*3.3.4 Acute health care utilization*

The *"Roaring Adventures of Puff "* program incorporated a multitude of childhood educational approaches based on theory and evidence of factors that influence a child's motivation and self-efficacy [13]. This school-based program targeted the children and their support community (parents, peers, and teachers). After a 12-month follow-up, the number of unscheduled doctors and ED visits due to asthma was reduced in the experimental and the control group. However, three child-parent education programs did not show a significant difference in ED visits and hospitalizations between the intervention and the control group at follow-up [19, 20, 26].
