpilot RCTschool-based |
| spellingShingle | Marina Reznik, MD, MS Florinda Islamovic, MD Jill S. Halterman, MD, MPH Cheng-Shiun Leu, PhD Jiaqing Zhang, PhD Philip O. Ozuah, MD, PhD Multicomponent intervention for schoolchildren with asthma: Pilot cluster randomized controlled trial Journal of Allergy and Clinical Immunology: Global Physical activity urban youth asthma intervention pilot RCT school-based |
| title | Multicomponent intervention for schoolchildren with asthma: Pilot cluster randomized controlled trial |
| title_full | Multicomponent intervention for schoolchildren with asthma: Pilot cluster randomized controlled trial |
| title_fullStr | Multicomponent intervention for schoolchildren with asthma: Pilot cluster randomized controlled trial |
| title_full_unstemmed | Multicomponent intervention for schoolchildren with asthma: Pilot cluster randomized controlled trial |
| title_short | Multicomponent intervention for schoolchildren with asthma: Pilot cluster randomized controlled trial |
| title_sort | multicomponent intervention for schoolchildren with asthma pilot cluster randomized controlled trial |
| topic | Physical activity urban youth asthma intervention pilot RCT school-based |
| url | http://www.sciencedirect.com/science/article/pii/S2772829325000190 |
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