Maier Vanessa F, Dhaliwal Olivia, Liu Amanda, Foreman Kim, Linick Matthew, Feldman Katie
Department of Family Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Department of Family Medicine, The MetroHealth Medical Center, Cleveland, Ohio, USA.
J Sch Health. 2025 Aug;95(8):622-630. doi: 10.1111/josh.70033. Epub 2025 Jun 20.
There is a large body of research suggesting the role of school-based health centers (SBHCs) in improving outcomes for children with asthma, but there are no evidence-based guidelines for the care of children with asthma in SBHCs. We conducted a randomized trial to assess screening in children with asthma in an urban SBHC.
Participants were screened for asthma triggers. The intervention group received home assessments and medical legal partnership (MLP) referrals as indicated. The primary outcome of asthma severity was assessed using the asthma control test (ACT). All participants completed semi-structured interviews to evaluate their experience.
All families randomized to intervention qualified for and completed home remediation. There were no statistically significant differences in asthma severity. There was 100% retention of participants, and all participants rated their experience as good or excellent.
IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE AND EQUITY: This study demonstrates a high prevalence of home-based asthma triggers for children with asthma who receive care in SBHCs. Although not large enough to demonstrate significance in primary outcomes, participants were successfully recruited from a diverse population and retained through completion of the study. Participants rated their experience as good or excellent, suggesting that the recruitment and retention of diverse participants for clinical trials in SBHCs can be successful.
Home-based asthma triggers for children with asthma who receive care in SBHCs are prevalent. Although complex collaborations are required, SBHCs are a viable site for clinical trials. More research is needed to understand the benefit of interventions in SBHCs to reduce asthma severity.
大量研究表明学校健康中心（SBHCs）在改善哮喘儿童的治疗效果方面发挥着作用，但目前尚无基于证据的SBHCs中哮喘儿童护理指南。我们进行了一项随机试验，以评估城市SBHCs中哮喘儿童的筛查情况。
对参与者进行哮喘触发因素筛查。干预组根据需要接受家庭评估和医疗法律合作（MLP）转诊。使用哮喘控制测试（ACT）评估哮喘严重程度的主要结局。所有参与者完成半结构化访谈以评估他们的体验。
所有随机分配到干预组的家庭都符合条件并完成了家庭整治。哮喘严重程度方面没有统计学上的显著差异。参与者的保留率为100%，所有参与者都将他们的体验评为良好或优秀。
对学校健康政策、实践和公平性的启示：本研究表明，在SBHCs接受治疗的哮喘儿童中，家庭哮喘触发因素的患病率很高。尽管样本量不足以证明在主要结局方面具有显著性，但参与者成功地从不同人群中招募，并一直参与到研究结束。参与者将他们的体验评为良好或优秀，这表明在SBHCs中为临床试验招募和保留不同参与者是可以成功的。
在SBHCs接受治疗的哮喘儿童中，家庭哮喘触发因素很普遍。尽管需要复杂的合作，但SBHCs是进行临床试验的可行场所。需要更多的研究来了解SBHCs中干预措施对降低哮喘严重程度的益处。
