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Asthma 411: A school health improvement strategy

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Presentation on theme: "Asthma 411: A school health improvement strategy"— Presentation transcript:

1 Asthma 411: A school health improvement strategy
Colleen M. Richmond, RN, BSN, MPH Emily V. Pike, MPH Angela Hobson, MPH Jamie Kleiss, MPH Jamie Wottowa, MPH Kristin D. Wilson, MHA David A. Sterling, PhD, CIH

2 Quick Asthma Facts In 2004, asthma prevalence among children was 9.1% in the St. Louis region, compared to 8.0% for all children in Missouri ( In St. Louis, MO, one in eleven children under the age of 18 lives with asthma, but some area schools report as many as one out of every five children has asthma ( National data shows children with asthma miss on average 2.5 days of school/year MORE than children without asthma (Wang, et al, 2005).

3 Introduction Controlling Asthma in Saint Louis – (CASL)
One of seven CDC sites for the “Controlling Asthma in American Cities Project” Collaboration among: Saint Louis Regional Asthma Consortium Washington University Saint Louis College of Pharmacy Midtown Catholic Family Services Saint Louis University Five CASL Components Community Asthma Program (CAP) Pharmacy (Asthma Friendly Pharmacies) Community Outreach Schools (Asthma 411); A Consulting Physician-School Nurse Model Evaluation of Institutionalization

4 Asthma 411 Five urban school districts (93 schools) in St. Louis, MO area Total student population ~ 49,000 5-18% of population with asthma (nurse reported) 80% qualify for free and reduced lunches Reduced = 185% of poverty line family of 4: $37K/year Free = 130% of poverty line family of 4: $26K/year Transient population

5 Asthma 411 - Objectives Decrease absences due to asthma
Decrease number of children with asthma sent home Increase number of physician written Asthma Action Plans (AAPs) on file

6 Asthma 411 Conceptual Framework
External Support Primary Care Physicians (PCP) Parents/Guardians Community/Other Care Communication Evaluation and Education Internal Support Administrative Support ITS assistance Teacher Support/Curriculum SCHOOL NURSE Case identification Asthma Action Plans Absence and office visit tracking Use of standing orders Establish relationship with PCPs CONSULTING PHYSICIAN Provision of standing orders Policy review/revision Consultations External Support Primary Care Physicians (PCP) Parents/Guardians Community/Other CONSULTING PHYSICIAN Provision of standing orders Policy review/revision Consultations Education SCHOOL NURSE Case identification Asthma Action Plans Absence and office visit tracking Use of standing orders Establish relationship with PCPs Internal Support Administrative Support ITS assistance Teacher Support/Curriculum

7 Key Indicators Identification of students with asthma
Children sent home due to asthma Physician written AAPs 911 Calls Absences due to asthma

8 Results Identification of Students with Asthma
Statistically significant increase from 1st year to 2nd and 3rd years of participation Year 1 to Year 2: 8.7 to 9.6% (p = ) Year 2 to Year 3: 9.6 to 12.7% (p < )

9 Results Children Sent Home due to Asthma
Statistically significant decrease as years of participation increase Year 1 to Year 2 7.0 to 5.7% of children sent home due to asthma (p = ) Year 2 to Year 3 5.7 to 4.7% of children sent home due to asthma (p = 0.015)

10 Results Asthma Action Plans
Statistically significant increase between 1st and 3rd years of participation Year 1 to Year 3 21.7 to 28.8% of student with asthma have an AAP (p = )

11 Results 911 Calls due to Asthma
Statistically significant decrease in % of 911 calls due to asthma as year of participation increase Year 1 to Year 3 25.5 to 7.7%: (p = 0.02)

12 Results Absenteeism (Absences due to Asthma)
Statistically significant decrease in absences due to asthma in one school district From 10.4 to 9.74 absence days/year for children with asthma (p = .02) Calculates to a savings of over 600 school days/year

13 Conclusion The longer a district implements Asthma 411, the greater the improvement in asthma management. The decrease in children sent home and the reduction in absences may have an impact on state education reimbursement to the district because students in Asthma 411 schools remain in the classroom. The decrease in children sent home increases student time in the classroom which in turn effects academic achievement. Asthma 411 is an innovative program school districts can adopt which can have a significant impact on absenteeism and other health indicators related to asthma and illness. The results of this program provide evidence which supports CDC’s Strategies for Addressing Asthma within a Coordinated School Health Program.

14 richmocm@slu.edu Acknowledgements:
Asthma 411 is funded by: Centers for Disease Control and Prevention, US Department of Health and Human Services, under Cooperative Agreement U59/CCU723263

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