Challenges of asthma management in school districts with high asthma hospitalization rates

Background: In 2003, a survey of 1,550 school nurses in NYS was conducted to learn about asthma management in an elementary school environment.

Purpose: To focus on school districts in Westchester County, NY with the highest asthma hospitalization rates among children ages 5-14 and compare the results with the state-wide results of 2003.

Significance: To gain an increased understanding of the challenges facing schools in areas with high rates of hospitalizations for elementary school-aged children.

Methods: School districts with the highest rates of asthma hospitalization among children 5-14 years were contacted for inclusion in the study. Within these, 56 elementary school nurses were contacted and 44 agreed to participate. School nurses completed a survey with 33 closed-ended questions, including many from the NYS survey and a short telephone interview with 12 open-ended questions.

Results: Responses from study nurses were compared to those of the NYS nurses. For example, NYS nurses were more likely to report lack of time and lack of funding for supplies as major challenges, while study nurses were more likely to emphasize poor communication with parents, poor parental support and lack of supplies from families. NYS nurses were most likely to find out that a student had asthma from parents or school records, while study nurse were more likely to find out from school records and when children manifested asthma symptoms.

Conclusion: Communication with parents, parental support and understanding about asthma appear to be major challenges for asthma management in this environment.