539 - Managing Childhood Asthma at School: Current Practices, Challenges, and Improvements in Inhaler Accessibility

Poster Number: 539
Publication Number: 539.242

Devika Jaishankar, University of Chicago Division of the Biological Sciences The Pritzker School of Medicine, Chicago, IL, United States; Romy Portieles Pena, University of Chicago Division of the Biological Sciences The Pritzker School of Medicine, Chicago, IL, United States; Sumiko Maristany, University of Chicago Division of the Biological Sciences The Pritzker School of Medicine, CHICAGO, IL, United States; Monica E. Kowalczyk, University of Chicago Division of the Biological Sciences The Pritzker School of Medicine, Chicago, IL, United States; Anna Volerman, University of Chicago Division of the Biological Sciences The Pritzker School of Medicine, Chicago, IL, United States

Background: Asthma is the most common chronic disease of childhood, affecting up to 1 in 4 children in Black and Latinx communities in urban cities like Chicago. Although pediatric asthma can be managed in clinical settings, schools play an important role in supporting access to medications for children. Numerous barriers persist in school-based asthma care, especially in schools with high asthma burden, staff shortages, and restrictive policies on carrying inhalers.

Objective: This project aimed to understand perspectives from school stakeholders on current practices, challenges, and improvements in inhaler accessibility and asthma management at school.

Design/Methods: Qualitative data was collected through semi-structured, virtual interviews conducted over Zoom in 2020. Interviews took place with key staff involved with asthma care at two schools in predominantly Black and Latinx communities in Chicago. Questions focused broadly on school asthma care, with a subset analysis on medication accessibility. An iterative coding process using grounded theory methods and thematic content analysis was conducted by coding team members using NVivo software.

Results: Eight interviews were completed with school stakeholders including principals, nurses, counselors, case managers, and other support staff. Current practices related to asthma medication management were highlighted, such as inhaler storage and self-carry policies, documentation of asthma diagnoses and action plans, and establishment of 504 and IEP plans for school accommodations. Four themes also emerged regarding challenges: 1) lack of a point person for medication distribution and asthma management, 2) limited inhalers at school given expiration and cost issues, 3) poor access to primary care to obtain formal diagnoses and prescriptions, and 4) gaps in understanding about managing asthma symptoms. Recommendations to improve medication access included streamlined health forms, increased inhaler education, and better communication with healthcare providers.Conclusion(s): Schools are well-positioned to support pediatric asthma care, and school staff provide unique perspectives on day-to-day medication management. Restrictive policies on carrying inhalers, complex school health documents, and costly medications remain major obstacles to medication accessibility in schools. School asthma programs can strive to designate a point person to provide individualized guidance on asthma needs, connect families to primary care, and ensure easily retrievable medications, thereby improving medication access and overall academic and health outcomes for children with asthma.