A School‐Based Asthma Intervention Program in the Buffalo, New York, Schools

Abstract

This project investigated the feasibility and effectiveness of a school asthma program in reducing asthma exacerbations among school children. In 1997-1998, two schools were selected for a case control pilot study. The intervention required that students with asthma, who needed medication daily at school, must present a written plan from the health care provider. Students with asthma were identified through parent/guardian or school reports. The pilot program was expanded into five schools in 1998-1999. All schools kept records of rescue treatments for asthma episodes. The pilot intervention resulted in an 80% decrease in rescue treatments from 1996-1997 to 1997-1998. In the additional five schools, an overall decrease of 17% occurred in rescue treatments during 1998-2000. Overall, 65% of physicians provided requested Asthma Care Plans (ACP). In two schools, the number of asthma care plans that required anti-inflammatory medications tripled. Preliminary results indicate this school asthma program proved feasible and effective in reducing the frequency of asthma exacerbations at school.

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

“…Many studies describe successful school-centered interventions, including education for students and parents, 15,16,[21][22][23][24][25][26][27][28] case management, 25,27 enhanced communication with providers, 15,21,26,27 access to providers in school-based health centers 27,29,30 or as consults, 31,32 provision of asthma action plans, 15,23 directly observed therapy, 32,33 and home visits. 27 These programs have shown improvements in asthma control and have different strengths, but many have small numbers and lack sustainability mechanisms.…”

School-based asthma programs

“…One program in which the principal sent a letter home requiring the family to obtain a written asthma treatment plan from the student's physician was successful in obtaining plans from more than two thirds of students with asthma, and this program, which in addition provided asthma education for students at school, also showed reduced rescue treatments in school. 30 In a controlled trial, Yawn et al 31 reported that sending letters to parents recommending medical follow-up of symptomatic children increased physician visits and resulted in medication changes.…”

“…22 In the absence of having a full-time medical staff, medication administration and asthma exacerbations are handled by school administrators, faculty, and staff who often send children home early or to an ED. 30 Deaths from asthma exacerbations in school may be attributed, in part, to hesitation and/or delay by school staff to provide medical assistance. 56 Inadequate asthma management at schools may a result of poor knowledge of asthma by school personnel.…”

Written action plans: Potential for improving outcomes in children with atopic dermatitis

“…The most relevant information gleaned from the review is summarized in Table I. [7][8][9][10][11][12] Results from individual RCTs in the Cochrane review by Bhogal, Zemek, and Ducharme 5 are summarized in Table II. [13][14][15][16] This study's major limitation for our purposes is that none of the RCTs compared a group with WAPs to a control group with no intervention; all studies compared symptom-based WAPs to peak flowebased WAPs.…”