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A Central Georgia asthma prevalence assessment of school-age children and compliance with Senate Bill 472Background: A common theme among the counties of the North Central Health District is the disparity between the number of asthma-related visits of African-American and white children ages 1-14 to the emergency department. In 2013, 858 children ages 1-14 in the district had emergency room visits related to asthma. The purpose of this study was to assess North Central Health District (NCHD) schools to determine the prevalence of self-reported asthma by parents and school age children and the adequacy of students’ access to maintenance inhalers at school, and to identify schools that qualify for Asthma Friendly School Recognition. Methods: The “Asthma School Policy Assessment” from the 2015 Georgia Asthma-Friendly Schools Toolkit and Recognition Guidance was used to assess policies and practices for addressing asthma with school staff, parents, and children within the NCHD schools. The Lead School Nurses in each of the 13 counties were contacted in the fall of 2015 via email to request their participation in the assessment. Each was sent a link via email to complete the consent and assessment online; Lead Nurses then sent the link to their team nurses. Data were analyzed using descriptive statistics. IRB approval was obtained from Mercer University. Results: The findings from the study indicate that 75% of the reporting schools have asthmatic students enrolled. The number of students with asthma ranged from 5 to 79 per school. However, only two reporting schools could identify a medication policy that allows children to possess and self-administer asthma medication. Furthermore, none of the schools reported having all five policies necessary to obtain Asthma Friendly School recognition. Conclusions: The results indicate a need for school health nurse training to ensure schools implement and adhere to policies to reduce asthma disparities among school age children as outlined in the 2015 Georgia Asthma-Friendly Schools Toolkit and Recognition Guidance.
A multisite evaluation of pediatric asthma-related treatment in accordance to the 2007 National Heart, Lung, and Blood Institute Expert Panel Report – 3 guidelinesBackground: To determine if Georgia-based healthcare providers who received continuing education on pediatric asthma as described by 2007 National Heart, Lung, and Blood Institute Expert Panel Report – 3 guidelines demonstrated improvements in asthma-related treatment. Methods: We used a multi-site, cross-sectional design. Data were collected via surveys administered to healthcare providers and via randomized medical chart abstractions. Chart abstraction occurred at 12 months prior to intervention (n = 149); one-month post-intervention (n = 208); and three months post-intervention (n = 123). Results: Substantial improvements were observed among the providers who used pre/post bronchodilator spirometry (5% at baseline, 12% at one month, and 19% at three months), and there was a significant increase in the number of patients being advised to improve conditions at home or school to avoid asthma triggers (9% at baseline, 43% at one month, and 37% at three months). However, prescription of preventive medications and patients being taught proper medication/spacer technique by providers decreased from baseline to three-months (69% vs 55% and 41% vs 27%, respectively). Providers’ self-reported barriers and patient load were consistently associated with poorer treatment outcomes. Healthcare providers who received continuing education on NHLBI - EPR 3 guidelines demonstrated an increase in spirometry use and in advising patients on improving home and school conditions. While these findings are useful, provider-reported barriers such as time, organizational, and insurance barriers prevent providers from effectively systematically incorporating all of the EPR 3 guidelines. Conclusions: Internal efforts to address clinical barriers combined with continued education may result in improvements in pediatric asthma-related treatment outcomes.