Establishing Early Asthma Control in Brooklyn Preschool Children

Abstract

RationaleHead Start and other subsidized preschool childcare programs are heavily impacted by asthma. High asthma morbidity rates among low-income minority children in central Brooklyn may reflect poor asthma management. Asthma education and early use of inhaled corticosteroids (ICS) has been shown to improve control in children with persistent asthma by reducing symptom burden, exacerbations, and rescue medication use.MethodsTwenty Head Start and preschool centers in central Brooklyn with high asthma prevalence were selected. The study was conducted from August 2006-June 2007 with 2052 enrolled children ranging in age from 2.9-5 years old. A Brief Respiratory Questionnaire (BRQ), a bilingual, 13-item survey was used as a validated screening tool to quantify asthma risk. If the BRQ identified a child with “probable asthma”, the parents received an Asthma Action Plan (AAP) to be completed by a physician if asthma was confirmed. A child was started on an ICS if a diagnosis of persistent asthma was made.ResultsA total of 1500 (73%) BRQs from 15 participating sites were received and 272 (18%) children screened positive for “probable asthma“. Of these children, 157 (58%) were confirmed asthmatics by the completed AAPs and data from 8 centers revealed 40 (43%) children were subsequently started on ICS.ConclusionSuccessful screening and identification of asthma in high-risk inner-city preschool children can lead to early management with ICS and improved asthma care in central Brooklyn. RationaleHead Start and other subsidized preschool childcare programs are heavily impacted by asthma. High asthma morbidity rates among low-income minority children in central Brooklyn may reflect poor asthma management. Asthma education and early use of inhaled corticosteroids (ICS) has been shown to improve control in children with persistent asthma by reducing symptom burden, exacerbations, and rescue medication use. Head Start and other subsidized preschool childcare programs are heavily impacted by asthma. High asthma morbidity rates among low-income minority children in central Brooklyn may reflect poor asthma management. Asthma education and early use of inhaled corticosteroids (ICS) has been shown to improve control in children with persistent asthma by reducing symptom burden, exacerbations, and rescue medication use. MethodsTwenty Head Start and preschool centers in central Brooklyn with high asthma prevalence were selected. The study was conducted from August 2006-June 2007 with 2052 enrolled children ranging in age from 2.9-5 years old. A Brief Respiratory Questionnaire (BRQ), a bilingual, 13-item survey was used as a validated screening tool to quantify asthma risk. If the BRQ identified a child with “probable asthma”, the parents received an Asthma Action Plan (AAP) to be completed by a physician if asthma was confirmed. A child was started on an ICS if a diagnosis of persistent asthma was made. Twenty Head Start and preschool centers in central Brooklyn with high asthma prevalence were selected. The study was conducted from August 2006-June 2007 with 2052 enrolled children ranging in age from 2.9-5 years old. A Brief Respiratory Questionnaire (BRQ), a bilingual, 13-item survey was used as a validated screening tool to quantify asthma risk. If the BRQ identified a child with “probable asthma”, the parents received an Asthma Action Plan (AAP) to be completed by a physician if asthma was confirmed. A child was started on an ICS if a diagnosis of persistent asthma was made. ResultsA total of 1500 (73%) BRQs from 15 participating sites were received and 272 (18%) children screened positive for “probable asthma“. Of these children, 157 (58%) were confirmed asthmatics by the completed AAPs and data from 8 centers revealed 40 (43%) children were subsequently started on ICS. A total of 1500 (73%) BRQs from 15 participating sites were received and 272 (18%) children screened positive for “probable asthma“. Of these children, 157 (58%) were confirmed asthmatics by the completed AAPs and data from 8 centers revealed 40 (43%) children were subsequently started on ICS. ConclusionSuccessful screening and identification of asthma in high-risk inner-city preschool children can lead to early management with ICS and improved asthma care in central Brooklyn. Successful screening and identification of asthma in high-risk inner-city preschool children can lead to early management with ICS and improved asthma care in central Brooklyn.