Pike 2011.

Methods	Included as process evaluation Intervention study design: quasi‐experimental, pre‐post, control groups Unit of allocation: children in 15 classes were provided with the intervention (data available for 10), and 4 additional classrooms served as controls; 167 children were in the intervention group and 69 were in the control group Process evaluation methods: survey data were collected with descriptive/bivariate analyses of data
Participants	Setting: elementary schools in a district in St Louis, Missouri, USA Age of children: 9 to 11 years of age (based on grade) Child characteristics (BME/SES): 81% of control group and 69% of intervention group were African American; 78% of intervention group and 86% of control group were receiving free school meals Asthma status: asthmatic and non‐asthmatic (mixed class; this is a core feature of the intervention so as not to disrupt normal school functioning) Intervention recipients: children and teachers
Interventions	School type: primary/elementary Intervention description: a curriculum was developed for teachers that contained 15 lesson plans created or adapted from various existing sources and aligned with existing standards for communication arts, science, mathematics, and health. Intervention classroom teachers were asked to teach 7 of the 15 lesson plans, including 3 specific lesson plans chosen by the investigators (which included information on asthma basics, signs and symptoms, triggers, and use of a peak flow metre); the remaining 4 lesson plans were self‐selected by the teacher Control description: usual care/no additional asthma education Theoretical framework: no information
Outcomes	Core processes evaluated (child level): dosage
Notes	Process evaluation category: stand‐alone Breadth and depth: depth ‐ not breadth Voice of children given prominence: not featured Funding source: not reported
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	High risk	No theory was named and little literature was presented
Transparent and clearly stated methods and tools	Unclear risk	Some tools or aspects of tools were not clearly explained, for example, asthma knowledge
Selective reporting	Unclear risk	A full account of what was collected for assessment was not presented; some aspects were not reported ‐ e.g. the teacher focus group
Harmful effects	Unclear risk	How study authors accounted for this remains unclear
Population and sample described well	High risk	Some demographic characteristics, particularly the asthma status of children, were not explained well
Continuous evaluation	Low risk	Pre‐post assessment was included
Evaluation participation equity and sampling	Unclear risk	Sample information was collected from several stakeholders
Design and methods overall approach	Low risk	Multiple sources of evidence were used
Tools and methods of data collection reliable/credible	High risk	How asthma knowledge was measured remains unclear
Tools and methods of data analysis reliable/credible	High risk	No way to assess this without seeing a full output ‐ e.g. of the focus group
Performance bias/neutrality/credibility/conformability	Unclear risk	Some blinding was undertaken
Reliability of findings and recommendations	Unclear risk	Whether this was an effective intervention is not clear, as the information was not presented fully
Transferability of findings	Unclear risk	Study authors explained how the curriculum was developed, so transferability is low for part of this study ‐ but not enough information was provided in other sections
Overall risk of bias of process evaluation	Unclear risk	This is a good study of teachers, but study authors did not provide a lot of other information