Program in the Delta Takes Aim at Asthma Disparity for Low-Income, Minority Children

Tamara Perry, M.D. 
Pediatric Specialist 
Arkansas Children’s Hospital

Nancy Dockter

Diversity Process Coordinator
Center for Diversity Affairs

Asthma disproportionately affects children in low-income and minority communities. Now a free school-based program in the Arkansas Delta aims to reduce this health disparity using telemedicine. The study will examine the efficacy of a school-based asthma telemedicine intervention in rural areas.

Dr. Tamara Perry, an Arkansas Children’s Hospital pediatric specialist in allergy and immunology, is the principal investigator on the study, which is supported by a $2.2 million grant from the National Heart Lung Blood Institute. The Breath Connection program, which was launched in May 2010 and will conclude in 2015, will target 12 rural school districts in nine counties. In all, 540 children and their parents, school nurses and primary physicians will be served by the program.

Asthma disparities have been “extensively studied in inner-city environments but not rural environments such as the Delta,” Perry explained. “Interventions that have been developed for inner-city children cannot be easily applied to rural children due to cost constraints, travel distance to tertiary health clinics, lack of extensive community resources and few pediatric specialty providers.”

Asthma is the leading childhood illness, resulting in significant childhood morbidity. It is also the leading cause of missed school days due to illness for school-age children. Medically underserved communities are most affected, with emergency department visits and hospitalizations resulting in significant economic burdens.

Previous studies by Perry and fellow researchers found that rural children in the Delta are less likely to be on a therapy consistent with national guidelines. As a result, they are more likely to experience poorly managed symptoms resulting in utilization of emergency care.

The program consists of an intervention at the participating child’s school as well as asthma care at the child’s regular doctor. To be eligible, a child must be 7-14 years old, have symptoms or a diagnosis of asthma, and be enrolled in a school taking part in the study. The child and his or her parents must also speak English and have a telephone.

The program uses telemedicine technology to educate children with asthma and their parents; educate school nurses about asthma and the individualized treatment plans for participating students; monitor asthma symptoms and lung function; and provide each participant’s health care provider with an individualized treatment plan based on national asthma guidelines.

“Telemedicine works by teleconferencing capabilities that allow us to see and communicate with participants in real time,” Perry said. “We can remotely connect to a distant location (i.e. the school) and teach participants about asthma, demonstrate the proper use of different asthma devices, and answer questions.”