As schoolchildren enter their teenage years, they tend to start making more of their own health care decisions. But that transition can be challenging, and certain behaviors — such as making sure they take their daily asthma medication — can sometimes fall through the cracks.
In an attempt to help urban teens keep their asthma symptoms in check, Jill Halterman, M.D., M.P.H., associate professor of pediatrics at UR Medicine’s Golisano Children’s Hospital, has developed a study which combines giving students their medications at school with motivational counseling specifically designed for teens.
“We plan to encourage the teens to reflect on how good they feel when they’re using their preventive medication routinely,” said Halterman. “For example, if the student is an athlete, they might notice better performance in their sport. We’ll help them think about that so they can decide, on their own, whether they want to be independent with taking their medication.”
The 5-year study, which was developed in partnership with the Rochester City School District and the district’s nurses, is supported by a $3.6 million grant from the National Institutes of Health. A pilot study, which generated initial data used in the application to NIH, was funded by the CTSI.
“Dr. Halterman’s study is a fascinating project that has the potential to improve health for teens across the country, and it’s also a perfect example of what our Pilot Program is designed to do,” said Kathleen Jensen, executive director of finance for the CTSI. “Relatively small investments from the CTSI can be used to generate the early stage data that can lead to big awards like this one.”
The most common chronic childhood illness, asthma affects an estimated 1 in 10 children and teenagers in the United States. Low-income and minority youth develop asthma even more often, and Halterman has spent the past decade attempting to improve outcomes for this population.
The team’s School-Based Asthma Therapy trial for younger children, which began in 2006 and involved 530 children in the City School District, showed reduced asthma morbidity and decreased absenteeism for students who took their daily medication in the presence of a school nurse.
The new study will modify and expand on some of these methods, randomly assigning teens to three different conditions. For the first six to eight weeks of the school year, some teens will take their medication in front of a school nurse, who can provide instruction, if necessary. The hope is that the teen can then transition to independent medication use after receiving a special counseling intervention that emphasizes the benefits of daily preventive therapy.
The study, which aims to enroll 430 teenagers starting in the 2014-2015 school year, will compare the teens’ adherence and asthma outcomes to groups of teens that receive alternate levels of intervention. The ultimate goal of the program is develop an effective new system of care for urban teens that can be continued in the city school district and disseminated to other sites.