Asthma Research into Action
What Do Schools, Children with Asthma, and Parents Who Smoke Have in Common? An NIH-Supported Study in Rochester, NY
Jill S. Halterman, M.D., M.P.H., Associate Division Chief and Director of the Health Services Research Division of General Pediatrics, University of Rochester School of Medicine and Dentistry is no stranger to the Rochester City (NY) School District's 60 elementary schools and preschools.
Jill S. Halterman, M.D., M.P.H.
Since the early 2000s, Dr. Halterman and several colleagues have been studying whether providing a diverse group of urban children their provider-prescribed daily anti-inflammatory asthma medications in school (through school nurses/aides) helps reduce their symptoms and their risk of asthma attacks.
“We wondered if partnering with schools and having them administer the medications daily would help,” said Dr. Halterman. “We found that it helped only those school children who were not exposed to smoke in the home.”
The number of children exposed to smoke in Rochester’s urban homes is eye-opening. Dr. Halterman reports that approximately half of the study’s participants were exposed to tobacco smoke in the home.
The finding that these smoke-exposed children were not benefiting from the school-based program triggered the launch of a follow-up study, School-based Asthma Therapy: Stage 2 Effectiveness Study (SBAT), in August 2006. Sponsored by the University of Rochester in collaboration with the National Heart, Lung, and Blood Institute and the Halcyon Hill Foundation, the second study enrolled 530 participants ages 3–10, and had the following two-pronged approach:
- Administration of daily anti-inflammatory asthma medication at school
- A environmental tobacco smoke reduction program in the home (counseling using motivational interviewing was conducted by trained nurses who made one home visit and two follow-up calls)
“The enhanced intervention had an effect for both groups,” said Dr. Halterman. “During peak winter season, children receiving preventive medications through school had significantly more symptom-free days, used rescue medications less, and had fewer days with limited activity compared to the usual-care group. In addition, children in the intervention group were less likely to have an asthma attack.”
Researchers are currently investigating a “novel, Web-based technology,” according to Halterman, as part of a method to disseminate and sustain the program, and ultimately help children in other cities and urban settings breathe more easily.
Last Updated December 2010