Building Bridges for Asthma Care: Reducing school absence for inner-city children with health disparities

Abstract

Children enrolled in the Building Bridges for Asthma Care Program experienced reduced school absence and improved asthma control.

Introducing telehealth and adherence monitoring to school‐centered asthma management

“…An a priori stratification by asthma severity showed a substantial improvement in CASI scores amongst those with more severe asthma following the intervention. These findings are consistent with observations made with other school‐based intervention strategies 7,9–11,17 . In a comparison of two recent school‐centered asthma programs, one strategy focused on providing a nurse‐centered school‐based asthma intervention on children with high risk for an asthma exacerbation identified by uncontrolled asthma or a recent asthma exacerbation while another program focused its efforts on providing once‐daily inhaled corticosteroid using a school‐based intervention program 10,11 .…”

“…These findings are consistent with observations made with other school‐based intervention strategies 7,9–11,17 . In a comparison of two recent school‐centered asthma programs, one strategy focused on providing a nurse‐centered school‐based asthma intervention on children with high risk for an asthma exacerbation identified by uncontrolled asthma or a recent asthma exacerbation while another program focused its efforts on providing once‐daily inhaled corticosteroid using a school‐based intervention program 10,11 . While the nurse‐centered asthma program demonstrated improved asthma control and a significant reduction in school absence when compared to an equally severe asthma cohort, the school‐based medication administration did not show a difference in clinical outcomes.…”

“…Where health care delivery in conventional settings has failed to address these well‐documented disparities, innovative delivery models in communities, schools, and homes that address social determinants of health have made some inroads 7–11 . It is clear that health care delivered in a silo is not effective, and strategies that move the needle on addressing common barriers to access to high‐quality care are needed.…”

School-based interventions: Where do we go from here?

“…1,2 In this month's issue of the Journal, 2 reports attempt to build on past interventions and implement them on a wider scale. Szefler et al 3 developed Building Bridges by integrating 2 existing asthma programs, Easy Breathing and the Colorado Step Up Asthma Program, into the Hartford, Connecticut, and Denver, Colorado, public school systems. Gerald et al 4 adapted Supervised Asthma Medicine in Schools (SAMS), an efficacious school-supervised asthma therapy program that the authors had developed in Birmingham, Alabama, 5 for implementation in the Tucson Unified School District.…”

“…To do this, both interventions used existing school health forms as the initial screen. Although Gerald et al 4 included all students with asthma in their intervention, Szefler et al 3 targeted those at risk for adverse asthma outcomes. However, review of school records potentially misses students whose parents do not inform schools of their children's asthma.…”