Received 7 April 2009; received in revised form 26 May 2009; accepted 27 May 2009. published online 17 July 2009.
Asthma is prevalent in school-age children and contributes to school absenteeism and limitation of activity. There is a sizable literature on school-based interventions for asthma that attempt to identify children with asthma and improve outcomes. The purpose of this review is to describe and discuss limitations of screening tools and school-based asthma interventions. Identification of children with asthma may be appropriate in schools located in districts with a high prevalence of children experiencing significant morbidity and a high prevalence of undiagnosed asthma, provided there is access to high-quality asthma care. We review strategies for improving access to care, for teaching self-management skills in schools, and for improving school personnel management skills. Although studies indicate that school-based programs have the potential to improve outcomes, competing priorities in the educational system present challenges to their implementation and emphasize the need for practical, targeted, and cost-effective strategies.
aNew York University Child Study Center, New York University School of Medicine, New York, NY
bDepartment of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY
Reprint requests: Meyer Kattan, MD, Columbia University Medical Center, 3959 Broadway, CHC 7-701, New York, NY 10032.
Disclosure of potential conflict of interest: M. Kattan has received research support from the National Institutes of Health. D. Evans has received research support from the National Institute of Environmental Health Sciences, the National Heart, Lung, and Blood Institute, and the Merck Childhood Asthma Network. J.-M. Bruzzese has declared that she has no conflict of interest.
ABSTRACT