"In inner-city areas such as Los Angeles, asthma is both underdiagnosed and undertreated in school-age children. Children with undiagnosed or poorly controlled asthma often cannot sleep through the night because of trouble breathing, and when their asthma flares up, they are more likely to have to go to the emergency department or hospital, miss school, and not participate in normal activities," said lead researcher Craig A. Jones, MD, FCCP, Los Angeles County and University of Southern California Medical Center, Los Angeles, CA. "With the Breathmobile Program's new asthma case identification process, we have been able to identify thousands of children with asthma at their school sites and offer free evaluation and ongoing asthma treatment."
Researchers from the Los Angeles County and University of Southern California Medical Center and the Southern California Chapter of the Asthma and Allergy Foundation of America examined the scalability of a customized survey designed to identify the prevalence of asthma in children in a large urban population. The bilingual (English and Spanish), seven-question survey addresses 11 elements regarding a child's respiratory health, ultimately classifying a child as having or not having asthma and indicating the degree to which asthma is managed. The previously validated survey was administered in 24 Los Angeles-area elementary and middle schools using a process that relies on the classroom teacher's independent distribution and collection of the surveys. As an incentive, teachers in 13 of the schools were offered a $25 school supplies gift certificate for a survey return rate of at least 80 percent. Researchers used a complete and an abbreviated scoring method to analyze 4,110 surveys collected from 210 classrooms that had a survey return rate of at least 80 percent. The survey and scoring method correctly identified 86.5 percent of all children known to have asthma and 83.6 percent of those children without asthma. The complete scoring method estimated the prevalence of known asthma to be 6.1 percent and an overall prevalence of 14.1 percent. The abbreviated scoring method estimated overall asthma prevalence as 12.2 percent. In regards to survey return rates, researchers found that incentives increased survey return rates from 35.3 percent to 65 percent. In addition, the percentage of classroom return rates increased from 9.3 percent to 27.5 percent.
"The impact of asthma on inner-city children is quite severe, particularly among those in lower socioeconomic groups and ethnic minorities," said Richard S. Irwin, MD, FCCP, President of the American College of Chest Physicians. "Through comprehensive and reliable asthma identification methods, we can begin to understand the prevalence and severity of asthma in underserved children and work to ensure our young patients receive optimal asthma management."
CHEST is a peer-reviewed journal published by the ACCP. It is available online each month at www.chestjournal.org. ACCP represents more than 15,700 members who provide clinical, respiratory, and cardiothoracic patient care in the United States and throughout the world. ACCP's mission is to promote the prevention and treatment of diseases of the chest through leadership, education, research, and communication.