School-based asthma management program in inner-city New Orleans: Outcomes

Abstract

Rationale To decrease morbidity among inner-city schoolchildren who have persistent asthma. Methods One hundred six mild to moderate-persistent inner-city asthmatic schoolchildren received asthma education and nurse-case management November 2001-February 2002. Base-line assessment included demographic information, health history, quality-of-life, and asthma knowledge. ER visits, hospitalizations, school absences and parental work absences, unscheduled office visits, and nights awakened due to asthma symptoms were tracked monthly for 5 months. Data analysis performed using SAS compared follow-up outcomes to base-line data. Chi square for categorical data and t-tests for continuous data were performed. Results The mean age in this group was 10 years; 42.4% female, 48.5% male; 30% of mothers had some college education; and 58% of the sample size had insurance. The ratio of steroid to short acting beta agonist improved from 1:4 to 1:2 (50% steroid use, p<.005). Significant increases in asthma knowledge, use of asthma tools, and knowledge of asthma medication occurred during the intervention. Three months after the intervention significant reductions in ER visits (p<0.0009), hospitalizations (p<0.02), urgent care visits (p<0.0038), missed school days (p<0.001), missed work days (p<0.03), and nights awakened due to asthma symptoms (p<0.00003) were recorded. Conclusions A School-Based Asthma Management Program that utilizes asthma education and nurse case management significantly reduces asthma morbidity in inner-city minority schoolchildren. School environments provide an appropriate setting for evidence-based medical interventions for chronic pediatric disorders.