Paper
Wednesday, July 21, 2004
This presentation is part of : Evidence-Based Nursing with Children
Asthma Management of Adolescents in an Urban School Setting
Joan Edelstein, MSN, DrPH, RN1, Joyce Ycasas, MPH2, and Rana Cheng, MSW2. (1) Oakland Unified School District, Oakland, CA, USA, (2) Oakland Kicks Asthma, American Lung Association of the East Bay, Oakland, CA, USA
Learning Objective #1: Identify at least two evidence-based strategies for asthma management in adolescents in the school setting
Learning Objective #2: List at least three benefits of Open Airways for Schools curriculum as implemented in an urban school setting
Evidence Based Intervention: Open Airways for Schools is an educational program targeted for pediatric minority populations that has been shown to help students manage asthma, control asthma symptoms, and improve school attendance and performance. Oakland Kicks Asthma is a CDC funded grant to improve asthma outcomes in the adolescent population of a high risk urban setting through a combination of case management intervention in the school and in the home. Based on a pilot project, results of case management had demonstrated overall reduced frequency of symptoms, reduced school absences, and increase in self-management behaviors.

Population: One thousand nine hundred sixty three 6th and 9th graders were surveyed in eight middle and high schools in Oakland. Incidence of students with an asthma diagnosis ranged from 11.5-20.9%. The incidence of Emergency Room visits realted to asthma over the previous year among students with an asthma diagnosis ranged from 19.2-61.9%.

Strategy: A designated School Nurse, Asthma Specialist was funded to provide direct education for students and staff in the school setting. Relevant goals included changes in effectiveness and consistency in the Asthma Action Plan; implementation of policy related to asthma management in the schools; development of a standard of care for asthmatic students; and institutionalization of the position. Education included Open Airways for Schools to include student with asthma as well as students who had a family member/friend with asthma. School Based care was integrated with a Case Management Program including Case Management support for students and parents/guardians; three home visits; and at least three follow up phone calls.

Summary: Evidence based interventions in the school setting provide for an effective means to reach public health goals in the community and serve to reduce asthma morbidity in a high risk ethnically diverse urban population.

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Sigma Theta Tau International
July 21, 2004