title: Identifying barriers to chronic disease reporting in Chicago Public Schools: a mixed-methods approach.
abstract: BACKGROUND
  Chronic disease among school-aged children is a public health concern, particularly for asthma and food allergy. In Chicago Public Schools (CPS), rates of asthma and food allergy among students are underreported. The aim of this study was to determine the barriers to chronic disease reporting as experienced by CPS parents and school nurses.
  
  
  METHODS
  A mixed-methods approach included focus groups and key informant interviews with parents and school nurses, and a cross-sectional survey was completed by parents. Qualitative data analysis was performed and survey data were analyzed to determine the significant demographic and knowledge variables associated with successfully completing the reporting process.
  
  
  RESULTS
  The three main barriers identified were 1) a lack of parental process knowledge; 2) limited communication from schools; and 3) insufficient availability of school nurses. Parents were significantly more likely to successfully complete the reporting process if they knew about special accommodations for chronic diseases, understood the need for physician verification, and/or knew the school nurse.
  
  
  CONCLUSIONS
  These findings suggest that increasing parental knowledge of the reporting process will allow schools to better identify and manage their students' chronic conditions. A parent-focused intervention informed by these results has been completed.
authors.forename: Victoria
authors.initials: V
authors.lastname: Rivkina
authors.forename: David E
authors.initials: DE
authors.lastname: Tapke
authors.forename: Lilliana D
authors.initials: LD
authors.lastname: Cardenas
authors.forename: Blair
authors.initials: B
authors.lastname: Harvey-Gintoft
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Whyte
authors.affiliation: Center for Community Health, Northwestern University, Feinberg School of Medicine, 750 North Lake Shore Drive, Suite 670, Chicago, IL 60611, USA. r-gupta@northwestern.edu.
authors.forename: Ruchi S
authors.initials: RS
authors.lastname: Gupta
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology; D002641:Chicago / Q000453:epidemiology; D002648:Child; D002908:Chronic Disease / Q000453:epidemiology*; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D005512:Food Hypersensitivity / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents; D017150:Public Sector; D012574:Schools; D013334:Students