A Pilot Study to Improve Preventive Asthma Care for Urban Adolescents

A Pilot Study to Improve Preventive Asthma Care for Urban Adolescents

The goal of this pilot study is to implement directly observed therapy with preventive asthma medications through a partnership with the school nurse (with input and direction from the primary care provider) to assure that the teen receives guideline based preventive medications, and provide a motivational interviewing intervention to help the teen transition to independence with their medical treatment plan. We hypothesize that this community-based pilot intervention will; 1) be feasible and acceptable among this population and among school personnel, and 2) yield reduced asthma morbidity (symptom-free days, absenteeism, and emergency room / urgent care use for asthma care). We anticipate that enhancing preventive healthcare for urban teens with asthma through partnerships with schools will yield improved health, prevention of suffering, decreased absenteeism from school, and reduced healthcare costs. This new method of preventive care delivery could be sustained within the school nursing system, and could be implemented in schools nationwide. Further, it could be applied to other chronic illnesses affecting disadvantaged populations.

Inclusion Criteria:

• Physician-diagnosed asthma
• Persistent asthma (criteria based on NHLBI guidelines).
• Age >12 and <15 years.
• Attending school in the Rochester City School District.
• Signed physician permission to enroll the child.
• Current prescription of a daily preventive asthma medication
• Parent or caregiver and the adolescent must consent to the intervention.

Exclusion Criteria:

• Inability to speak and understand English.
• No access to a working phone for follow-up surveys
• The family planning to leave the school district within fewer than 6 months.
• The teen having other significant medical conditions
• The teen having a diagnosed developmental condition per parent report.
• Adolescents in foster care or other situations in which consent cannot be obtained from a guardian.
• Adolescents that were previously enrolled in our School-Based Asthma Study