Mosnaim 2011.

Methods	Included as outcome evaluation Study design: clustered parallel‐group RCT Setting: elementary schools in Chicago Period: not reported
Participants	Eligible sample frame: not reported Randomised: 344 pupils within the youth group (275 in the intervention group and 69 in the control group) and 192 within the teen group (141 in the intervention group and 51 in the control group) participated. 25 youth classes (19 intervention groups and 6 control groups) and 16 teen classes (11 intervention group and 5 control groups) from 26 schools participated Completed (intervention): not reported Inclusion criteria: not reported Exclusion criteria: not reported Baseline characteristics Age of children: youths and teens 5 to 15 years old. Median age was 10 for the youth group and 13 for the treatment group Ethnicity: 65.5% in the youth intervention group were African American; 11.6% were Hispanic; and 22.3% were other. In the teen intervention group, 85.1% were African American, 7.1% were Hispanic, and 7.1% were other Socio‐economic status: not reported, but study author described participants as predominantly low income Gender: females represented 43% of participants. In the youth intervention group, 41.5% were female; in the teen intervention group, 48.2% were female Asthma status: not reported
Interventions	Intervention: certified asthma educators provided 1‐to‐1 training on spacer technique, peak flow meter use, and use of an asthma action plan. The teen programme also addressed tobacco avoidance, asthma‐related peer pressure, and asthma self‐management skills Control: usual care Intensity: four 45‐minute sessions conducted in school on 4 consecutive days Instructor: certified asthma educators Theoretical framework: not reported Parental engagement: not reported Child satisfaction: not reported Timing of intervention in school day: not explicitly reported, but sessions were scheduled at times with the least impact on instruction, as determined by each school
Outcomes	Extractable outcomes were collected for: None
Notes	Considered for process evaluation: study did not include the core components of a process evaluation Funding source: Abbott Laboratories Unrestricted Grant
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	Potential breach of randomisation schedule through systematic bias in selection of schools for the control group: "The allocation scheme first determined whether an eligible school could accommodate the intervention schedule. Those that could not were automatically assigned to the control group, whereas those that could were subject to the 3:1 randomisation scheme"
Allocation concealment (selection bias)	High risk	Potential breach of randomisation schedule through systematic bias in selection of schools for the control group: "The allocation scheme first determined whether an eligible school could accommodate the intervention schedule. Those that could not were automatically assigned to the control group, whereas those that could were subject to the 3:1 randomisation scheme"
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not addressed by study authors
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not addressed by study authors
Incomplete outcome data (attrition bias) All outcomes	Low risk	Relatively low levels of missing data; study authors state that this had no impact on the outcome: "Approximately 15% of the participants overall were missing posttest scores (39 youth and 44 teen participants). Based on feedback from our trained educators as to the source of the absenteeism, we concluded that these missing data were missing at random and did not merit use of data imputation methods"
Selective reporting (reporting bias)	Low risk	No evidence of indicators measured but not reported. However, indicators that were not included in our protocol were collected
Other bias	Unclear risk	Missingness ‐ unclear risk ‐ missing data but no imputation strategy ‐ study authors stated that it was not necessary to implement imputation strategies Baseline imbalance ‐ unclear risk ‐ some ethnic and gender differences at baseline but impact on outcomes unclear; no differences in asthma knowledge at baseline Risk of contamination ‐ low ‐ unit of randomisation was the school, lowering the risk of contamination
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