title: Analyzing Who, When, and Where: Data for Better Targeting of Resources for School-Based Asthma Interventions.
abstract: Rates of uncontrolled asthma vary by demographics, space, and time. This article uses data on ambulance-treated asthma attacks in children to analyze these variations so that school districts can improve their asthma management interventions.
  
  
  
  Incidence rates of 1826 ambulance-treated asthma attacks for children aged 5-18 years were calculated for school zones for elementary, middle, and high schools in the Houston (Texas) Independent School District (HISD). Zones with rates in the upper quartile were identified as the highest rate zones and were compared with other school zones in the district by demographics, location, and timing of attacks.
  
  
  
  The ambulance-treated asthma rate was respectively 5, 3, and 2 times greater in the highest rate school zones compared with all other school zones for those school levels. Ambulance-treated asthma attacks in the high-rate school zones occurred most at midday and in the evening and high-rate zones were often geographically contiguous. Schools in the high-rate zones had a higher percent of socioeconomically disadvantaged students and were more often without a school nurse.
  
  
  
  Spatial and temporal analysis of ambulance data can be valuable tools for schools to focus policy and program interventions for the students in need of improved asthma management.
authors.affiliation: Statistics Department, Rice University, 6100 Main Street, Houston, TX 77005.
authors.forename: Loren H
authors.initials: LH
authors.lastname: Raun
authors.affiliation: Statistics Department, Rice University, 6100 Main Street, Houston, TX 77005.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Campos
authors.affiliation: Stevenson Solutions, LLC 2778 Foster Ridge Road, Atlanta, GA 30345.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Stevenson
authors.affiliation: Statistics Department, Rice University, 6100 Main Street, Houston, TX 77005.
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Ensor
authors.affiliation: Health and Medical Services, Houston Independent School District, 4400 W. 18th St Houston 77092, Houston, TX 77005.
authors.forename: Gwen
authors.initials: G
authors.lastname: Johnson
authors.affiliation: The Office of The Medical Director Emergency Medical Services Houston Fire Department, City of Houston, 600 Jefferson Suite 800, Houston, TX 77002.
authors.forename: David
authors.initials: D
authors.lastname: Persse
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000552:Ambulances / Q000706:statistics & numerical data*; D001249:Asthma / Q000453:epidemiology* / Q000208:ethnology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006291:Health Policy; D006801:Humans; D015994:Incidence; D008297:Male; D012572:School Health Services / Q000458:organization & administration*; D012573:School Nursing / Q000458:organization & administration / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D062211:Spatio-Temporal Analysis; D013781:Texas / Q000453:epidemiology; D013997:Time Factors
keywords: ambulance-based asthma care; asthma; asthma interventions; childhood asthma; emergency asthma care; school-based asthma