Non-white children, especially Black and Hispanic children, are disproportionately affected by asthma prevalence and adverse asthma outcomes. One way that pediatric asthma is managed is through care by school nurses. However, children that are most affected by asthma disparities are more likely to attend schools with a higher demand for nursing care and fewer resources for treatment.
This study, published in the Journal of Pediatric Psychology, sought out possible interventions to improve treatment equity for children with asthma by interviewing school nurses about current barriers.
Despite an average of 28% of students having asthma, the nurses reported that only 12% of these students had asthma action plans, and only 15% had asthma medications at school. The nurses identified four key elements of asthma management that were missing from the students’ care: coordination of care, asthma education, access to care, and medication adherence.
The first point, coordination of care, was described by the nurses as the failure of parents, nurses, and doctors in sharing comprehensive communication. This poor communication could result in overlooked forms and missed medications. One solution proposed by the nurses was to have direct communication with doctors so that signatures and forms could be obtained directly.
The second point, asthma education, was emphasized by the nurses as the need for parents and their children to have a better understanding of the signs and triggers of an asthma attack. According to the nurses, most children did not know how to properly use their inhalers, which hindered their ability to manage their asthma.
The third point, access to care, was noted by the nurses as a major barrier. Many students were not receiving proper treatment due to a lack of transportation and a lack of financial means to cover the costs of care. If more resources were available at schools, the nurses explained, then these barriers could be lifted.
Finally, regarding the fourth point, medication adherence, the nurses noted that the lack of coordination of care, asthma education, and access to care all contributed to a lack of medication adherence among parents and their children.
Overall, this discussion highlighted the barriers faced by children with asthma while emphasizing the need for coordinated care and greater resources for treatment in schools. Along with structural change, improved coordination between physicians and school nurses could be one important step toward treatment equity for minority children with asthma .