MJA
MJA

An education intervention for childhood asthma by Aboriginal and Torres Strait Islander health workers: a randomised controlled trial

Med J Aust 2010; 192 (10): 574-579.

Summary

Objective: To assess the outcomes of an education intervention for childhood asthma conducted by Australian Indigenous health care workers (IHCWs).

Design and setting: Randomised controlled trial in a primary health care setting on Thursday Island and Horn Island, and in Bamaga, Torres Strait region of northern Australia, April 2005 to March 2007.

Participants: 88 children, aged 1–17 years, with asthma diagnosed by a respiratory physician (intervention group, 35; control group, 53; 98% Indigenous children).

Interventions: Children were randomly allocated to: (i) three additional asthma education sessions with a trained IHCW, or (ii) no additional asthma education. Both groups were re-assessed at 12 months.

Main outcome measures: Primary endpoint: number of unscheduled visits to hospital or a doctor caused by asthma exacerbation. Secondary outcomes: measures of quality of life (QoL) and functional severity index; asthma knowledge and understanding of asthma action plans (AAPs); and school days missed because of wheezing.

Results: The groups were comparable at baseline (except for asthma severity, which was adjusted for in the analysis). There were no significant differences in the primary outcome (number of unscheduled medical visits for asthma). School children in the intervention group missed fewer school days because of wheezing (100% < 7 days v 21% of those in the control group missed 7–14 days). Significantly more carers in the intervention group could answer questions about asthma medication, knew where their AAP was kept (84% v 56%), and were able to describe the plan (67% v 40%). In both the intervention and control groups (before-and-after comparison), there was a significantly reduced frequency of asthma exacerbations, as well as an improved QoL score and functional severity index, with no significant differences between the groups.

Conclusions: A community-based asthma education program conducted by trained IHCWs improves some important asthma outcomes in Indigenous children with asthma.

Trial registration: Australian Clinical Trials Registry ACTRN012605000718640.

  • Patricia C Valery1
  • Ian B Masters2
  • Brett Taylor3
  • Yancy Laifoo4
  • Peter K O’Rourke1
  • Anne B Chang0,5,6

  • 1 Queensland Institute of Medical Research, and Australian Centre for International and Tropical Health, University of Queensland, Brisbane, QLD.
  • 2 Department of Respiratory Medicine, Royal Children’s Hospital, Brisbane, QLD.
  • 3 The Asthma Foundation of Queensland, Brisbane, QLD.
  • 4 Thursday Island Primary Health Care Centre, Thursday Island, QLD.
  • 5 Menzies School of Health Research, Charles Darwin University, Darwin, NT.
  • 6 Queensland Children’s Respiratory Centre and Queensland Children’s Medical Research Institute, Royal Children’s Hospital, Brisbane, QLD.


Acknowledgements: 

We thank Valerie Logan for technical support; the District Health staff, Saimo Gela and Debra Nona, for help with data collection; and Janelle Stirling (former coordinator of the Queensland Institute of Medical Research Indigenous Health Research Program), Vanessa Clements and Torres Strait personnel for their help with culturally appropriate, paediatric asthma education packages. We also thank Gail Garvey (coordinator of the Queensland Institute of Medical Research Indigenous Health Research Program). We are grateful to the children and their families for participating in the study. We also acknowledge the support of the Torres Strait communities and the District Health Council — Torres Strait Health and Northern Peninsula Area, Queensland Health.

Competing interests:

None identified.

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