Fidelity of a peer-led asthma self-management intervention and its attention control in a multisite study of urban adolescents.
Hyekyun Rhee, Annette Grape, Laurene Tumiel-Berhalter and 3 others
PMID 31793688WHAT IT FOUND
Peer leaders delivered asthma knowledge and skills to urban adolescents as reliably as adult educators, but psychosocial content and follow-up contacts were less consistent.
The paper did not report asthma outcomes.
Key findings
01Peer leaders and adult educators delivered knowledge and skills content 88% to 90% of the time, with no significant group difference.
02Peer leaders delivered psychosocial content less consistently than adult educators, 78% vs 96%.
03Peer-led participants received fewer bimonthly contacts than attention control participants, 2.6 vs 4.6, and 22 of 136 never received a successful contact.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The paper assessed how the intervention was delivered, not whether it improved asthma outcomes. Fidelity of camp sessions relied on one adult observer and camper reports, without recordings or interrater reliability. Follow-up contact fidelity relied on peer leaders' own checklists, sometimes completed days or weeks later. The study did not measure educator skillfulness or quality of delivery, only content coverage and time. Attention control participants did not complete camper fidelity forms, so participant-reported receipt could not be compared between groups. Some attention control contacts included asthma topics, and the amount of contamination was not quantified. The sample was urban adolescents with asthma, and 61 enrolled teens did not attend camp.
Declared interests
The authors declared no conflicts of interest. The publication types indicate NIH extramural research support, but the supplied text does not state whether the funder designed or wrote the study.
The easy way to misread this
Do not read this as evidence that peer-led asthma self-management improves asthma outcomes. The paper measured delivery of content and contacts, not asthma control, and peer-led follow-up was less consistent than staff follow-up.