School Nurse Perspectives on the Barriers and Facilitators to School-Supervised Asthma Therapy

Abstract

Background: Asthma Link is a program that aims to increase adherence to inhaled corticosteroids among children with persistent asthma by delivering evidence-based school-supervised therapy. This program, which leverages existing infrastructure, improves asthma outcomes in children from low-income, minority families. Our aim was to elicit the perspectives of school nurses who supervise preventive medication administration. Methods: Semi-structured qualitative interviews were conducted with 12 school nurses participating in Asthma Link. Thematic analysis was used to identify themes related to barriers and facilitators to preventive medication delivery. Results: Barriers described by school nurses included communication challenges with families and providers, inconsistent supplies of the preventive medicine at school, and the perception by some families and nurses that preventive therapy should be provided at home. Facilitators included the ease of incorporating preventive medication delivery into morning routines, recognizing the positive impacts on children from families with limited resources, feeling part of the preventive health care team, and being well-positioned to engage families in preventive asthma care. Conclusions: To facilitate Asthma Link adoption, it is critical to incorporate school nurse feedback in the program’s protocol refinement. School-supervised asthma therapy programs are advised to engage school nurses in the opportunity to provide preventive care, streamline communication, and address social and logistical challenges which may impede families from bringing medication to school.