Creating District Readiness for Implementing Evidence-Based School-Centered Asthma Programs

Abstract

Asthma is a common chronic childhood disease that is associated with high rates of school absenteeism and educational disparities. Effective school-based programs exist that are able to reduce school absenteeism and the burden that asthma exacts on students. However, despite the availability of effective school-centered asthma programs conducted as research projects, many schools have struggled to implement the programs and experience their benefits. As the literature from the implementation sciences highlights, readiness of the school environment is crucial and central to success. This is an often overlooked and underacknowledged aspect to successful implementation. This article provides a case study of a large school district, highlighting its experience in preparing the district for broad-scale implementation of a school-centered asthma program.

A Review of School Nurses’ Self-Efficacy in Asthma Care

“…Future outcome research should explore whether school nurses with higher SE in asthma care are more likely to achieve results that include (1) performance of necessary skills, such as assessment of student's level of asthma control or peak flow measurement skills; (2) development of a partnership with the student and family; (3) retaining an AAP for each child with asthma; (4) establishing a school-wide emergency asthma plan; (5) integrating self-management into asthma care and; (6) encouraging a partnership with a community provider (U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, 2014b). These outcomes will help build a strong nursing presence in schools, create a healthy school community, and support many of the NAEPP guidelines (Cicutto et al, 2016;Gleason et al, 2016). The NAEPP, coordinated by the National Heart Lung Blood Institute (NHLBI), aims to raise awareness about asthma and develop guidelines and resource materials based on the latest scientific evidence for clinical practice including schools and childcare centers (U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, 2014a).…”

Building Bridges for Asthma Care Program: A School-Centered Program Connecting Schools, Families, and Community Health-Care Providers

“…Before initiating a multifaceted school-based asthma program, it is important to understand the readiness of the school district and the school. Key readiness factors include understanding the skill level of school nurses and other school health team members related to programmatic activities, such as computer skills and leading change, existing senior administrative support for the program and for school nurses implementing the program, and assuring infrastructure exists to support implementation, such as an electronic academic record with a functional health tab, school nursing practice supports, and appropriate policies and procedures (Cicutto et al, 2016). The Asthma Intake Form, school asthma care plans, standardized inhaler technique checklist, and the electronic portal were tools that supported school nursing practice.…”

Addressing the Social Determinants of Health: A Call to Action for School Nurses

“…Asthma is directly influenced by SDOH, and many asthma-related health disparities exist (Lynn, Oppenheimer, & Zimmer, 2014). Urban children from low-income areas experience higher asthma morbidity due to inadequate medical care and poor medication adherence (Basch, 2011), behavioral or emotional problems (Cicutto et al, 2016), and household or environmental exposure to cockroaches, cats, dogs, mice, dust mites, and mold (Huffaker & Phipatanakul, 2014). Family turmoil, community violence, noise, and crowding may also play a role in asthma management for urban youth (Koinis-Mitchell et al, 2007).…”