Dataset Information

Identification and education of adolescents with asthma in an urban school district: results from a large-scale asthma intervention.

ABSTRACT: Asthma is a leading cause of hospitalizations, acute care utilization, health care costs, and school absences in children. Asthma morbidity is disproportionately high in inner city populations. In general, community-based public health interventions to reduce asthma morbidity have had modest success due in part to their limited reach and low participation by the targeted population. Adolescents have been especially difficult to reach. A coalition of community organizations developed a school-based, population-level system to identify, prioritize, and provide interventions for middle school children with asthma in a large urban school district in Oakland, CA. Nearly 92% (n = 8,326) of students in the targeted schools took an asthma case identification survey. Of those students who took the survey, 17.5% (n = 1,458) had active asthma and were eligible for services. Among those identified with active asthma, 83% (n = 1,217) voluntarily attended asthma self-management classes at school. The 4-week curriculum previously has been shown to significantly improve several indicators of asthma control in this population. Retention was high-72% of students who enrolled attended at least three of the four curriculum sessions. Many higher-risk students were subsequently referred to and enrolled in off-site asthma services. Large school districts with incomplete or inadequate health records, high asthma prevalence, and internal or external services available for students with asthma may benefit from a similar model. A system such as the one described may be an effective public health strategy for school districts, health departments, and community coalitions addressing asthma or other conditions with high childhood prevalence.

SUBMITTER: Davis A

PROVIDER: S-EPMC2329749 | biostudies-literature | 2008 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Identification and education of adolescents with asthma in an urban school district: results from a large-scale asthma intervention.

Davis Adam A Savage Brown Amanda A Edelstein Joan J Tager Ira B IB

Journal of urban health : bulletin of the New York Academy of Medicine 20080311 3

Asthma is a leading cause of hospitalizations, acute care utilization, health care costs, and school absences in children. Asthma morbidity is disproportionately high in inner city populations. In general, community-based public health interventions to reduce asthma morbidity have had modest success due in part to their limited reach and low participation by the targeted population. Adolescents have been especially difficult to reach. A coalition of community organizations developed a school-bas ...[more]

PMID: 18330708

Similar Datasets

Project description:ObjectiveTo evaluate the impact of the School-Based Asthma Therapy trial on asthma symptoms among urban children with persistent asthma.DesignRandomized trial, with children stratified by smoke exposure in the home and randomized to a school-based care group or a usual care control group.SettingRochester, New York.ParticipantsChildren aged 3 to 10 years with persistent asthma.InterventionsDirectly observed administration of daily preventive asthma medications by school nurses (with dose adjustments according to National Heart, Lung, and Blood Institute Expert Panel guidelines) and a home-based environmental tobacco smoke reduction program for smoke-exposed children, using motivational interviewing.Main outcome measureMean number of symptom-free days per 2 weeks during the peak winter season (November-February), assessed by blinded interviews.ResultsWe enrolled 530 children (74% participation rate). During the peak winter season, children receiving preventive medications through school had significantly more symptom-free days compared with children in the control group (adjusted difference = 0.92 days per 2 weeks; 95% confidence interval, 0.50-1.33) and also had fewer nighttime symptoms, less rescue medication use, and fewer days with limited activity (all P < .01). Children in the treatment group also were less likely than those in the control group to have an exacerbation requiring treatment with prednisone (12% vs 18%, respectively; relative risk = 0.64; 95% confidence interval, 0.41-1.00). Stratified analyses showed positive intervention effects even for children with smoke exposure (n = 285; mean symptom-free days per 2 weeks: 11.6 for children in the treatment group vs 10.9 for those in the control group; difference = 0.96 days per 2 weeks; 95% confidence interval, 0.39-1.52).ConclusionsThe School-Based Asthma Therapy intervention significantly improved symptoms among urban children with persistent asthma. This program could serve as a model for improved asthma care in urban communities.

Project description:Background To address low state physical education (PE) quantity and quality law implementation in elementary schools, the New York City Department of Education (NYCDOE) delivered a multilevel intervention (PE Works; 2015-2019), which included a district-led audit of school PE-law implementation, feedback, and coaching with principals. Using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) implementation science framework, we assessed the primary multilevel drivers of success for this approach in increasing adherence to PE quantity and quality law. Methods We conducted in-depth, semi-structured interviews with district-level personnel (n=17), elementary school administrators (n=18), and PE teachers (n=6) in 2020-21. Results Interview results suggested several key RE-AIM drivers of successful PE law implementation. Reach: Ensure higher-need schools receive the necessary initial support to improve PE and later focus on lower-need schools. Effectiveness: Provide support tailored to school needs, not penalties, to improve PE. Adoption: Increase the priority of PE at both district and school levels (e.g., audit and feedback, themselves, appear to elevate PE’s priority). Streamline data collection and feedback reports; collecting/reporting too much information is burdensome and leads to lack of focus. Involve qualified (i.e., skilled in both school administration and PE programming/pedagogy) district-level personnel to work collaboratively with schools. Implementation: Build strong, trusting district-school relationships. Maintenance: Provide ongoing district-level support to schools and involve parents to advocate for quality PE. Conclusions PE audits, feedback, and coaching (PEAFC) can guide schools in establishing long-term plans for successfully implementing PE-related law. Future research should examine the impact of PEAFC elsewhere (e.g., secondary schools, other districts). Supplementary Information The online version contains supplementary material available at 10.1186/s12966-023-01479-1.

Dataset Information

Identification and education of adolescents with asthma in an urban school district: results from a large-scale asthma intervention.

Publications

Identification and education of adolescents with asthma in an urban school district: results from a large-scale asthma intervention.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets