Studies of RAP's Impact

RAP’s effectiveness was evaluated in a randomized controlled trial involving 256 students in 26 suburban Toronto elementary schools1.  By every measurement except two, the students who had completed the RAP program reported significant gains:  improved asthma quality of life, better self-efficacy, fewer absences, fewer days of interrupted activity and fewer urgent health-care visits1. Similar results have been recorded in other studies2;3. Well controlled asthma positively impacts quality of life4, physical activity4 school performance5, overall health and thereby reduces the likelihood of other chronic diseases.

Dr. Allan Becker, and his team at the Children’s Asthma Education Centre, Children’s Hospital of Winnipeg, evaluated RAP’s efficacy in a study involving 25 urban and 2 rural Manitoba schools.Their findings make a compelling case for expanding the reach of RAP – most particularly in remote areas. Using questionnaire data collected for each child before and 6 months after RAP was completed, they found that RAP significantly reduced the number of missed school days for children with asthma  - by a total of 378 days. RAP also significantly improved the quality of life for the children and their parents in all domains, and significantly improved home productivity for parents6. They concluded as follows: 

“RAP has had both statistically significant and clinically relevant benefits for the child, family, and the school. Asthma education in schools provides a supportive peer environment and is a valuable option for families who otherwise would be unable to attend in traditional asthma education settings. We strongly encourage the adoption of RAP as a school based education program for children with asthma6.”

In a recent interview featured in ‘Success Stories (Spring 2011)’ with AllerGen NCE, the funder of the above-noted study, Dr. Becker expressed the need for additional research into factors affecting the impact of education: program delivery; involvement of family and health care team; learning styles and cultures. AAC’s project activities, with its collaborative, community team based approach are designed to address a number of these parameters.


Puff in plane


Reference List

  (1)    Cicutto L, Murphy S, Coutts D et al. Breaking the access barrier: evaluating an asthma center's efforts to provide education to children with asthma in schools. Chest 2005; 128(4):1928-1935.

  (2)    McGhan S, Wong E, Sharpe H et al. A children's asthma education program: Roaring Adventures of Puff (RAP), improves quality of life. Can Respir J 2010; 17(2):67-73.

  (3)    McGhan SL, Wong E, Jhangri GS et al. Evaluation of an education program for elementary school children with asthma. J Asthma 2003; 40(5):523-533.

  (4)    Schmitz N, Wang J, Malla A et al. The impact of psychological distress on functional disability in asthma: results from the Canadian community health survey. Psychosomatics 2009; 50(1):42-49.

  (5)    Kohen DE. Asthma and school functioning. Health Rep 2010; 21(4):35-45.

  (6)    Stewart L, Gillespie C, Filuk S et al. The Roaring Adventures of Puff" (RAP) - A School Based Asthma Education Program for Children with Asthma. Asthma and Education 2011: Canadian Network for Respiratory Care and Education. 2011.