Culture-specific programs for children and adults from minority groups who have asthma

In this review, we examined if culture-specific asthma education programmes improves asthma related outcomes in children and adults from minority groups with asthma. Four studies with 617 patients, aged from 5 to 59 years were included in the review. We found that culture specific programmes were better in improving quality of life in adults and asthma knowledge in children but did not significantly improve asthma exacerbations. However there is insufficient data to be confident about the impact on exacerbations or whether culture specific programmes are beneficial in all settings. Nevertheless, it could be argued that asthma education programmes should be as culturally specific as possible, given the increased severity of asthma in minority groups and the complexity of health outcomes and culture. More studies are clearly required to address this question and to further inform relevant clinical practice and health policy.

Authors' conclusions: 

Current limited data show that culture-specific programmes for adults and children from minority groups with asthma, are more effective than generic programmes in improving most (quality of life, asthma knowledge, asthma exacerbations, asthma control) but not all asthma outcomes. This evidence is limited by the small number of included studies and the lack of reported outcomes. Further trials are required to answer this question conclusively.

Read the full abstract...

People with asthma who come from minority groups have poorer asthma outcomes and more asthma related visits to Emergency Departments (ED). Various programmes are used to educate and empower people with asthma and these have previously been shown to improve certain asthma outcomes. Models of care for chronic diseases in minority groups usually include a focus of the cultural context of the individual and not just the symptoms of the disease. Therefore, questions about whether culturally specific asthma education programmes for people from minority groups are effective at improving asthma outcomes, are feasible and are cost-effective need to be answered.


To determine whether culture-specific asthma programmes, in comparison to generic asthma education programmes or usual care, improve asthma related outcomes in children and adults with asthma who belong to minority groups.

Search strategy: 

We searched the Cochrane Register of Controlled Trials (CENTRAL), the Cochrane Airways Group Specialised Register, MEDLINE, EMBASE, review articles and reference lists of relevant articles. The latest search was performed in May 2008.

Selection criteria: 

All randomised controlled trials (RCTs) comparing the use of culture-specific asthma education programmes with generic asthma education programmes, or usual care, in adults or children from minority groups who suffer from asthma.

Data collection and analysis: 

Two review authors independently selected, extracted and assessed the data for inclusion. We contacted authors for further information if required.

Main results: 

Four studies were eligible for inclusion in the review. A total of 617 patients, aged from 5 to 59 years were included in the meta-analysis of data. Use of a culture-specific programme was superior to generic programmes or usual care, in improving asthma quality of life scores in adults, pooled WMD 0.25 (95% CI 0.09 to 0.41), asthma knowledge scores in children, WMD 3.30 (95% CI 1.07 to 5.53), and in a single study, reducing asthma exacerbation in children (risk ratio for hospitalisations 0.32, 95%CI 0.15, 0.70).