Highest Level of Household Education is Associated with Asthma Action Plan Receipt in an Urban School-Based Cohort
Monday, March 5, 2018
South Hall A2 (Convention Center)
Margee Louisias, MD, MPH, Carter Petty, MA, Wanda Phipatanakul, MD MS FAAAAI

Previous studies have identified that most asthmatic children do not have written asthma action plans (AAPs), which serve as a self-directed tool of asthma management/communication between physicians and school nurses. We evaluated the predictors of AAPs in urban school-age asthmatic children.


School Inner-City Asthma Study is a NIH/NIAID prospective cohort evaluating school/classroom-specific environmental factors and asthma morbidity of urban asthmatic children 4-13 years. Baseline surveys were conducted of 351 enrolled students evaluating demographics, clinical symptoms and health care utilization. Logistic regression was used to determine the clinical and socioeconomic predictors of AAPs.


Among 351 enrolled asthmatic students, 37% denied AAP receipt. Compared to students with AAPs, students without AAPs had significantly lower proportion of: household educational level attained (72.8% vs 85.5% with at least GED/HS diploma, p=0.005); being on ICS (38.4% vs 65.2%, p=0.0001). Students without AAPs also had significantly higher proportion of: no routine asthma follow-up care (15.5% vs 3.5%, p= 0.001). A significantly higher proportion of students with AAPs reported seeing a specialist that prescribed their asthma medicines (8% vs 2.6%, p= 0.005). In the final multivariate logistic regression model, highest household educational level (OR 1.27, CI 1.04-1.55); being on ICS (OR 1.9, CI 1.07-3.38); and place of routine asthma care (OR 0.3, CI 0.09-0.94) were significant predictors of AAP receipt.


Highest household educational level attained, being on ICS and place of routine asthma care were significant predictors of AAP receipt, suggesting that sociodemographics and access to care are integral to outcomes in this inner-city school-based cohort.