| Learning Objective #1: Describe the diverse nursing roles and partnerships utilized in the collaborative interdisciplinary approach to asthma management in children with asthma | |||
| Learning Objective #2: Evaluate treatment modalities for children with asthma at inner city schools in Dallas, Texas |
Asthma disproportionately affects poor and inner-city families and is a leading cause of chronic school absenteeism, negatively impacting the academic progress of students with asthma and potentially decreasing state funding to some school districts. The majority of students in the Dallas Independent School District (DISD) live in low socioeconomic areas of the inner city. Since 1994, the Baylor University Louise Herrington School of Nursing, the Baylor Asthma and Pulmonary Rehabilitation Center (BAPRC), and DISD have collaborated on studies that explore asthma treatment modalities. A pilot project conducted among 22 students in one school investigated the feasibility of delivering inhaled corticosteroids (ICS) in a school based setting. At the end of 14 weeks, the students who received ICS at school experienced a 15% improvement in peak flow rates and a 66% decrease in inhaled bronchodilator use compared to students in a control group who received the community standard of care. Fifty students in eight schools participated in an expanded study. Students receiving school-based ICS therapy had a 92% attendance rate, compared to an 86% attendance rate for students receiving home-based ICS therapy, and a 78% attendance rate for the control group. A third study investigating ICS therapy began in fall 2002 with the development of screening tools to identify at-risk students. Interdisciplinary teams further evaluated children for persistent asthma. Beginning in February 2003 an estimated 200 subjects in 20 schools will be randomized into one of four treatment arms comparing home-based and school-based therapy. Outcome measurements include school absences, frequency of bronchodilator use at home and school, doctor and emergency room visits, hospitalizations, and student’s reports of asthma symptoms.
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