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Effect of Asthma Education on Asthma Self-Management Practices among Adolescents in Nigeria

Abstract

Asthma is a common chronic respiratory condition that can affect adolescents' physical activity, school attendance, academic performance, social participation, and overall quality of life. Effective self-management is important for controlling symptoms, reducing exposure to triggers, using prescribed medications appropriately, recognizing worsening symptoms, and seeking timely medical care. Asthma education provides adolescents with information and practical skills concerning asthma symptoms, common triggers, medication use, inhaler technique, symptom monitoring, asthma action plans, prevention of exacerbations, emergency response, and appropriate healthcare-seeking. Asthma self-management practices refer to the behaviours adolescents undertake to control their asthma and prevent complications, including correct use of prescribed inhalers and medications, avoidance of known triggers, monitoring of symptoms, adherence to asthma action plans, recognition of worsening symptoms, appropriate response to asthma attacks, and timely healthcare utilization. In Nigeria, inadequate asthma self-management may be associated with limited asthma knowledge, misconceptions about asthma and its treatment, poor medication adherence, incorrect inhaler technique, inadequate access to healthcare, and limited awareness of asthma triggers and warning signs. Effective asthma education may improve adolescents' knowledge, confidence, and ability to manage their condition appropriately. Against this background, this study investigates the effect of asthma education on asthma self-management practices among adolescents in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and the Knowledge-Attitude-Practice framework. The Health Belief Model provides a framework for understanding adolescents' adoption of asthma self-management practices through perceived susceptibility to asthma complications, perceived severity, perceived benefits of effective self-management, perceived barriers, and cues to action. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, environmental conditions, and health behaviour in shaping asthma self-management. The Knowledge-Attitude-Practice framework provides a basis for examining how asthma education may improve adolescents' knowledge and attitudes and influence their self-management practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how asthma education may influence asthma self-management practices among adolescents in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from adolescents with asthma in selected schools, healthcare facilities, and communities in Nigeria using a structured interviewer-administered or self-administered questionnaire, asthma knowledge assessment, and asthma self-management practice tool. A multistage sampling technique will be employed to select states, local government areas, schools or healthcare facilities, and eligible adolescents. Where feasible, selected adolescent groups or study settings will be assigned to intervention and comparison groups. Adolescents in the intervention group will receive structured asthma education covering asthma symptoms and triggers, medication adherence, correct inhaler technique, use of prescribed medications, asthma action plans, symptom monitoring, recognition of worsening symptoms, prevention of asthma attacks, avoidance of known triggers, physical activity considerations, and appropriate healthcare-seeking during exacerbations. Asthma self-management practices will be assessed using indicators such as correct inhaler technique, adherence to prescribed medication, avoidance of identified triggers, symptom monitoring, use of an asthma action plan, recognition of warning signs, appropriate response to asthma attacks, and timely attendance at healthcare appointments. Where appropriate and ethically feasible, inhaler technique will be assessed through direct observation using a standardized checklist. Descriptive statistics will be used to summarize participants' sociodemographic and clinical characteristics, previous asthma education, asthma knowledge, and self-management practice scores. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be used to determine the effect of asthma education on asthma self-management practices. Where appropriate, self-management practices before and after the intervention will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that asthma education has a significant positive effect on asthma self-management practices among adolescents in Nigeria. Adolescents exposed to structured asthma education are expected to demonstrate improved knowledge of asthma symptoms, triggers, medication use, inhaler technique, warning signs, and appropriate responses to exacerbations. Education may encourage better adherence to prescribed medications, more accurate inhaler use, greater avoidance of identified triggers, regular symptom monitoring, appropriate use of asthma action plans, and timely healthcare-seeking when symptoms worsen. Practical demonstrations of inhaler technique and scenario-based training are expected to strengthen adolescents' confidence and ability to manage asthma effectively. However, education alone may not guarantee sustained self-management because adolescents may encounter challenges such as medication cost, limited access to healthcare, stigma, forgetfulness, dependence on caregivers, inadequate school support, and limited availability of asthma medications and educational resources. Consequently, asthma education may be most effective when supported by accessible healthcare services, caregiver involvement, school-based asthma support, availability of prescribed medications, regular follow-up, and appropriate asthma-management resources. The study is expected to contribute to the literature on asthma education, adolescent health, chronic disease self-management, respiratory health, health education, school health, and public health in Nigeria by providing empirical evidence on the effect of asthma education on asthma self-management practices among adolescents. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, state ministries of health and education, hospitals, primary healthcare centres, schools, school health programmes, respiratory-health professionals, public health practitioners, health educators, parents and caregivers, development partners, and policymakers regarding strategies for improving asthma management among adolescents. The study will also provide evidence-based recommendations for integrating asthma education into school and healthcare programmes, strengthening inhaler-technique education, improving access to asthma medications, supporting caregiver and teacher involvement, promoting asthma action plans, strengthening follow-up services, and improving self-management practices among adolescents living with asthma in Nigeria.

Keywords: Asthma education, asthma self-management practices, adolescents, Nigeria, asthma management, respiratory health, inhaler technique, medication adherence, chronic disease management, adolescent health, health education, school health, asthma action plan, public health.