Anna Volerman, MD

Asthma is the most common chronic childhood condition and disproportionately affects urban, minority, and low-income youth. Nearly half of children with asthma miss school, making it the leading cause of absenteeism. Affected children also suffer in school readiness and academic achievement, with more severe asthma correlated with poorer performance. These negative outcomes can be minimized with proper treatment and prevention of flares. Children spend much of their day in school, necessitating schools to fill a critical role in asthma management. Guidelines detail key components of asthma management; however, most schools are ill-equipped due to limited staffing and resources. Recognizing this, the Chicago Public Schools (CPS) adopted an innovative Asthma Management Policy in 2012. The policy promotes daily management, prevents flare-ups, and supports staff training in schools. Since the adoption of this policy, no district-wide analysis of asthma management has been conducted. Research is needed evaluate the impact of this innovative policy. This study aims to evaluate the impact of the CPS Asthma Management Policy on health and academic outcomes at the student- and school-levels, with a focus on disparities based on race/ethnicity and poverty. Our central hypothesis is that implementation of the asthma policy is variable among schools, and this variation aligns with existing asthma disparities. This study uses a retrospective cohort design to examine the impact of the school asthma policy by evaluating health and academic outcomes for children with asthma prior to and after adoption of the policy. Baseline data is from the 2010-2011 academic year and post-implementation is from the 2017-2018 years - five years after policy adoption. Data will be utilized to identify gaps in the implementation of asthma policy overall and by sub-groups of youth and schools. In Year 1, we made great strides toward the aims for this project. We 1) established regular team meetings of research staff at University of Chicago and Chapin Hall, 2) developed and executed a data request for retrieval of CPS data specific to this study, 3) amended and approved this work with the UChicago BSD IRB (IRB19-0548), 4) updated the CPS Statement of Work (SOW #44), 5) received school-level data from CPS, and 6) are currently working on data quality and descriptive analyses. To-date, there are two memos describing the quality and contents of the CPS datasets received. The first memo describes data on asthma trainings for CPS staff, the content of trainings, number of trainings per school and networks, and school staff role. The second memo includes asthma-related health incident data and shows the number of asthma-related incidents by school and month. We did experience challenges during the execution of the CPS data request and in obtaining the CPS data mainly due to limitations resulting from the COVID-19 pandemic and staff; however, now that data has been obtained, we are on schedule to move forward with our evaluation and complete this research during Year 2.

Update: In Year 1, we have collaborated closely with Chicago Public Schools (CPS) to extract school- and student-level data. To-date, there are two memos from our partners at Chapin Hall describing the quality and contents of the CPS datasets received. The first memo describes data on asthma trainings for CPS staff and the content of trainings, number of trainings per school and across networks, and types of school staff that completed trainings. The second memo includes asthma-related health incident data and shows the number of asthma-related incidents by school and month. In Year 2, we will utilize these data to identify gaps in implementation of asthma policy in the overall population and across sub-groups.