Table 2.
Overview of study characteristics of included trials
| Study, Country | Population characteristics | Intervention characteristics | ||||||
|---|---|---|---|---|---|---|---|---|
| Aim | Ethnicity; Participants; Sample age; Sample size (I/C) | Study setting; SES/area | Intervention description/length | Control /other group descriptions | Delivery (ethnicity; language) | Mode of delivery | Modified; Targeted; Tailored | |
| ‘Majority’ South Asian trials | ||||||||
| Agrawal30 India | Evaluated efficacy of PAAPSs for asthma control | Indian; Patients; parents; 2–12; 60 (32/28) | Tertiary (university clinic) | Education; sessions, training including on asthma symptom diary and peak flow measurements | No PAAP, standard asthma therapy and education | Trained physician; social scientist (-) | Individual; Written material | Modified |
| – | PAAPs | |||||||
| Asthma therapy/not stated | ||||||||
| Behera31 India | Assessed patient knowledge of self-care needs and develop/evaluate a self-care manual | Indian | Tertiary (outpatient university clinic) | Education-booklet in Hindi (included a PAAP) | No specific instructions/pilot study used to develop booklet in Hindi (n = 45) | Not stated (Hindi) | Written material | Targeted |
| Patients; 18–60; 523 (260/263) | – | Booklet evaluation/not stated | Other methods not stated | |||||
| Ghosh32 India | Assessed the impact of self-management education and training on health status and resource use | Indian | Tertiary (university clinic) | Education; sessions, training, written instructions, audio-visual aids, role models, group/scenario discussions | Regular care e.g. drug administration | Trained social scientist (-) | Group; | Modified |
| Patients; Parents; 10–45; 276 (140/136) | – | Daily diary (included symptom assessment and financial workbook) | Written material | |||||
| Asthma therapy | ||||||||
| PAAPs/four 2 hour sessions | ||||||||
| Shanmugam33 India | Provided pharmaceutical care through partnership of pharmacists and patients for good asthma control | Indian | Tertiary (university hospital) | Education; sessions, asthma care diary in English and Tamil (including leaflet), PAAP and symptom log sheet | No pharmaceutical care | Not stated (English and Tamil) | Written material; | Modified |
| Patients Age; −; 66 (33/33) | – | Medication counselling/not stated | Other methods not stated | |||||
| ‘Minority’ South Asians trials | ||||||||
| Griffiths34 UK | Tested whether specialist nurses across ethnically diverse and deprived areas reduce unscheduled care | South Asians (mostly Bangladeshi) White Caucasians, Other (Black/African Caribbean/Other) | Primary/secondary (out-of-hours GP service/hospital) | Education; training based on guidelines, nurse review with advice | Usual care; single nurse visits to discuss asthma guidelines and check inhaler technique | Trained nurse specialists (partially; PAAPs explained in Sylheti) | Individual; | Modified |
| PAAP explained in English and Sylheti | Written material; | |||||||
| Ongoing clinical support for professionals on computer prompts | ||||||||
| Patients; 4–60; 164 (95/69) | Deprived/urban | Peak flow meters provided | Telephone | |||||
| Oral corticosteroids/2 one hour visits for GP practices; 194 days | ||||||||
| Griffiths35 UK | Tested whether culturally specific education programmes adapted from USA interventions reduce unscheduled care | South Asians (Bangladeshi, Pakistani, Indian, Sri Lankan) | Primary (GP) | Education; session including PAAP, nurse follow-ups to book appointments (CDSMP), research training with video based on guidelines, South Asian actors and manualised programme (PACE)/PACE; two seminars; CDSMP; 2-hour session | Usual care; nurse delivered standardised consultation. No PAAP/follow-up appointments provided | PACE; Nurse specialists, Academic GPs CDSMP; Trained nurse specialists (South Asians) | Group; | Modified |
| Patients; Primary/secondary care clinicians; 3 and above; 375 (183/192) | Deprived/urban | Video/DVD; | ||||||
| Written material | ||||||||
| Moudgil36 UK | Tested whether bilingual education of treatment optimisation and follow-up reduce urgent healthcare and improve quality of life | South Asian (mainly Indian and Pakistani), White European | Primary (GP) | Education; community sessions delivered in South Asian languages including written literature, education follow-up | Usual asthma care follow-up | Trained GP (South Asian) | Individual; | Modified |
| Patients; GP; 11–59; 344 (171/173) | Low or medium deprivation/urban | Booklet including PAAP (based on BTS guidelines) and peak flow measurements | Written material | |||||
| GP trained on prescribing, optimal treatment, knowledge and medication | ||||||||
| Peak flow meter provided | ||||||||
| Asthma therapy/40 minutes | ||||||||
| Poureslami37 Canada | Explored the effectiveness of different culturally relevant information formats and impact on self-management | South Asians (Indian Punjabi), Chinese | Other/tertiary (home, university clinic)- | Education; videos (physician-led, community and physician-led/community combination) | Pictorial pamphlet in either Mandarin, Cantonese or Punjabi | Research facilitators (South Asian) | Group/video | Targeted |
| Patients; 21 and above; 45 (33/12) | Peak flow meter | /Co-development of intervention (n = 35); focus group sessions (n = 40) | ||||||
| PAAPs/1 month | ||||||||
| ‘Minority’ African American trials | ||||||||
