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The BREATHE asthma intervention did not reduce respiratory hospitalizations or emergency department (ED) visits.

An illness like asthma makes inequalities obvious. Among American Indians and Alaska Natives, it is well known that asthma diagnosis and inadequate control of asthma symptoms are related to lower levels of education, poverty, and minority status. This association may be due to the intersection of socioeconomic, genetic, and immune factors in this particular population.

Despite large differences in asthma prevalence, severity, and illness burden among American Indian children, few asthma education interventions have been evaluated in this community. 

This randomized controlled study was published in Scientific Reports and aimed to evaluate the efficacy and practicality of the BREATHE intervention with American Indian children and parents over a 3-year follow-up period (n = 108). Electronic medical records (EMR) were used to identify children with asthma. The intervention included an initial instructional component from an asthma counselor regarding asthma and discussions about managing the condition with caretakers involved in the participant’s care. The control group received standard care. The primary outcome was the frequency of EMR-documented visits to the ED or hospitalization for respiratory symptoms.

After a 24-month follow-up period, there was no statistical difference between the intervention and control groups regarding primary outcomes (p = 0.75) or the percentage of patients who visited the emergency department or were hospitalized (p = 0.99). There was a marginally significant difference in time from the primary result after a year.

The present investigation did not reveal a lasting benefit of this intervention, despite its modest sample size. However, the search for a successful, doable, and culturally appropriate pediatric asthma intervention must go on.

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Reference:

O’Leary, R. A., O’Leary, M. A., Torgerson, D. G., Mettler, R. D., Enright, K. J., & Best, L. G. (2022). Efficacy and feasibility of the BREATHE asthma intervention with American Indian children: a randomized controlled trial. Sci Rep, 12(1), 21220. https://doi.org/10.1038/s41598-022-25447-0