Shah 2001.

Methods	Included as outcome evaluation Study design: clustered parallel‐group design Setting: high schools in Tamworth, rural New South Wales, Australia Period: pupils were recruited in February 1998 and completed the study in October 1998 ‐ 3 months after the intervention was completed
Participants	Eligible sample frame: 325 pupils Randomised: 272 pupils: 148 in the control group and 124 in the intervention group Completed (intervention): 251 pupils; 138 in the control group and 113 in the intervention group Inclusion criteria: not reported Exclusion criteria: not reported Baseline characteristics Age of children: 118 pupils in year 7; 133 pupils in year 10 Ethnicity: not reported Socio‐economic status: not reported Gender: 62% to 68% female in the intervention group; 44% to 48% female in the control group Asthma status: 69% to 80% had received an asthma diagnosis
Interventions	Intervention: the intervention involved a 3‐step approach to educating and empowering students with asthma. In step 1, students learnt how to educate their peers about asthma and its management using games, videos, worksheets, and discussions as teaching tools. In step 2, peer leaders conducted three 45‐mnute health lessons for year 10 classes at school. In step 3, year 10 students developed and presented to year 7 students key messages learnt in the lessons Control: wait‐list control group received usual care during data collection Intensity: in step 1, volunteers from year 11 were trained as asthma peers during a 6‐hour workshop. In step 2, three 45‐minute sessions were taught. No information was recorded on length and intensity in step 3 Instructor: peers 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: Experience of daytime and night‐time symptoms Lung function Health‐related quality of life Withdrawal
Notes	School absence data were collected as median values but were not reported in full Funding source: Commonwealth Department of Health and Aged Care and Asthma NSW
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Concealed random allocation was performed by study author (who was not involved in administration of the study), using a random number generator and the closed envelope technique
Allocation concealment (selection bias)	Low risk	Concealed random allocation was performed by PGG (who was not involved in administration of the study), using a random number generator and the closed envelope technique
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	Low levels of attrition: 272 participated in baseline testing; matched data at baseline and after the intervention were available for 251 students
Selective reporting (reporting bias)	Unclear risk	No direct evidence, although median number of days missed was collected and could not be combined in the meta‐analysis
Other bias	Unclear risk	Missingness ‐ low risk ‐ missing data described as uncommon and occurred owing to misclassification, students changing schools or being absent on the day of testing, or failure to complete the questionnaire Baseline imbalance ‐ unclear risk ‐ differences between groups, although it is unclear if these are significant for the outcome Risk of contamination ‐ low ‐ schools were the unit of randomisation, thereby lowering 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