Exploring ways to improve outcomes for urban teens with asthma

(Medical Xpress)—An article published in February's Journal of Asthma, and authored by School of Nursing associate professor of clinical nursing Susan Blaakman, Ph.D., A.P.R.N.,has identified some potential ways to improve the outcomes of city teens with asthma by taking a novel approach—asking the teens themselves.

"Urban minority teens face one of the highest risks of being hospitalized and dying from asthma," says Blaakman. "We need to gain a deeper understanding of the reasons why, so that we can more effectively help them control it, and prolong their lives. It seems like common sense, but there are very few studies that explore this issue purely from the perspective of students."

Blaakman's article,"Asthma Medication Adherence Among Urban Teens," analyzes student responses that were collected during a 2009-10 pilot study at four Rochester city high schools. Jill Halterman, M.D., M.P.H., co-vice chair for research in the UR Medicine Department of Pediatrics, was principal investigator on the study. UR School of Medicine and Dentistry student Alyssa Cohen also collaborated and conducted the qualitative data analysis.

Even though persistent asthma can be successfully controlled through the routine use of a corticosteroid inhaler at home and/or under the supervision of a school nurse, there are many reasons why urban teens might neglect to take their medications before or during a busy school day, says Blaakman.

"Teenage students from low-income neighborhoods are often faced with unique social and environmental pressures and stressors," she says. "Just having to rely on public transportation to get to school and part-time jobs, or having to walk through security scanners on the way into school, can put a strain on available time and disrupt schedules. Many factors at home can also lead to kids not following a good routine, hurrying out the door in the morning and forgetting to take their medications."

In this study, many teens were happy to receive their preventive asthma medication from the nurse at school each day. However, some described difficulty getting to the nurse's office at their scheduled time because they didn't want to fall behind in their classwork, miss a favorite class, or simply felt too busy in their school day. Blaakman says many students already have a high rate of absenteeism due to their illness, and "missing even 15 minutes of math class can make things harder."

Difficulty obtaining hall passes, competing social pressures, and lengthy distances to the nurse's office were other challenges that teens noted, she says.

"Teens often know they feel better when they're taking their medications regularly, but there are hurdles in the way," she says. "I think we have the potential to improve outcomes through better collaboration with students, and by giving them more of a voice in developing routines that make sense for them, and that they can stick to."