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Effects of a peer-led asthma self-management program for adolescents.

ABSTRACT: To evaluate the effectiveness of a peer-led asthma self-management program for adolescents.Randomized controlled trial comparing a peer-led asthma program (intervention group) and a conventional adult-led asthma program (control group). Each program was implemented at a full-day camp.A city and adjacent suburbs in upstate New York.A total of 112 adolescents aged 13 to 17 years with persistent asthma.A peer-led asthma self-management program implemented at a day camp.The Child Attitude Toward Illness Scale and the Paediatric Asthma Quality of Life Questionnaire were administered at baseline and immediately and 3, 6, and 9 months after the intervention. Spirometry was conducted twice: before and 9 months after the intervention.The intervention group reported more positive attitudes at 6 months (mean difference, 4.11; 95% confidence interval [CI], 0.65-7.56) and higher quality of life at 6 months (difference, 11.38; 95% CI, 0.96-21.79) and 9 months (difference, 12.97; 95% CI, 3.46-22.48) than the control group. The intervention was found to be more beneficial to adolescents of male gender or low family income, as shown by greater improvement in positive attitudes toward asthma and quality of life than their counterparts.An asthma self-management program led by peer leaders is a developmentally appropriate approach that can be effective in assisting adolescents with asthma in improving their attitudes and quality of life, particularly for males and those of low socioeconomic status.clinicaltrials.gov Identifier: NCT01161225.

SUBMITTER: Rhee H

PROVIDER: S-EPMC3252732 | biostudies-literature | 2011 Jun

REPOSITORIES: biostudies-literature

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Effects of a peer-led asthma self-management program for adolescents.

Rhee Hyekyun H Belyea Michael J MJ Hunt John F JF Brasch Judith J

Archives of pediatrics & adolescent medicine 20110601 6

<h4>Objective</h4>To evaluate the effectiveness of a peer-led asthma self-management program for adolescents.<h4>Design</h4>Randomized controlled trial comparing a peer-led asthma program (intervention group) and a conventional adult-led asthma program (control group). Each program was implemented at a full-day camp.<h4>Setting</h4>A city and adjacent suburbs in upstate New York.<h4>Participants</h4>A total of 112 adolescents aged 13 to 17 years with persistent asthma.<h4>Intervention</h4>A peer ...[more]

PMID: 21646583

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Project description:ImportanceLong-term effectiveness of a peer-led asthma self-management program in improving asthma outcomes in adolescents living in urban areas has not been established.ObjectiveTo determine the long-term effects of a peer-led program on asthma control, quality of life, and asthma management among predominantly racial and ethnic minority adolescents living in urban areas.Design, setting, and participantsA parallel-group, randomized clinical trial was conducted in 2015 to 2019 in 3 metropolitan cities in the US: Buffalo, New York; Baltimore, Maryland; and Memphis, Tennessee. Adolescents aged 12 to 17 years old with persistent asthma were recruited mainly through clinical practices and schools. Participants were followed-up for 15 months after the intervention. Double-blinding was achieved for baseline. Data analysis was performed from June 2019 to June 2020.InterventionsThe intervention group received a peer-led asthma self-management program; the control group received the identical program led by adult health care professionals. Peer leaders made follow-up contacts every other month for 12 months.Main outcomes and measuresThe primary outcome was quality of life measured by the Pediatric Asthma Quality of Life Questionnaire, which consists of 3 subscales that measure symptoms (10 items), activity limitations (5 items), and emotional functioning (8 items) in the past 2 weeks. Each item was measured on a 7-point scale, with higher mean scores indicating better quality of life. Secondary measures included the Asthma Control Questionnaire and an asthma self-management index capturing steps to prevent and manage symptoms, self-efficacy, and lung function.ResultsOf 395 eligible adolescents, 35 refused, 38 did not show or were lost to contact, and 2 withdrew before randomization; 320 adolescents participated (mean [SD] age, 14.3 [1.71] years), including 168 boys (52.5%), 251 Black or African American adolescents (78.4%), and 232 adolescents (72.5%) with public health insurance. Of 320 enrolled, 303 were included in the longitudinal analysis. Response rates were 80% or higher at all time points. The peer-led group had greater improvement in outcomes than the adult-led group, with adjusted mean differences (AMDs) between baseline and 15 months of 0.75 vs 0.37 for quality of life (between-group AMD, 0.38; 95% CI, 0.07 to 0.63) and -0.59 vs -0.31 for asthma control (between-group AMD, -0.28; 95% CI, -0.51 to -0.01). Outcomes were not affected by bimonthly contact doses.Conclusions and relevanceIn this randomized clinical trial, a peer-led asthma self-management education was more effective than an adult-led program in improving asthma outcomes, with the improvements sustained for up to 15 months. These findings suggest that a peer-led asthma self-management program should be considered in addressing the disproportionate asthma burden in racial and ethnic minority adolescents living in urban communities.Trial registrationClinicalTrials.gov Identifier: NCT02293499.

Project description:Chronic pain is common among older adults and is associated with adverse physical and psychological outcomes. Given the burden of pain and limited healthcare resources, devising innovative and cost-effective ways of managing chronic pain is of high priority. The aim of this paper is to explore the experiences and perceptions of peer volunteers (PVs) in a peer-led pain management program among nursing home residents in Hong Kong. Forty-six PVs were recruited and trained to lead a pain management program (PAP). The PAP consisted of one 1 hour session per week for 12 weeks. It included 20 min of physical exercises performed under the supervision of PVs, followed by 30 min of pain management education, including information on pain situations, the impacts of pain, the use of drugs and non-drug strategies for pain management, demonstrations, and return demonstrations of various non-drug pain management techniques. Quantitative data were collected from questionnaires (demographics, pain situation, and pain knowledge) for all PVs. Qualitative data (PVs' experiences in leading the PAP, their perceived benefits, barriers encountered, and recommendations for improving the PAP) were collected at week 12 (upon completion of the PAP). Data were analyzed using the Statistical Package for Social Sciences and content analysis for qualitative data. A total of 46 PVs were recruited (34 females, 74%), with a mean ± SD age of 61.0 ± 5.1 years. Thirty-one of them reported having chronic pain. Before the training, their self-rated pain knowledge was 40.0 ± 20.5 (maximum 100 points) while their actual pain knowledge score was 86.1 ± 10.6 (maximum 100 points). The PVs reported an improvement in their knowledge and skills after leading PAPs. No PVs reported having received any negative comments about their role in leading the PAP but mentioned that they had received feedback on how to improve the program. This study provides further evidence that peer-led pain management programs are feasible and can lead to positive experiences for the PVs. Peer support models are coming into wide use because they show promise in helping patients to manage chronic conditions. Peer volunteers will become important resources in elderly care. The barriers that were identified may lead to improvements in the design and planning of future PAPs.

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Effects of a peer-led asthma self-management program for adolescents.

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Effects of a peer-led asthma self-management program for adolescents.

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