A qualitative study of parent perspectives on barriers, facilitators and expectations for school asthma care among urban, African-American children

Abstract

Objectives: Minority children experience the disproportionate burden of asthma and its consequences. Studies suggest ethnic groups may experience asthma differently with varied perceptions and expectations among parents of African-American and Latino children. Because parents coordinate asthma care with the school, where children spend a significant amount of their day, this study’s goal was to determine parents’ perspectives on school asthma management. Methods: Focus groups were conducted with parents of children with asthma at four urban schools whose student population is predominantly African-American. A semi-structured guide was utilized focusing on barriers, facilitators and expectations for asthma care at school. Grounded theory principles were applied in this study. Results: Twenty-two parents (91% females) representing 13 elementary and 10 middle school children with asthma (61% boys) participated in four focus groups. Most children (87%) had persistent asthma. The identified barriers to effective school-based asthma care included limited awareness of children with asthma by teachers/staff, communication issues (e.g. school/parent, within school), inadequate education and lack of management plans or systems in place. In contrast, the identified facilitators included steps that fostered education, communication and awareness, as supported by management plans and parent initiative. Parents described their expectations for increased communication and education about asthma, better systems for identifying children with asthma, and a trained asthma point person for school-based asthma care. Conclusions: Parents of children with asthma identified important barriers, facilitators and expectations that must be considered to advance school asthma management. Improved school-based asthma care could lead to better health and academic outcomes.

Keywords:

• Minority
• urban
• asthma
• caregivers

Acknowledgements

We would like to acknowledge Ashley Hull, BS for leading the focus groups and Nick Antos, BA for assistance with the data analysis. We would also like to thank the Chicago Asthma Consortium and the University of Chicago Charter School for their support of the project. Finally, we would like to thank all the parents who participated in the focus groups.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article. The authors have no financial relationships relevant to this article to disclose.

Additional information

Funding

All phases of this study were supported by The University of Chicago Medicine Institute for Translational Medicine Community Benefit Grant and The University of Chicago Center for Health Administration Studies Solicited Proposals to Advance Research Questions.

The REDCap project at the University of Chicago is hosted and managed by the Center for Research Informatics and funded by the Biological Sciences Division and by the Institute of Translational Medicine, CTSA grant number UL1 TR000430 from the National Institutes of Health.

Dr. Volerman was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number KL2TR000431.

Dr. Dennin was supported by the University of Chicago Pritzker School of Medicine Summer Research Program.

Dr. Press was supported by a National Heart Lung and Blood Institute under Award Number K23 HL118151.

The remaining authors received no funding.