Developing, Implementing, and Evaluating a School-Centered Asthma Program: Step-Up Asthma Program

Area of Science:

• Pediatric Health
• Public Health Interventions
• School Health Programs

Background:

• Asthma affects 9.3% of US children, leading to increased healthcare use, worse outcomes, and academic challenges, especially in urban settings.
• Persistent childhood asthma in inner cities is linked to significant healthcare utilization, poorer health outcomes, increased school absenteeism, and diminished academic performance.

Purpose of the Study:

• To develop and assess a school-centered asthma program aimed at decreasing asthma-related illness and fostering asthma-friendly school environments.
• The objective was to evaluate the effectiveness of a school-based intervention in managing childhood asthma.

Main Methods:

• The Step-Up Asthma Program, a multidisciplinary, school-centered initiative, was implemented and evaluated over two years (2010-2012).
• The program utilized asthma counselors to connect specialty care, primary care, school nurses, and children with asthma, focusing on identification, education, and case management.
• A pre-post study design assessed changes in students' asthma knowledge, inhaler technique, and exacerbation frequency.

Main Results:

• 252 students participated in the Step-Up Asthma Program over two years, showing improvements in asthma action plans, school-based medication access, and controller medication use.
• Participants demonstrated significant gains in asthma knowledge (P < .001) and improved inhaler technique (P < .0001).
• The program led to significant reductions in asthma exacerbations, including fewer oral steroid courses, urgent care visits, and missed school days (P < .05), with sustained effects.

Conclusions:

• A guideline-based, school-centered asthma program effectively reduces childhood asthma morbidity.
• Asthma counselors are crucial for program success, facilitating education and care coordination.
• The Step-Up Asthma Program's core elements are transferable to other school systems, demonstrating long-term viability.