Asthma Knowledge and Asthma Management Behavior in Urban Elementary School Teachers

Abstract

BACKGROUND While schools are an important setting for asthma care in youth, teachers’ asthma knowledge and symptom management is poor. This study investigated the knowledge, prevention and management behaviors, and communication regarding asthma of teachers of low income ethnic minority students. It was hypothesized that relative to colleagues whose students did not have active asthma (i.e., did not have symptoms during the day), teachers of students with active asthma would have better asthma knowledge and that more would take asthma prevention steps and communicate with parents and school nurses. METHODS Drawing from 25 elementary schools in NYC, 320 Pre-Kindergarten through 5th grade classroom teachers with at least one student with asthma completed measures assessing their asthma knowledge, steps taken to manage asthma, communication with the school nurse or parents, information they received about asthma and whether or not they had at least one student in their class experience asthma symptoms. T-test and chi-square were used to test hypotheses. RESULTS Asthma knowledge varied among teachers. Most could identify potential triggers, yet few knew that medication taken prior to exercise could prevent symptoms and that students with asthma need not avoid exercise. Communication between teachers and school nurses and between teachers and parents was lacking. Relative to colleagues whose students did not have active asthma, teachers whose students had active asthma had better asthma knowledge; more took steps to prevent students from having asthma symptoms, communicated with parents and initiated communication with the nurse. CONCLUSIONS Teacher knowledge about asthma and asthma management is limited, especially among those whose students did not have active asthma. Teachers respond reactively to students who have symptoms in class by increasing prevention steps and communications with parents and the school nurse. A more proactive approach to managing asthma in schools is warranted.

In-school asthma management and physical activity: children’s perspectives

“…These results differed from another study that reported the most common treatment was for teachers to send students to the nurse (without specifying the need for medication) (17). The aforementioned study did not differentiate between PE teachers and classroom teachers.…”

“…In addition, many teachers incorrectly believed children with asthma should avoid strenuous activity, and that asthma medication taken prior to activity would not help students during exercise (17). These results, while obtained by surveying school staff, resonate with our findings.…”

“…Multiple studies investigating how asthma is managed in schools have focused on various aspects such as control and prevention, treatment, staff knowledge, and communication (15, 17–19). All of these studies surveyed school staff to determine the effectiveness of asthma management.…”

Asthma management in New York City schools: A classroom teacher perspective

“…One explanation of this finding is that teachers were not familiar with typical symptoms of an asthma exacerbation, which is consistent with other studies. [22–24] Several teachers admitted to not being comfortable identifying symptoms of an asthma attack. This finding is of concern as teachers who are not able to identify symptoms of acute asthma will likely not be able to effectively assist children who are experiencing an acute exacerbation.…”

Asthma Self-Management is Sub-Optimal in Urban Hispanic and African American/Black Early Adolescents with Uncontrolled Persistent Asthma

“…This interpretation is supported by the finding that participant’s as-needed reliever medication is refilled at higher rates than daily controller medication (26), and the fact that early adolescents are often not adherent to treatment regimens (13). This reactive management style is not unique to early adolescents; it has also been found to be used by parents (27, 28) as well as elementary school teachers (29), suggesting that early adolescents may learn to manage asthma reactively through modeling.…”