Implementation of evidence-based practices to improve asthma in an urban school system

Background: Springfield, MA is an urban center with 27.6% of the population below the poverty level. The Springfield Public Schools (SPS) nursing department reports a student asthma prevalence of 20%, which is almost double the statewide prevalence in Massachusetts. Children in Springfield also experience marked racial/ethnic asthma disparities, with hospitalization rates among Hispanic children almost 4 ½ times higher, and Black children almost double the asthma hospitalization rates of White children. The Pioneer Valley Asthma Coalition's work to improve asthma in the Springfield Public Schools has become a regional model to address high prevalence, poor symptom management and disparities in care. Purpose: This work is a case study that describes health education, promotion and systems change work to reduce asthma disparities through asthma management, asthma education and improved indoor air quality in an urban school district. Findings: Key elements of these successes include: 1. Multi-pronged approach to reduce asthma disparities; focused on asthma education, asthma management and indoor air quality. 2. Multi-sector collaboration between local schools, community organizations and health departments to leverage resources and identify best practices. 3. Increased capacity to address asthma through School Nurse Asthma Champions who improved the use of asthma action plans, facilitated communication with students, and coordinated asthma education. 4. Support from key changemakers, including the school physician, school nursing leadership and the Director of Facilities. Conclusion: Key findings for successful implementation were improved communication, increased infrastructure within the school nursing department, and connecting individuals with available resources.