Impact of asthma intervention in two elementary school-based health centers in the Bronx, New York City

Mayris P. Webber, Anne Marie E. Hoxie, Michelle Odlum, Tosan Oruwariye, Yungtai Lo, David Appel

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

This study examines healthcare utilization over time in Bronx, New York schoolchildren with asthma who were previously identified via parent surveys in six elementary schools. Four of the schools have on-site school-based health centers (SBHCs), and two do not have on-site health services (control schools). At baseline, we reported an asthma prevalence of 20%, and high rates of emergency department (ED) use (46%) in the previous year. To determine if asthma morbidity (specifically, ED use, community provider use, and hospitalizations for asthma) could be reduced by incorporating an aggressive intervention at two schools with SBHCs, we prospectively followed children for up to 3 years. Parents were scheduled for interviews every 6 months, and were queried about their children's use of health services for asthma in the prior 6 months. In multivariate models, children in the two intervention SBHC schools were less likely to have visited a community provider for asthma (relative rate ratio, 0.52; 95% confidence interval (CI), 0.30-0.88) or an emergency department for asthma (odds ratio, 0.44; 95% CI, 0.14-1.38; P = 0.059) in the prior 6 months compared to children attending control schools. There was no difference in community provider use or emergency department use for asthma between children attending nonintervention SBHCs and control schools. However, school type did not affect asthma hospitalization rates, which declined in all groups. Our findings support the effectiveness of aggressive school-based asthma services provided by SBHCs to reduce asthma morbidity and complement community health services.

Original languageEnglish (US)
Pages (from-to)487-493
Number of pages7
JournalPediatric pulmonology
Volume40
Issue number6
DOIs
StatePublished - Dec 1 2005

Keywords

  • Asthma
  • Elementary schoolchildren
  • Healthcare
  • Inner city
  • Intervention
  • School-based health centers

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

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