Improving care for urban children with asthma: design and methods of the School-Based Asthma Therapy (SBAT) trial.
The School Based Asthma Therapy (SBAT) trial builds on a pilot study in which we found that school-based administration of preventive asthma medications for inner-city children reduced asthma symptoms. However, the beneficial effects of this program were seen only among children not exposed to environmental tobacco smoke (ETS). The current study is designed to establish whether this intervention can be enhanced by more stringent adherence to asthma guidelines through the addition of symptom-based medication dose adjustments, and whether smoke-exposed children benefit from the intervention when it is combined with an ETS reduction program. The intervention consists of both administration of preventive asthma medications in school (with dose adjustments according to NHLBI guidelines) and a home-based ETS reduction program utilizing motivational interviewing principles. This paper describes the methodology, conceptual framework, and lessons learned from the SBAT trial. Results of this study will help to determine whether this type of comprehensive school-based program can serve as a model to improve care for urban children and reduce disparities.
Halterman
Jill S
JS
Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Golisano Children's Hospital at Strong, Rochester, New York 14642, USA. jill halterman@urmc.rochester.edu
Borrelli
Belinda
B
Fisher
Susan
S
Szilagyi
Peter
P
Yoos
Lorrie
L
D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D012107:Research Design; D012572:School Health Services; D012574:Schools; D014028:Tobacco Smoke Pollution; D014505:Urban Population
D018927:Anti-Asthmatic Agents; D014028:Tobacco Smoke Pollution