Evaluating the asthma friendly schools program in primary schools in Gippsland Victoria

The AFS Program was launched in 2001 to enhance asthma management of children in schools. For a school to be deemed Asthma Friendly, it must meet a set of criteria that promotes an understanding of asthma and its management across the school community. The literature review undertaken as part of this study located only two unpublished studies that had evaluated the AFS program. Both of these used qualitative methodologies and focused on the uptake of the program rather than outcomes. The primary aim of this study was to evaluate the efficacy of the Asthma Friendly Schools (AFS) Program in primary schools in Gippsland, Victoria by comparing Accredited AFS, Registered AFS and non-AF schools on selected measures. These measures included: the health status and outcomes, coping ability, asthma knowledge and life satisfaction of children with asthma; asthma knowledge and the attitudes of non-asthmatic children towards children with asthma; parents‟ knowledge of asthma; and primary school teachers‟ knowledge of asthma and confidence in managing children with asthma. A convenience sample of 16 primary schools from six shires in the Gippsland region agreed to participate in this study (8 AFS, 4 Registered AFS, and 4 non-AF schools). Four groups of participants were recruited from each school: children with asthma (n=102), children without asthma (n=545), parents of children with asthma (n=68), and primary school teachers (n=122). Children with and without asthma completed an asthma knowledge test and either (i) an attitudes towards children with asthma scale (for non-asthmatic children) or (ii) a life satisfaction scale (for asthmatic children) as a class activity. Questionnaires were distributed to parents of children with asthma to obtain family details and medical information on the child with asthma (current treatment, healthstatus, coping ability and health outcomes such as their use of health services). Parents were also asked to complete an adult asthma knowledge test. Teachers were sent a questionnaire that included the adult asthma knowledge test and a measure of their confidence in managing children with asthma. Of the total sample, 15.8 % of children had asthma of which 67% reported a family history of the disease. Most of these children had mild intermittent asthma as indicated by the relatively low prevalence of asthma symptoms, episodes of acute asthma attacks and use of health services. Most children coped well with their asthma and scored high on life satisfaction. Other notable findings were high asthma knowledge scores reported by children with and without asthma, parents of children with asthma, and primary school teachers; positive attitudes of primary school children towards children with asthma, and high teacher confidence in managing children with asthma. Tests of the hypotheses to evaluate the effectiveness of the AFS program found no significant differences between participant groups based on the asthma friendly status of each school on any of the key measures examined. Although all seven hypotheses tested were rejected, children with asthma attending an AF school reported fewer asthma attacks and unscheduled doctor visits, and better life satisfaction than children with asthma attending a non-AF school. Findings from this study are discussed in relation to previous studies and the implications for promoting the health and wellbeing of children with asthma. Also discussed are the strengths and limitations of the study and recommendations for further investigation. The general conclusion is that the AFS program is a worthwhile initiative which does have the potential to increase public awareness and knowledge of asthma, and improve health outcomes for children with asthma.