Leveraging Partnerships: Families, Schools, and Providers Working Together to Improve Asthma Management

Abstract

Asthma is one of the most common illnesses of school-aged children and can lead to both health and educational disparities. Children from low socioeconomic backgrounds and racial/ethnic minorities suffer the greatest impact. They often lack the asthma self-management skills to successfully monitor, navigate, and negotiate appropriate asthma care. School settings are a strategic point of contact for this additional support. School nurses can monitor for signs of asthma worsening, manage symptoms, provide care coordination, and reinforce self-management skills. Likewise, school-based asthma programs have the potential to reduce health and educational disparities, but it is the strong linkage to the asthma care provider that is critical to successful school-based asthma management. Healthcare providers are encouraged to establish partnerships with families through patient-centered care and schools through clear communication and care coordination to ensure asthma is well controlled so the child is in school and ready to learn.

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).…”

“…The goals and research commitments of NAEPP include raising the awareness of patients, health care practitioners, and the public about the seriousness of asthma; ensuring the timely recognition of symptoms; and increasing effective control between health care providers and patients through the utilization of modern treatment and education (U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, 2014a). Given that school nurses frequently provide care to children with asthma in the school setting, they must stay current on national guidelines, understand how the guidelines impact practice, and implement asthma management programs based on the guidelines (Gleason, Cicutto, Haas-Howard, Raleigh, & Szefler, 2016). It is also vital that nurses receive appropriate education that supports their ability to provide care (De Tratto et al, 2014).…”

Stakeholder Perspectives on Optimizing Communication in a School‐Centered Asthma Program

“…A specific SAP, Building Bridges, was designed to bridge this gap in communication and care coordination between schools and PCPs. Established in 2012, Building Bridges combines features from a school‐based asthma monitoring program (Step‐Up Asthma) and a provider‐based asthma management program (Easy Breathing © ) to provide asthma care to children with poorly controlled asthma in urban elementary schools in Hartford, Connecticut and Denver, Colorado . The methods of the Building Bridges program have been described previously elsewhere .…”

The Effects of the Environment on Asthma Disease Activity

“…It is associated with significant morbidity, healthcare utilization and productivity loss 1,3,4 . Despite advances in asthma therapies and health insurance expansion 5 ; the biologic, physical and psychosocial environment can still impact asthma disease activity 6 .…”