Asthma Case Finding in the Head Start and Early Head Start Populations

Undiagnosed or undertreated asthma places children at increased risk. Early detection and intervention are crucial to reduce the adverse outcomes associated with asthma. Children 0-4 years old  have the highest emergency room visits and hospitalization rates for asthma. After completing Human Subjects training, family advocates assisted parents/caregivers of children enrolled in Head Start and Early Head Start in the Family Enrichment Network, Johnson City, New York in completing questionnaires about asthma symptoms in their children (n=293). Frequencies were calculated for each item on the questionnaire. While 14% of the children were reported as having an asthma diagnosis, only two indicated asthma under control. For children with an asthma diagnosis, 95% had difficulty breathing; 90% had a cough that lasted more than one week; 93% used medicine for wheezing; 78% had trouble sleeping because of coughing; and 49% had been treated in an ER or hospital for breathing problems. For children without an asthma diagnosis, 31% had difficulty breathing; 37% had a cough that lasted more than one week; 17% used medicine for wheezing; 30% had trouble sleeping because of coughing; and 9% had been treated in an ER or hospital for breathing problems. These findings illustrate a high likelihood of undiagnosed as well as undertreated cases of asthma in Head Start and Early Head Start.  It is essential that the nurses and faculty/staff be able to identify and refer these children to health care for further evaluation and treatment, as well as reinforce management for this condition.