NIH Grant Takes Successful School-Based Asthma Program to Next Level

Telehealth assistant with boy

Adam Sternberg, a telehealth assistant at the University of Rochester Medical Center, examines Dante Dickinson Lott, an RCSD School 43 student who has asthma.

A new $3.6 million NIH grant will help pediatric researchers at Golisano Children’s Hospital at the University of Rochester Medical Center (URMC) connect their Rochester City School-based asthma management program to doctors’ offices. This new program builds off a long-standing URMC collaboration with the city schools to improve asthma care, as well as Rochester’s successful school district-wide telemedicine program.

“We hope that by adding telemedicine visits for systematic asthma assessments, we will be able to improve asthma symptoms even more than with our previous work,” said Jill Halterman, M.D., M.P.H., principal investigator of the study and associate chair of Clinical Research in the Department of Pediatrics at URMC. “And because we are building off two existing – and successful – programs, it has the potential to become a sustainable model other communities can use to improve care for children with chronic illnesses.”

Almost 7 million children in the U.S. have asthma. That’s more than 9 percent of children in the U.S., and as in many urban areas with high concentrations of poverty, the city of Rochester’s rate is more than 10 percent. Among U.S. children ages 5 to 17, the Centers for Disease Control and Prevention name asthma as the leading cause of school absences from a chronic illness, accounting for 14 million missed school days per year and more hospitalizations than any other childhood disease. Unfortunately, many children with asthma do not receive optimal preventive treatment, and suffer from illness that may be preventable.

“If this model of preventive care is successful and sustainable, we’d be able to make a huge impact on the health and, by extension, the educational experience, for high-risk children with asthma,” Halterman said.

The School-Based Asthma Therapy trial that the University of Rochester launched in 2006 partnered with the Rochester City School District and school nurses to provide preventive asthma medications in school to children with persistent asthma. This ensures that these children get the medicine that they need and are taking it properly, in order to avoid asthma symptoms. The trial improved children’s symptoms, reduced absences due to asthma, and reduced the need for urgent visits. The pediatric telemedicine program uses specialized equipment and trained health care assistants to gather health information and sends this information, through the internet, to a health care provider. Telemedicine has expanded to include every school in the Rochester City School District and has shown a 63 percent reduction in absences due to illness. It allows children who are in school and ill to be seen by a provider who can often diagnose and begin treatment for common childhood illnesses — without the child ever leaving school or the parent leaving work.

This new trial, which started enrolling students in the fall, will allow children with asthma in the intervention group to not only continue to receive their preventive treatments at school, but it will also connect them with their health care provider through the telemedicine program. Ongoing contact with a health care provider will help ensure that guideline-based asthma medications are prescribed and adjusted as needed in follow-up visits. The control group will receive their usual asthma treatment from their health care provider.

“We hope this will streamline care for children with this common disease and improve their symptoms. Further, if it is successful, this model of care could be implemented in other communities around the country,” Halterman said.

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