Developing, Implementing, and Evaluating a School-Centered Asthma Program: Step-Up Asthma Program

Liptzin, Deborah R.; Gleason, Melanie; Cicutto, Lisa; Cleveland, Chris L.; Shocks, Donna; White, Martha K.; Faino, Anna; Szefler, Stanley J.

doi:10.1016/j.jaip.2016.04.016

Cited by 33 publications

(32 citation statements)

References 35 publications

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“…School‐centered programs can identify those with uncontrolled asthma, help them understand and monitor their asthma better, relate with healthcare providers, 62,63 and reduce attacks and school absences 68‐71 . Trained community health workers can assist school nurses 72 . However, in many countries, schooling is far from universal, and this is where the local community “asthma champion” has a role, identifying children who are not at school and advocating for them.…”

Section: Setting Standards and Improving Guidelines For Primary Carementioning

confidence: 99%

A worldwide charter for all children with asthma

Szefler

Fitzgerald

Adachi

et al. 2020

Pediatric Pulmonology

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Childhood asthma is a huge global health burden. The spectrum of disease, diagnosis, and management vary depending on where children live in the world and how their community can care for them. Global improvement in diagnosis and management has been unsatisfactory, despite ever more evidence‐based guidelines. Guidelines alone are insufficient and need supplementing by government support, changes in policy, access to diagnosis and effective therapy for all children, with research to improve implementation. We propose a worldwide charter for all children with asthma, a roadmap to better education and training which can be adapted for local use. It includes access to effective basic asthma medications. It is not about new expensive medications and biologics as much can be achieved without these. If implemented carefully, the overall cost of care is likely to fall and the global future health and life chance of children with asthma will greatly improve. The key to success will be community involvement together with the local and national development of asthma champions. We call on governments, institutions, and healthcare services to support its implementation.

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Section: Setting Standards and Improving Guidelines For Primary Carementioning

confidence: 99%

A worldwide charter for all children with asthma

Szefler

Fitzgerald

Adachi

et al. 2020

Pediatric Pulmonology

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“…These may include the introduction of interactive web‐based platforms for HIPPA and FERPA compliant chronic disease communication, the use of CHWs within the school and/or mobile clinic space to help bridge the medical, school, and community sectors, as well as consideration of policy and further implementation of stock albuterol to improve emergency mediation availability in asthma. Tools, such as the School‐based Asthma Management Program or SAMPRO (Lemanske et al., ) created by the American Academy of Allergy, Asthma, and Immunology, exist to help guide school districts to standardize asthma management programs and reduce nurse administrative work (Lemanske et al., ; Liptzin et al., ). Furthermore, policymakers need to address school nurse staffing shortages and help legislatively to support the vital role of school nursing in Chicago, in Illinois, and across the country.…”

Section: Discussionmentioning

confidence: 99%

Chicago Public School nurses examine barriers to school asthma care coordination

Pappalardo

Paulson

Bruscato

et al. 2018

Public Health Nursing

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Objective/Design: Well documented asthma disparities in Chicago pose a continual challenge for the Chicago Public Schools (CPS). Coordinated Healthcare for Complex Kids (CHECK) is a health care demonstration project funded by a Centers for Medicare and Medicaid Services Health Care Innovation Award. A collaborative partnership was formed between CHECK and CPS. With CHECK support, CPS administered a survey to 160 nurses to understand the asthma problems nurses perceived and interest in intervention. Results: Seventy-five per cent (n = 120) completed the survey. While asthma was the top diagnosis managed by 95%, 72% reported gaps in asthma understanding. Appropriate communication between school nurses and providers occurred 33% of the time; 18% believed they received sufficient support to follow-up on deficient paperwork. The barriers mentioned were lack of medications (73%), time (67%), and communication with providers (61%). When asked their opinions on potential interventions, 78% of nurses supported web-based applications, 66% community health workers (CHW), and 66% stock albuterol in schools. Conclusions: The greatest barriers for CPS nurses with asthma management are time and communication. Potential interventions such as web-based communication applications and CHW in schools were well received. K E Y W O R D S asthma, Centers for Medicare and Medicaid Services, community health worker, communitybased participatory research, health disparities, nurse, pediatric asthma, school-based asthma, schools, survey, vulnerable population

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“…We therefore speculate that schools are an important 'third space' for delivering interventions aimed at improving asthma control, and that any school-based intervention should address asthma knowledge, perceived peer pressure about inhaler use and the establishment of a regular ICS ± LABA preventer inhaler habit. Indeed, previous US studies suggest that targeting knowledge of asthma in schools reduces unscheduled primary care and hospital visits [20,21]. In one of these studies, Liptzin et al [20] recently reported the results of the 'Step-Up' Asthma programme, a multidisciplinary school-centred asthma program providing asthma counsellors as a bridge between subspecialty asthma care, primary care providers, school nurses and children with asthma.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, previous US studies suggest that targeting knowledge of asthma in schools reduces unscheduled primary care and hospital visits [20,21]. In one of these studies, Liptzin et al [20] recently reported the results of the 'Step-Up' Asthma programme, a multidisciplinary school-centred asthma program providing asthma counsellors as a bridge between subspecialty asthma care, primary care providers, school nurses and children with asthma. Although not a randomized control trial, in the 252 participants enrolled into the programme over 2 years, there were improvements in asthma knowledge scores, inhaler techniques and a sustained drop in exacerbations.…”

Section: Discussionmentioning

confidence: 99%

Asthma control in London secondary school children

Harris

Mosler

et al. 2017

Journal of Asthma

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Objective: The asthma control test (ACT) is a validated tool for assessing control in asthmatic children aged 12 years and older. Using the ACT, we sought to assess asthma control and knowledge in London secondary school children. Methods: Secondary schools in London, UK, participated in this study. Children with doctor-diagnosed asthma were invited to complete an online questionnaire that included the ACT and questions about asthma. Suboptimal asthma control was defined as an ACT score of ࣘ 19 out of a maximum score of 25. Data are summarised as median and interquartile range (IQR), and were analysed by either Mann-Whitney test, or chi-square test. A p value of < 0.05 was considered significant. Results: A total of 799 children completed the questionnaire; 689 (86.2%) were included for analysis. Suboptimal asthma control was reported by 49.6% of students. Over a third (42.4%) of students prescribed a short-acting β2-agonist inhaler felt uncomfortable using it at school, and 29.2% (n = 173) reported not using this inhaler when wheezy. 56.4% (n = 220) of those with regular inhaled corticosteroids did not take them as prescribed, and 41.7% did not know what this inhaler was for. Suboptimal control was associated with a greater proportion of students reporting that they were 'somewhat' , 'hardly' or 'not at all' comfortable using inhalers at school (52.7% vs 29.1%, p < 0.01) and outside school (22.8% vs. 14.8%, p < 0.01). Conclusions: Suboptimal asthma control and poor asthma knowledge are common in London schoolchildren.

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Developing, Implementing, and Evaluating a School-Centered Asthma Program: Step-Up Asthma Program

Cited by 33 publications

References 35 publications

A worldwide charter for all children with asthma

A worldwide charter for all children with asthma

Chicago Public School nurses examine barriers to school asthma care coordination

Asthma control in London secondary school children

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