School-based self-management interventions for asthma among primary school children: a systematic review

Abstract

A Cochrane review of school-based asthma interventions (combining all ages) found improved health outcomes. Self-management skills, however, vary according to age. We assessed effectiveness of primary school-based self-management interventions and identified components associated with successful programmes in children aged 6-12 years. We updated the Cochrane search (March 2020) and included the Global Health database. Two reviewers screened, assessed risk-of-bias and extracted data. We included 23 studies (10,682 participants); four at low risk-of-bias. Twelve studies reported at least one positive result for an outcome of interest. All 12 positive studies reported parental involvement in the intervention, compared to two-thirds of ineffective studies. In 10 of the 12 positive studies, parental involvement was substantial (e.g. attending sessions; phone/video communication) rather than being provided with written information. School-based self-management intervention can improve health outcomes and substantial parental involvement in school-based programmes seemed important for positive outcomes among primary school children.

Fig. 1. PRISMA diagram.

This figure illustrates the article selection process using the PRISMA diagram.

Fig. 2. Harvest plot illustrating effectiveness of included studies across parental involvement.

Harvest plot illustrating the effectiveness on school absenteeism, asthma control and urgent healthcare services across parental involvement for school-based self-management asthma educational intervention. The shading of the bars indicates the duration of the study and the height of the bars describes the number of participants. The overall risk of bias is reflected on top of the bars.