Gerald 2009.

Methods	Included as outcome evaluation Study design: parallel‐group design, with a 2‐group randomised longitudinal design, randomised by the child Setting: USA Period: baseline data collection occurred from October 2005 to December 2006. Children were randomised in January 2006. The study comprised a longitudinal design with 15‐month follow‐up. Follow‐up data were collected from January 2006 to December 2006
Participants	Eligible sample frame: 290 children were randomised Randomised: 290 children were randomised ‐ 145 in each arm Completed (intervention): 240 (83%) Inclusion criteria: children were eligible if they had physician‐diagnosed persistent asthma requiring daily controller medication, they attended one of the 36 participating schools, and they were able to use a dry powder inhaler and a peak flow meter Exclusion criteria: not reported Baseline characteristics Age of children: mean age, 11.0 years Ethnicity: 91% black ethnicity Socio‐economic status: not reported. Gender: 57% male; 43% female in total Asthma status: mixed levels of severity ‐ 15% mild persistent asthma, 79% moderate persistent asthma, 6% severe persistent asthma
Interventions	Intervention: children were given 20 minutes of asthma education, including discussion about avoidance of triggers. Children in the supervised therapy group also received supervision from study staff each day on the use of inhaled corticosteroids. If a child was observed using the inhaler incorrectly, staff provided education with the aid of a placebo inhaler Control: usual care Intensity: a single education session for 20 minutes; multiple supervisions for the intervention group Instructor: study personnel Theoretical framework: not reported Parental engagement: not reported Child satisfaction: not reported Timing of intervention in school day: not reported
Outcomes	Extractable outcomes were collected for: Parent‐reported absence from school Lung function Use of reliever therapies Withdrawal
Notes	This paper did not provide much detail; however the study was previously reported in a separate paper (Gerald 2009) Considered for process evaluation: implementation data were not considered to have been collected via structured or recognised tools Funding source: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Study authors reported: "a random sequence of treatment codes, stratified by school system, was generated using the SAS System (Version 9.1, Cary, North Carolina) by the statistician"
Allocation concealment (selection bias)	Low risk	Centrally generated: study authors reported: "a random sequence of treatment codes, stratified by school system, was generated using the SAS System (Version 9.1, Cary, North Carolina) by the statistician"
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	No measures were described as implemented around blinding
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No measures were described as implemented around blinding
Incomplete outcome data (attrition bias) All outcomes	Low risk	Study authors described: "79.3% completion rate in the control group and 86% completion rate in the intervention group. Reasons and details provided"
Selective reporting (reporting bias)	Unclear risk	No evidence shows selective reporting
Other bias	Unclear risk	Missingness ‐ low risk ‐ all those who were followed up submitted information Baseline imbalance ‐ low risk ‐ no significant differences between groups were found in baseline demographic characteristics or asthma symptom Risk of contamination ‐ high ‐ children were the unit of randomisation; children with different treatment allocations were present in the same school
Transparent and clearly stated aims	Unclear risk	N/A
Explicit theories underpinning and/or literature review	Unclear risk	N/A
Transparent and clearly stated methods and tools	Unclear risk	N/A
Selective reporting	Unclear risk	N/A
Harmful effects	Unclear risk	N/A
Population and sample described well	Unclear risk	N/A
Continuous evaluation	Unclear risk	N/A
Evaluation participation equity and sampling	Unclear risk	N/A
Design and methods overall approach	Unclear risk	N/A
Tools and methods of data collection reliable/credible	Unclear risk	N/A
Tools and methods of data analysis reliable/credible	Unclear risk	N/A
Performance bias/neutrality/credibility/conformability	Unclear risk	N/A
Reliability of findings and recommendations	Unclear risk	N/A
Transferability of findings	Unclear risk	N/A
Overall risk of bias of process evaluation	Unclear risk	N/A