2001 OPEN FORUM Abstracts
ARE SELF-REPORTEDSURVEY TOOLS ADEQUATE FOR SCREENING OF ASTHMA IN ELEMENTARY SCHOOLS?
Mike Trevino, RRT;Sharon Trongaard, RRT; Denise Rebel, RRT; Melody Rodriquez, MA; RichardGilder, RN, CNOR; Gary Weinstein, MD, Presbyterian Hospital of Dallas, Dallas,TX.
BACKGROUND:The health of children is a top priority for both legislatures and school districtsstatewide. Hearing, vision, and spinal screenings are mandated by the Texaslegislature for school-aged children and are associated with prevalence ratesof 2.3%, 8.4% and 2.2%, respectively. The Texas Department of Health now identifiesasthma as the fifth leading reason for visits to school-based health centers.This being the case, it seems appropriate to focus efforts towards asthma surveillancein school-aged children. Asthma has traditionally been assessed through self-reportedsurvey methods in this population. However, this method may be inadequate toeffectively capture children that may benefit from asthma intervention. PulmonaryFunction Tests (PFTs) may offer a significant contribution to school-based assessmentof asthma.
PURPOSE: Thepurpose of this study was to determine if a self-reported screening tool wouldeffectively identify children with asthma or if this screening tool should becomplimented with Pulmonary Function Testing.
METHODS: Followingapproval from the School District, a short YES/NO questionnaire, in Spanishand English, was distributed in the school enrollment packets in August 2000.Surveys were distributed for students in grades one through six in five schoolsin a large metropolitan, economically depressed geographic area (avg. 77% schoollunch program participation). The questionnaire was designed to identify asthmaand allergy symptoms and included a permission slip to have PFT Studies performed.Questions focused on coughing/wheezing, and/or shortness of breath related todisease-specific variables. Respiratory Therapists performed pulmonary FunctionTests in the schools using a PB-100 hand-held spirometry system.
Results: 3694questionnaires were distributed, 1696 (46%) were returned and N=1490 met criteriafor inclusion (ability to produce reliable PFT) in the study. The demographicsfor this population were; 54% were Hispanic, 26% African American, 19% Caucasian,and 1% other. The mean age was 8.5 years. 51% were male, 49% female. To thequestion ?Have you ever been told your child has asthma or reactive airway disease??22.6% responded ?YES ?and of these, 78.7% had abnormal PFTs (<80% predictedvalues). Conversely, 77.4% responded ?NO? and 29.8% of this group had abnormaltest results (these would have gone unrecognized with a survey method only).Chi-square tests were performed to examine the relationship between normal/abnormalPFTs and disease- related variables. All findings were statistically significantat the p=.05 level:
|Variable||FEV1 Norm/Ab||Pearson?s Chi-Square||Sig.||FEF25-75Norm/Ab||Pearson?sChi-Square||Sig.|
CONCLUSION: Self-reportingsurvey tools may be inadequate to effectively capture children that may benefitfrom asthma intervention. Pulmonary Function Studies should be included as avital component of school-based asthma surveillance programs.