Asthma management in NYC schools: A teacher perspective

Background: Schools are an important environment for asthma management. Classroom teachers can be facilitators of school asthma management. Purpose: To assess problems with school asthma management based on a teacher perspective. Methodology: Qualitative interviews with 21 classroom teachers from 10 Bronx, NY elementary schools. Interviews were recorded, transcribed and independently coded for common themes. Results: Several problems with school asthma management were identified. Schools have a mechanism to identify students with asthma, called “emergency contact card”. However, teachers identified students with asthma through this mechanism only some of the time. More often teachers learned that a student had asthma through informal conversations with the student/parent or when students had asthma symptoms at school. Although there is a Department of Education policy on managing asthma in schools, none of the teachers were aware of it. Most teachers had a personal experience with asthma; however, they did not know how to handle an asthma attack or felt anxious if it were to occur in their classroom. Many mentioned failure of parent-school communication; parents often failed to submit a physician-completed form to allow administration of asthma medication during school or did not disclose child's asthma diagnosis. Conclusions: We found several problems that may contribute to inadequate school asthma management: poor school-teacher and parent-school communication about student asthma diagnosis; lack of teacher education about asthma school policies; and lack of comfort managing students' asthma. Interventions that include school staff education and reinforcing the implementation of existing policies may improve asthma management in inner-city schools.