| Blixen42 USA | Tested feasibility of a culturally appropriate in-patient education programme for hospitalisation | African Americans | Tertiary (hospital) | Education; sessions and video, asthma workbook using African-American images, references to famous celebrities, written education posted as follow-up | Received usual care | Trained nurse (Not stated) | Individual; | Modified |
| Patients; 8–50; 28 (14/14) | – | Peak flow meter; MDI spacer provided | Video/DVD; | |||||
| Toll free numbers for asthma organisations/Three 1-hour sessions | Written material | |||||||
| Fisher38 USA | Tested community-based intervention to improve asthma awareness, attitudes, management practices and reduce acute care | African Americans, White Caucasians, Others | Other (community, school) | Education; promotion campaigns, sessions, training residents to support patients in school and community/12 months | Four areas in the same location with similar SES characteristics | Trained university staff/residents (African American) | Group; | Modified |
| Patients; parents 5–14; 249 (100/149) | Low income | Individual | ||||||
| Fisher46 USA | Tested whether community health workers can reach low-income parents of hospitalised children and to reduce rehospitalisation | African American | Other/secondary (community, hospital) | Education; sessions by asthma coach based on guidelines and parental support contacts/meetings for readiness to change, training for asthma coaches (including PAAPs)/2 years | Usual care; inpatient education and discharge planning with PAAP, a suggested follow-up primary care within 1 week of discharge | Nurse, | Individual; | Modified |
| Parents; African-American Coaches; 2–8; 191 (97/94) | Low income/urban | psychologist, | Group; | |||||
| three trained coaches (African American) | Telephone | |||||||
| Ford43 USA | Reanalysed an education programme that assessed the effects on asthma outcomes | African Americans | Secondary (emergency department) | Education; sessions and follow-ups, handout, mailed sessions for non-attenders | Received no intervention | Trained healthcare professionals and nurses (not stated) | Group; | Modified |
| Patients; 18–70; 241 (119/122) | Urban and rural | Visual medical card | Written material | |||||
| Wallet sized card (with medication list, dose, frequency) | ||||||||
| Placebo inhaler to practice/3 sessions | ||||||||
| Keslo39 USA | Provided major long-term therapeutic intervention and intensive education | African Americans | Secondary /tertiary (emergency department/university clinic) | Education; sessions based on NIH guidelines, Follow-up clinics | Usual care | Pharmacy researcher, pulmonologist (not stated) | Individual; | Modified |
| Patients; 18 and above; 52 (30/22) | Low; deprived | Telephone; | ||||||
| Education booklet (including diary card for measurements and 1-page summary of asthma prevention, medications, triggers and peak flow meter product literature) | Written material | |||||||
| Asthma therapy for ICS | ||||||||
| Peak flow meter (colour-coded stickers), inhaled b-agonist and aero chamber provided/1-hour session | ||||||||
| Keslo44 USA | Tested if a long‐term management programme (emphasising ICS and patient education), would improve outcomes | African Americans | Tertiary (university based clinic) | Education; session | Usual care from local physicians | Pharmacy researcher (not stated) | Individual; | Modified |
| Patients; 18 and above; 39 (21/18) | Low; working and middle-class college students | Educational booklet | Group; | |||||
| Written instructions on asthma crisis management | Written material | |||||||
| Asthma therapy and peak flow meter (colour-coded stickers), MDI and other medications | ||||||||
| Follow-up clinics (including diary)/2 years | ||||||||
| Velsor-Friedrich40 USA | Tested the effect of a school-based education programme (Open Airways) on the psychosocial outcomes | African Americans | Other | Education; sessions/2 weeks, six 45 minute sessions per week | Usual care; participated in the Open Airways programme after intervention | Academic professor, nurse | Group | Modified |
| Patients; 8–13; 102 (40/62) | (Eight public primary school with nurse clinics) | (-) | ||||||
| Low/Urban | ||||||||
| Velsor-Friedrich41 USA | An extension of the study above (Velsor-Friedrich 2004): tested a two-part school-based education programme | African Americans | Other (eight public primary schools with nurse clinics) | Education-sessions (as above) | As above and all students received a PAAP | Academic professor, academic nurse(-) | Individual; Written material | Modified |
| Patients; 8–13; 52 (28/24) | Low/urban | A further 5-month visit with nurse where education information was reinforced, a packet of asthma information reviewed if needed, PAAPs adjusted, clinical assessment on medication and peak flow monitoring/7 weeks, 45 minute sessions, once per week | ||||||
| Velsor-Friedrich45 USA | Evaluated efficacy of a school-based asthma education program on psychosocial & health outcomes | African Americans | Other (5 secondary schools) | Education; sessions, coping skills training including role-playing & technology use (with a booster session as follow-up) | Routine education | Clinician, | Individual; Group | Modified |
| Patients; 13–19; 137 (74/63) | Low | Nurse practitioner reinforcement & clinic visit | nurse, | |||||
| Provided MDI, hydro fluoroalkane & static free chamber | clinical psychologist | |||||||
| Peak flow diary | trained doctoral student | |||||||
| PAAP/Six 45 minute sessions over 6 weeks | (-) | |||||||
Note: Missing data obtained from authors is noted in italic in the table