Evaluation of asthma burden and stock bronchodilator programs in public schools

Asthma is a significant public health burden for school-age children (Centers for Disease Control [CDC], 2021). A stock bronchodilator program (SBP) provides rescue medication for children who experience asthma symptoms while on school campuses. Very little is known about the prevalence of SBPs and the challenges, resources needed, and outcomes associated with such programs. The purpose of this exploratory descriptive quantitative study was to fill the identified knowledge gap by exploring school nurse perceptions of the current state of asthma burden and SBPs, along with the benefits and challenges of implementing School-Based Asthma Programs (SBAPs) and SBPs in public schools. Descriptive statistics were used to analyze demographic data, asthma burden, and SBP characteristics. Independent samples t-test, two-way between-groups analysis of variance, and multiple regression analyses were used to examine the differences in SBP subscale scores and select demographics. A total of 238 participants were included in the main study analysis. Most school nurses reported that less than 10% of their student population had an asthma diagnosis (n = 123, 51.7%). A statistically significant difference was found in SBP implementation challenge subscale scores between schools with and without a SBP (SBP M = 36.53, SD = 6.46; without SBP M = 27.7, SD = 7.58; t(179) = 6.43, p < .001, d = 1.2). There was not a statistically significant difference between mean challenge score and school-grade levels (F (3, 173) = .93, p = .429), geographic location (F (2, 175) = .2, p = .822), and whether or not the school was in an underserved healthcare area (F (1, 177) = .36, p = .536). The variance in correlation models was largely attributed to a school having a SBP much more than the years of school nurse experience (F(2, 178) = 20.61, p < .001, R2 = .19; βSBP = .43, rs2SBP = 1.0; βyrs = .02, rs2yrs = .02) or size of student population (F(2, 178) = 20.77, p < .001, R2 = .19; βSBP = .43, rs2SBP = .99; βpop = -.06, rs2pop = .03). This study highlighted challenges and crucial elements when implementing SBPs. Findings from this study can set the foundation for future research including experimental level designs examining the impact of a SBP on the overall asthma health and school performance of children.