Community-based strategy for improving asthma management and outcomes for preschoolers

Rationale: Asthma begins at ages 3-5, and programs offered through the child care setting may be effective at promoting asthma awareness, education, and improved management. Methods: 27 daycare centers in NYC participated in an asthma program, including staff training in recognizing symptoms, family education, and asthma awareness games for children. Parents were asked about their child's asthma or symptoms. Those reporting asthma were invited to participate in the program, including 2-3 educational sessions covering asthma basics, medications, and triggers, bilingual educational video, and asthma-related activities for children. At the end of the school year we assessed outcomes. Results: 73% of the parents (n=1781) completed a screener. 397 (22%) reported an asthma diagnosis and recent symptoms, and 224 (13%) reported symptoms only. 286 (46%) participated in the educational workshops and video presentations. Participating parents had significantly improved asthma management at follow-up: 50% reported receipt of an asthma action plan (8% among non-participants), 91% found it easier to talk to their doctor (59% among non-participants), and 85% had increased confidence managing their child's asthma (9% among non-participants). 41% of participating parents took steps to reduce triggers (6% among non-participants). 32% reported a reduction in their child's daytime symptom frequency and 30% reported reduced nighttime symptom frequency. Conclusions: Early childhood education programs are effective at implementing a center-based asthma screening and education program which can significantly improve asthma outcomes for young children.