"Quest for the Code": A study of a computer based education program for children with asthma

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




Barbara H. Fiese


Children, Asthma, Computer-based education, School-based intervention, Quest for the Code

Subject Categories

Health Psychology | Psychology | Social and Behavioral Sciences


Asthma is the number one childhood chronic illness affecting seven percent of children and is the largest cause of school absences. The National Heart, Lung and Blood Institute (NHLBI, 1998) has revised the guidelines for managing asthma with a particular emphasis placed on education of asthma management for children and parents. Recently, computer-based educational interventions have been developed as a tool for asthma management. This study examined the feasibility and effectiveness of a school-based computer educational intervention.

Twenty-five families in four inner-city elementary schools with children ages eight to 11 with pediatric asthma were recruited to participate in a feasibility study using a randomized controlled trial of an educational intervention. There were 16 children and caregivers in the intervention group and 9 children and caregivers in the control group. This randomized controlled feasibility trial included a pretest, posttest, and a three-month follow-up for both conditions. The Starbright "Quest for the Code" CD-ROM intervention was provided as a school-based asthma education intervention. Participants in the intervention condition had a single-time home-based medication intervention around medication routines to complement the school-based educational CD-ROM. Parents completed the Demographic Questionnaire, the Caregivers Quality of Life Questionnaire, the Family Ritual Questionnaire, Functional Severity Scale and the AIR Questionnaire. Children completed the Starbright Asthma Knowledge questionnaire, the Pediatric Quality of Life Questionnaire and the Family Ritual Questionnaire. Child asthma knowledge, health care utilization and quality of life were examined. It was hypothesized that in the intervention group asthma knowledge, quality of life and family routines would increase at posttest and be maintained at follow-up and that emergent health care utilization would decrease at posttest and be maintained at follow-up.

There were not any significant differences between the groups in overall asthma knowledge at posttest or follow-up. There also was not a significant increase in child or parent reported quality of life. There were significant findings in the intervention group in decreased asthma burden and increased meaning on the Family Ritual Questionnaire as reported by the parent. Functional Severity and health care utilization were also improved in the intervention group.

This study was limited by the small sample size, the multiple analyses conducted and that the intervention group did not get to complete all seven of the modules in "Quest for the Code." The school-based health centers were not feasible for complete dosing of the intervention. An after school program over a longer period of time with more frequent exposure may be a more appropriate context. Future studies should complete the dose of intervention and incorporate medication tracking.