LEAP: A randomized-controlled trial of a lay-educator inpatient asthma education program

Abstract

Objective: To evaluate the impact of LEAP, a volunteer-based, inpatient asthma education program for families of inner-city children with asthma.

Methods: 711 children ages 2-17 years admitted with status asthmaticus were randomized to receive usual care or usual care plus a supplemental education intervention. Both groups completed a baseline interview. Trained volunteer lay educators conducted individualized bedside education with the intervention group. Primary outcome was attendance at a post-hospitalization follow-up visit 7-10 days after discharge. Secondary outcomes included parent-reported asthma management behaviors, symptoms, and self-efficacy scores from a one month follow-up interview.

Results: Post-hospitalization asthma clinic attendance was poor (38%), with no difference between groups. Families randomized to the intervention group were more likely to report use of a controller (OR 2.4, 95% CI 1.3-4.2, p<0.01) and a valved-holding chamber (OR 2.9, 95% CI 1.1-7.4, p=0.03), and were more likely to have an asthma action plan at follow up (OR 2.0, 95% CI 1.3-3.0, p<0.01). Asthma self-efficacy scores were significantly improved among those who received the intervention (p=0.04).

Conclusions: Inpatient asthma education by trained lay volunteers was associated with improved asthma management behaviors.

Practice implications: This novel volunteer-based program could have widespread implications as a sustainable model for asthma education.

Keywords: Asthma; Asthma education; Inpatient education; Lay educator; Pediatric asthma; Social cognitive theory.