Asthma disparities are well documented in Chicago. Chicago Public Schools (CPS) is the 4th largest school district in the country and serves predominantly minority children.
Coordinated Healthcare for Complex Kids (CHECK) is large health care demonstration project funded by a Centers for Medicare and Medicaid Services Health Care Innovation Award. A collaborative partnership was formed between medical directors in CHECK and CPS nurse administration to address asthma disparities. With CHECK support, CPS administered a survey in December 2016 to 160 school nurses in order to understand the asthma problems nurses perceived and their interest in intervention options. Data included Likert scale questions and open-ended queries. Analyses were conducted using SAS 9.4.
Seventy–five percent of nurses completed the survey. While asthma was a top diagnosis managed by 95% of respondents, 72% felt gaps existed in their understanding of asthma. Appropriate communication between school nurses and providers was reported 33% of the time; 18% of nurses believed that they receive the support needed to follow-up on deficient paperwork. In open-ended responses, the most common barriers mentioned were lack of medications (73%), time (67%), and communication (61%). When asked their opinions on a variety of interventions, 78% of nurses supported a web-based application, 66% supported community health workers, 66% supported stock albuterol policy for schools, and 61% supported directly observed therapy.
The greatest barriers for CPS school nurses with asthma management are time and communication. Potential interventions such as web-based communication applications and community health workers involvement in schools were well received.