School-Based Preventive Asthma Care Technology: A Trial Using a Novel Technology to Improve Adherence

School-Based Preventive Asthma Care Technology: A Randomized Control Trial Using a Novel Technology to Improve Adherence

The goal of this new translational project is to test the feasibility and effectiveness of implementing school-based directly observed therapy of preventive asthma medications in a real-world setting, using state-of-the-art web-based technology for systematic screening, electronic report generation, and communication between nurses, caregivers, and primary care providers. With the use of a novel method to improve adherence and subsequently reduce morbidity, the investigators hypothesize that this novel adaptation of school-based asthma care will; 1) be feasible and acceptable among this population and among school and community stakeholders, and 2) yield reduced asthma morbidity (symptom-free days, absenteeism, and emergency room / urgent care use for asthma care). The investigators anticipate that enhancing preventive healthcare for young urban children with asthma through partnerships with the schools using a novel technology will yield improved health, prevention of suffering, decreased absenteeism from school, and reduced healthcare costs.

Inclusion Criteria (all 4 criteria must be met):

1. Physician-diagnosed asthma (based on parent report).

2. Persistent asthma (criteria based on NHLBI guidelines). Any 1 of the following:

   1. An average of >2 days per week with asthma symptoms
   2. >2 days per week with rescue medication use
   3. >2 days per month with nighttime symptoms
   4. ≥2 episodes of asthma during the past year that have required systemic corticosteroids

3. Age ≥3 and ≤10 years.

4. Attending school in participating Rochester City School District preschools or elementary schools.

Exclusion Criteria:

1. Inability to speak and understand English. (*Parents unable to read will be eligible, and all instruments will be given verbally.)
2. No access to a working phone for follow-up surveys (either at the subject's home or an easily accessible alternate phone number).
3. Family planning to leave the school district within fewer than 6 months.
4. The child having other significant medical conditions, including congenital heart disease, cystic fibrosis, or other chronic lung disease, that could interfere with the assessment of asthma-related measures.
5. Children in foster care or other situations in which consent cannot be obtained from a guardian.