Magzamen 2008.

Methods	Included as process evaluation Intervention study design: quasi‐experimental single‐group intervention examining change pre‐post intervention Unit of allocation: N/A Process evaluation methods: survey based using descriptive/bivariate analyses. Some regression analyses reported controlling for previous baseline observations
Participants	Setting: 15 schools in Oakland, California, USA Age of children: 11 to 16 years of age (although more than 80% were 11 to 12 years old) Child characteristics (BME/SES): ethnicity of children is unclear (although intervention took place in a diverse catchment area). Socio‐economic status of children unclear, although intervention took place within a deprived school system Asthma status: asthmatic only (diagnosed asthma) Intervention recipients: children only
Interventions	School type: junior/middle schools and high schools Intervention description: study authors presented results from Kickin' Asthma, described as "a 4‐session curriculum developed jointly by experts, nurses and peer educators and delivered over a 3‐year period. Kickin' Asthma is similar structurally to Open Airways for Schools, a curriculum designed for children at the elementary school level but with more advanced topics and learning modalities more suitable for adolescents' level of cognition and awareness. The 4 Kickin' Asthma sessions were each taught by a specialist nurse, about 50 minutes in length, and were spaced 1 week apart. The 4 sessions covered (1) lung physiology and asthma basics; (2) triggers, symptoms, and warning signs; (3) medication; and (4) emergencies, problem solving, and review. Each session has optional modules for skits, games, videos, and role‐playing scenarios and allowed certain modules to be taught by either the health educator or peer educators. Customized letters were sent home to the parents or guardians of all Kickin' Asthma participants that described the curriculum along with the specific health needs and goals of each student as assessed by the nurse educator" Control description: N/A (no control) Theoretical framework: no information
Outcomes	Core processes evaluated (child level): attrition, dosage, adherence
Notes	Process evaluation category: stand‐alone and named section (2 papers) Breadth and depth: depth ‐ not breadth Voice of children given prominence: not featured Funding source: Centers for Disease Control and Prevention Controlling Asthma in American Cities Project
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	N/A
Allocation concealment (selection bias)	Unclear risk	N/A
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	N/A
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	N/A
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	N/A
Selective reporting (reporting bias)	Unclear risk	N/A
Other bias	Unclear risk	N/A
Transparent and clearly stated aims	Low risk	Study aims were clearly stated
Explicit theories underpinning and/or literature review	Unclear risk	Some supporting literature was provided, but no theoretical framework was stated
Transparent and clearly stated methods and tools	Low risk	Lots of details about the tools used and how the study was conducted were provided
Selective reporting	Unclear risk	Data were collected individually and were presented ecologically
Harmful effects	Unclear risk	Harmful impacts ‐ particularly around equity and gathering a range of stakeholder views ‐ were not considered
Population and sample described well	Unclear risk	Data on SES and ethnicity are missing
Continuous evaluation	Unclear risk	Data that support different cohorts were provided, but whether they were analysed continuously (i.e. whether data were analysed and used to make any necessary changes to the programme) remains unclear
Evaluation participation equity and sampling	Unclear risk	Equitable sampling was described, along with a low response rate; data were not collected from all stakeholders involved
Design and methods overall approach	Unclear risk	Only one source of evidence was provided; however this is disaggregated across different cohorts
Tools and methods of data collection reliable/credible	High risk	Very low response rates suggest that methods of data collection used are unreliable
Tools and methods of data analysis reliable/credible	Unclear risk	Two sets of analyses were conducted ‐ ecological and individual. Insights gained by using both sets remain unclear
Performance bias/neutrality/credibility/conformability	Unclear risk	Study authors did not describe steps taken to minimise performance bias. Negative outcomes are discussed, as is delivery of the intervention by nurses vs researchers. Confidentiality/anonymity is not discussed
Reliability of findings and recommendations	High risk	Study authors reported low rates of response to the surveys used
Transferability of findings	Unclear risk	This was not assessed by study authors, but the information provided is rich enough to assess transferability
Overall risk of bias of process evaluation	Unclear risk	As an impact study, issues are evident, but as a process evaluation, data provided are useful