Trends in asthma prevalence and agency policies to monitor asthmatic children enrolled in head start programs from 2009 to 2012 in Boston, Massachusetts

Objectives: To establish trends in childhood asthma diagnosis among the Head Start population in Boston, Massachusetts from 2009 to 2012 and describe Action for Community Development (ABCD) Head Start asthma policies. Methods: A trend study of 3,941 children using cross-sectional data from 2009-2010 and 2011-2012 was employed to examine asthma prevalence among children 0 to 5 years in Head Start (HS)/Early Head Start (EHS). Data was collected using Promis Cleverex V5.16 database. Prevalence from two school years was compared. A review of ABCD HS child health policies was also conducted. Results: In 2009-2010, 177 children (17% of enrolled) had asthma: 172 (17.8%) in HS and 53 (20.1%) in EHS. In 2011-2012, 548 children (18.6% of enrolled) had asthma: 522 (19%) in HS and 35 (13.9%) in EHS. Children with an asthma diagnosis are required to have an Asthma Action Plan from the child's physician updated annually and emergency medication on site. Teachers are trained in medication administration. Parents are offered training sessions from an asthma specialist. In addition, ABCD Head Start and Boston Healthy Homes and Schools Collaborative are implementing the EPA Indoor Air Quality Tools for Schools framework. Conclusion: Head Start children have higher rates of asthma than the national and the MA state average. In addition asthma rates are increasing among 3-5 year olds. Head Start programs in Boston have policies and practices in place to successfully monitor children with asthma. ABCD is implementing new programs to improve asthma management and prevent asthma attacks in Head Start children.