A Randomized Controlled Trial of a Public Health Nurse-Delivered Asthma Program to Elementary Schools

Authors

  • Lisa Cicutto RN, PhD, CAE,

    Corresponding author
    1. Professor, Director, (cicuttol@njhealth.org), Community Outreach and Research, National Jewish Health and Director, Clinical Science Program, University of Colorado Denver-Anschutz Medical Campus, 1400 Jackson Street, G08a, Denver, CO 80209.
    • Address correspondence to: Lisa Cicutto, Professor, Director, (cicuttol@njhealth.org) Community Outreach and Research, National Jewish Health and Director, Clinical Science Program, University of Colorado Denver-Anschutz Medical Campus, 1400 Jackson Street, G08a, Denver, CO 80209.

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  • Teresa To PhD,

    1. Senior Scientist, (teresa.to@sickkids.ca), Research Institute, Hospital for Sick Children and Professor, University of Toronto, 555 University Avenue, Toronto, ON, Canada.
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  • Suzanne Murphy RN, CRE

    1. Asthma Education Program Coordinator, (Suzanne.Murphy@trilliumhealthpartners.ca), Cardiopulmonary Department, Trillium Health Partners, Credit Valley Hospital Site, 2200 Eglinton Avenue West, Mississauga, ON L5M 2N1, Canada.
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  • This project was funded by the Ontario Ministry of Health and Long Term Care.

ABSTRACT

BACKGROUND

Childhood asthma is a serious and common chronic disease that requires the attention of nurses and other school personnel. Schools are often the first setting that children take the lead in managing their asthma. Often, children are ill prepared for this role. Our study evaluated a school-based, multifaceted asthma program that targeted students with asthma and the broader school community.

METHODS

A randomized trial involving 130 schools with grades 1-5 and 1316 children with asthma and their families was conducted. Outcomes of interest for the child, at 1 year, were urgent care use and school absenteeism for asthma, inhaler technique, and quality of life, and for the school, at 14 months, were indicators of a supportive school environment.

RESULTS

Improvements were observed at the child and school level for the intervention group. Fewer children in the intervention group had a school absence (50% vs 60%; p < .01), required urgent care for asthma (41% vs 51%; p < .0001), or reported a day of interrupted activity (51% vs 63%; p < .01), and had improved quality of life (5.8 ± 1.2 vs 5.4 ± 1.4; p < .0001). Schools in the intervention group were more likely to have practices supporting an asthma-friendly environment.

CONCLUSIONS

Implementation of a multifaceted school-based asthma program can lead to asthma-friendly schools that support children with asthma to be successful managers of their asthma and experience improved quality of life and decreased disease associated burden.

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