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Asthma is a chronic respiratory ailment that requires careful management due to its varying symptoms and influencing factors. It is characterized by airway inflammation, bronchial hyperresponsiveness, and reversible airflow obstruction, leading to symptoms like wheezing, shortness of breath, chest tightness, and coughing. The symptom frequency and intensity may vary considerably over time. It is also linked to immune system responses to allergens and irritants, highlighting the complex...
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Developing, Implementing, and Evaluating a School-Centered Asthma Program: Step-Up Asthma Program.

Deborah R Liptzin1, Melanie C Gleason1, Lisa C Cicutto2

  • 1Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo; The Breathing Institute, Children's Hospital Colorado, Aurora, Colo.

The Journal of Allergy and Clinical Immunology. in Practice
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PubMed
Summary
This summary is machine-generated.

A school-based asthma program improved children's asthma knowledge and reduced exacerbations. This program, involving asthma counselors, significantly lowered urgent care visits and missed school days for students with asthma.

Keywords:
AsthmaCase ManagementSchool nursingSchools

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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.