title: Working toward a sustainable system of asthma care: development of the School-Based Preventive Asthma Care Technology (SB-PACT) trial.
abstract: OBJECTIVE
  We previously conducted the School-Based Asthma Therapy trial to improve adherence to national asthma guidelines for urban children through directly observed administration of preventive asthma medications in school. The trial successfully improved outcomes among these children; however, several factors limit its potential for dissemination. To enhance sustainability, we subsequently developed a new model of care using web-based guides for efficient communications and integration within school and community systems. This article describes the development of the School-Based Preventive Asthma Care Technology (SB-PACT) trial.
  
  
  METHODS
  We developed the SB-PACT web-based system based on stakeholder feedback, and conducted a pilot randomized trial with 100 children to establish its feasibility in facilitating preventive asthma care for high-risk children. The SB-PACT system represents a new model of care using web-based guides for asthma symptom screening, follow-up control assessments, and electronic communications with providers.
  
  
  RESULTS
  We enrolled and successfully screened all children using the web-based system. Most providers used the electronic communication system without difficulty, and the majority of children in the intervention group received preventive medications through school as planned and dose adjustments as needed. Several challenges to implementation also were encountered.
  
  
  CONCLUSIONS
  This program is designed to promote sustainability of school-based asthma care, reduce program costs, and ultimately succeed in a real-world setting. With further refinements, it has the potential to be implemented nationally in schools.
authors.affiliation: Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. jill_halterman@urmc.rochester.edu
authors.forename: Jill S
authors.initials: JS
authors.lastname: Halterman
authors.forename: Joseph
authors.initials: J
authors.lastname: Sauer
authors.forename: Maria
authors.initials: M
authors.lastname: Fagnano
authors.forename: Guillermo
authors.initials: G
authors.lastname: Montes
authors.forename: Susan
authors.initials: S
authors.lastname: Fisher
authors.forename: Paul
authors.initials: P
authors.lastname: Tremblay
authors.forename: Reynaldo
authors.initials: R
authors.lastname: Tajon
authors.forename: Arlene
authors.initials: A
authors.lastname: Butz
mesh_terms: D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003142:Communication; D055695:Electronic Prescribing; D005260:Female; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D020407:Internet; D008297:Male; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D012572:School Health Services / Q000458:organization & administration*; D014505:Urban Population
chemical_list: D018927:Anti-Asthmatic Agents