Tuesday, May 19, 2015

When school nurses identify children with asthma and support them and their families in getting the care they need absenteeism declines

Asthma is one of the most common chronic diseases in children, and it can only be managed, not cured. It affects a disproportionally higher percentage of low-income, urban minority children, and is also the most common disease-related reason for children missing school. This can have a negative effect on their academic achievement, as well as later success in life.

Initial results from a pilot study show that a new program called "Building Bridges for Asthma Care" -- an initiative that helps school nurses identify children with asthma and support them and their families in getting the care they need -- is helping reduce absenteeism. The program is a collaboration between Colorado Children's Hospital, Connecticut Children's Medical Center, the public school systems in Hartford, CT and Denver, CO, and GSK. The study specifically looked at 2,244 urban children attending three schools in Hartford: 40% were African American, 53% were Hispanic, and 7% were from other minority backgrounds.

The study will be presented at the ATS 2015 International Conference.

"Because children spend much of their time in school, a school nurse is ideally positioned to help. Through the program, school nurses work with children identified with asthma and their families, as well as their primary care providers to address asthma so the child does not miss as much school," said study lead author Jessica Hollenbach, PhD, Director of Asthma Programs, Connecticut Children's Medical Center, Hartford, Ct.

The program was piloted in five public inner-city elementary schools in Denver, Colo. and three in Hartford, Ct. during the 2013-14 school year. School nurses first identified, screened and enrolled children with inadequately controlled asthma in the program. Then, they monitored asthma control, taught the children how to use rescue inhalers, and served as a liaison between physicians, parents and caregivers to obtain and support the children's asthma treatment plans.

For the study, absenteeism data were collected for the 2012-13 to 2013-14 school years for all children, including the Building Bridges participants in Hartford. They found that the absenteeism rate for the 67 children enrolled in Building Bridges decreased nearly 12%. For children who had asthma that was severe enough that they could qualify for the program, but were not in it, absenteeism increased by nearly 9%.

"Although we currently only have data from one of the two school districts, this study demonstrates that we can make a difference and help more children with asthma manage their disease and stay in school," said Hollenbach. "This is positive news for everyone involved -- children benefit, but also their parents, who do not need to miss work to stay home with their child. The healthcare system benefits too, since their asthma is better managed, and therefore they require fewer health services, such as emergency care or hospitalization."

In the 2014-15 school year, the program has expanded to include 22 new schools. Data collection for the Denver, Colorado school system is ongoing and will be used to validate the current findings.

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