Asthma 411: A school health improvement strategy

Among chronic illnesses, asthma is the leading cause of school absenteeism, accounting for over 14 million lost school days annually. The Asthma 411 Initiative, part of the Controlling Asthma in St. Louis grant funded by the CDC, was created to help control and reduce the effects of asthma on school absences and academic achievement of children with asthma. Asthma 411 is currently being implemented in 5 school districts (94 schools) in St. Louis, MO, reaching a student population of 37,559, of which 12% have asthma. It emphasizes the use of a Consulting Physician – School Nurse model which includes a variety of strategies, but most importantly, the use of standing orders written by the physician. Evaluation results support the effectiveness of this model. Schools in their third year of adoption have seen a 14% reduction in 911 calls due to asthma. The number of children sent home due to illness has been cut in half by the third year of participation, and children sent home due to asthma has decreased from 7.0% to 5.1% (first and third years respectively). Initial analysis in one school district shows a reduction in the absence rate for students with asthma from 10.4 missed days to 9.7 missed days (p =.02). Asthma Action Plans also increased 8% by the third year of adoption. Based on preliminary analysis, adoption of the Consulting Physician model may be a useful method of reducing the effects of asthma, and potentially decreasing or offsetting overall costs to a school district.