The lessons learned in a school program that teaches elementary school children to manage their asthma appear to rub off on their parents, even when the parents are not directly involved with the program, according to a new study.

"We believe that it is likely that the homework assignments and other communication initiated by the children played a significant role in changing caregiver behavior, suggesting that children who have received health education can in turn teach their parents about asthma and how to manage it," says David Evans, Ph.D., an associate professor at Columbia University's College of Physicians & Surgeons and Mailman School of Public Health in New York.

A study by Evans and colleagues of 239 families showed that the parents of those asthmatic children who received special self-management training also made significant gains in helping their children manage the chronic condition compared with the parents of children who received no such training.

The study is published in the August issue of Health Education & Behavior.

The training program consisted of six 60-minute sessions that taught third- through fifth-graders new asthma management skills. The children learned to recognize symptoms and begin steps to manage them. The children also were given homework designed to initiate discussion with their parents about asthma management.

Previous studies of this curriculum have shown that the program, called "Open Airways for Schools," improved children's ability to manage the asthma and also improved their quality of life. The parents also reported that children had fewer symptoms after completing the program.

"Most studies of the impact of health education on the management of chronic childhood illness have focused on the primary adult caregiver as the key figure in changing family health behavior…. This study, however, examines the opposite question: to what extent do children initiate health communications with parents, and do these communications affect parents' health behavior in managing the children's illness?" the investigators say.

The study showed that mothers of the children in the program took more steps to manage their children's asthma both compared with mothers in the control groups and with their own measures before the start of the program. It also showed that the more children in the program talked about asthma with their mothers, the more steps their mothers took to manage asthma.

The researchers note that the overall change in parents' self-management was modest but still noteworthy considering the fact that parents were not directly involved with the program in any way.

"In order to cope with a chronic illness successfully, patients must learn how to teach and persuade others in their family or social environment to accept the changes in their daily routine and to help carry them out. Preparing patients to teach and change the behavior of others is an important skill that should be included in health education programs," he says.

The study was supported with a grant from the National Heart, Lung and Blood Institute and a gift from the Spunk Fund.

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Health Education & Behavior, a bimonthly peer-reviewed journal of the Society for Public Health Education (SOPHE), publishes research on critical health issues for professionals in the implementation and administration of public health information programs. SOPHE is an international, non-profit professional organization that promotes the health of all people through education. For information about the journal, contact Elaine Auld at (202) 408-9804.