Improving asthma outcomes with a multipronged approach

Minority children often have worse asthma outcomes than their white peers and many of them attend Head Start preschool programs. An investigation examines whether an intervention including both school and home components improves asthma outcomes.

Asthma is a fairly common disease in childhood and previous research has shown that Black children with asthma have worse morbidity and mortality than their non-minority peers with the disease. A number of the children who are at risk of poorer outcomes participate in Head Start programs. An investigation in JAMA Pediatrics examines whether a multilevel asthma education program in both the home and asthma led to improved asthma control when compared to a school-based only program.1

Researchers run a randomized clinical trial that included children with asthma who were enrolled in a Head Start program in Baltimore, Maryland. The children and their primary caregivers were recruited between April 2011 and November 2016. The intervention used was the Asthma Basic Care (ABC) family education combined with Head Start asthma education and was compared with Head Start asthma education alone. They measured asthma control via the Test for Respiratory and Asthma Control in Kids (TRACK) score.

A total of 398 children were included in the research, with 247 boys and an average age of 4.2 years. The investigators found that the children who were enrolled in the ABC plus Head Start program had reduced courses of oral corticosteroids corticosteroids (β = −0.61; 95% CI, −1.13 to −0.09; P = .02), improved asthma control (β = 6.26; 95% CI, 1.77 to 10.75; P < .001), as well as a reduction in hospitalizations (odds ratio, 0.36; 95% CI, 0.21-0.61; P < .001) during the course of a 12-month period.

The investigators concluded that children who were in the intervention that was given in both the home and at preschool led to improved outcomes including use of corticosteroids, the number of hospitalizations, and better asthma control. Utilizing this intervention in other communities, particularly communities with a significant population of low-income minority families, could help improve asthma outcomes and reduce the disparity currently seen in such outcomes.


1. Eakin M, Zaeh S, Eckmann T, et al. Effectiveness of a home- and school-based asthma educational program for head start children with asthma: a randomized clinical trial. JAMA Pediatr. October 5, 2020. Epub ahead of print. doi:10.1001/jamapediatrics.2020.3375

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