The Science Journal of the American Association for Respiratory Care

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:

VariableFEV1 Norm/AbPearson?s Chi-SquareSig.FEF25-75Norm/AbPearson?sChi-SquareSig.
Sudden Episodes 24.945.000 30.633.000
Night TimeSymptoms 17.978.000 19.904.000
Seasonal Episodes 25.318.000  32.195.000
Chest Colds 26.814.000 25.938.000
EnvironmentalExposures 12.694.000 19.072.000
Physical Activity 21.091.000  23.673.000

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.

OF-01-082

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