Evaluating outcomes of children's asthma self-management education through sustainable community-university partnerships.

OBJECTIVE: To evaluate the outcomes of a children's asthma management education program delivered through a community-university partnership. DESIGN: Quasi-experimental pretest/posttest. SAMPLE: Convenience sample of 50 children with asthma, grades 2-5, and their parent/caregiver from nine elementary schools in New York State. MEASUREMENTS: Child Asthma Management Self-Efficacy Survey, Child Asthma Control Test© , Parent Asthma Knowledge Test. INTERVENTION: Nursing students certified as Open Airways for Schools facilitators administered the program once weekly for 5 weeks. Parent handouts were sent home after each session. Pre/posttests for all measures were completed prior to Open Airways and at completion. RESULTS: Improved asthma management self-efficacy (p < .001) and improved asthma control (p = .013) for children with asthma were noted. Parent asthma knowledge was high pre- and posttest with no significant change. Parental knowledge regarding inhaled corticosteroids was consistently low. CONCLUSIONS: Collaboration between universities and local school systems allows for mutually beneficial exchange of knowledge and resources to address the need for asthma self-management for children with asthma. Nursing students trained in asthma management develop expertise and provide sustainable resources for this education.

Preschool asthma: Examining environmental influences using geographic information systems.

OBJECTIVE: This study was conducted to explore if environmental factors co-occur in areas with high asthma rates in Head Start (HS) children. DESIGN: Descriptive. SAMPLE: Convenience sample of 56 children with asthma enrolled in HS, ages 3-5 years. MEASUREMENTS: Geographic Information Systems using ArcGIS 10.4 was used to geocode and map aggregated address data at the census tract level through vector map analysis. Location, race, economic status, pollution remediation sites, age of housing, and blood lead levels were assessed for areas with high asthma concentration. RESULTS: Most children with asthma resided in one census tract, which was 1% of the total service area. Fifty-six percent of housing was built before 1960 with only 10% after 1990, suggesting deteriorating conditions. Pollution remediation sites were found in the vicinity of asthma cases. Elevated lead levels were found in 22% of all HS children; specific values for the children with asthma were not available. CONCLUSION: Several co-occurring factors were identified. The need for proactive interventions to decrease asthma risk/poor asthma outcomes with HS is evident. GIS locates children with high susceptibility to asthma. This allows public health nurses to target interventions and educate and empower families about environmental exposures and asthma risk factors.

Barriers to Asthma Management as Identified by School Nurses.

Asthma rates are increasing in children. School nurses have opportunities to care for children with asthma but need to overcome barriers impacting their ability to manage asthma in the school setting. This study (a) assessed barriers present in the school setting, (b) determined the impact of barriers on performance of asthma management behaviors, and (c) determined the impact of barriers on importance ratings of asthma management behaviors, asthma self-efficacy, and asthma attitudes (N = 537). Results revealed 72% of the nurses reported at least one barrier. As numbers of barriers increased, performance of asthma management behaviors decreased. Significant relationships were found between specific asthma management behaviors and specific barriers. No significant relationships were found between barriers and asthma self-efficacy, asthma attitude, or importance ratings of asthma management behaviors. Removing barriers may allow the nurse to perform at greatest effectiveness, enhancing the positive outcomes that result from appropriate asthma management.

Using the Health Belief Model to Understand School Nurse Asthma Management.

Ten million children in the United States have asthma. Since children are in school about 6 hr a day, school nurses are positioned to intervene and influence asthma outcomes. A descriptive correlational study was designed to investigate performance of school nurses' asthma management behaviors in relationship to asthma knowledge, asthma attitude, asthma self-efficacy, and rating of importance of asthma management behaviors. Results indicated that asthma attitude, asthma self-efficacy, and rating of importance of asthma management behaviors were associated with performance of asthma management behaviors. The higher the rating of importance of asthma management behaviors, the more likely school nurses were to perform the behaviors (p < .05). Higher levels of asthma self-efficacy were associated with performance of asthma management behaviors, indicating the importance of strengthening school nurses' asthma self-efficacy in asthma management. By understanding factors influencing performance of asthma management behaviors by school nurses, interventions can be implemented to increase asthma management behaviors, leading to improved outcomes for students with asthma.