0
Clinical Investigations: ASTHMA |

A School-Based Case Identification Process for Identifying Inner City Children With Asthma*: The Breathmobile Program

Craig A. Jones; Tricia Morphew; Loran T. Clement; Tania Kimia; Marc Dyer; Marilyn Li; Jean Hanley-Lopez
Author and Funding Information

*From the Department of Pediatrics (Drs. Jones, Clement, Kimia, Dyer, Li, and Hanley-Lopez), Keck School of Medicine at the University of Southern California, Los Angeles, CA; and the Southern California Chapter of the Asthma and Allergy Foundation of America (Ms. Morphew), Los Angeles, CA.

Correspondence to: Craig A. Jones, MD, FCCP, 1801 E Marengo, Rm 1G1, General Laboratories Bldg, Los Angeles, CA 90033; e-mail: craigjones@adelphia.net



Chest. 2004;125(3):924-934. doi:10.1378/chest.125.3.924
Text Size: A A A
Published online

Background: Striking increases in the prevalence and morbidity of asthma among inner city children have been documented.

Objective: To establish and evaluate a large-scale, school-based case-detection process designed to efficiently and reliably identify inner city children with asthma.

Methods: A bilingual, seven-question, self-administered, parental asthma screening survey was developed. Clinical validation was achieved in a sample of 675 consecutive parents bringing a child to the school-based Breathmobile Program for initial evaluation, using a comprehensive evaluation by a physician specialist (ie, allergist) as the standard. Survey response patterns were used to construct a novel seven-model, tiered scoring algorithm and an abbreviated algorithm that predict the probability of a child being clinically classified as “yes asthma” or “no asthma.” A systematic survey distribution process administered by a single coordinator was developed, and the impact of a classroom-oriented incentive offering a $25 school supply gift certificate for survey return rates of ≥ 80% was evaluated.

Results: A total of 636 parents provided one or more survey responses and information sufficient for clinical classification. The scoring algorithm correctly identified children with asthma (≥ 80% probability) with a sensitivity of 86.5%, a specificity of 83.6%, and a misclassification rate of 14.3% (91 of 636 children). The sensitivity for identifying persistent asthma was 91.3%. Asthma prevalence estimates derived using survey results from a larger sampling of the general population were similar to rates previously reported for comparable populations. The inclusion of an inexpensive incentive increased the median survey return rates from 35.3 to 65% (z= −11.9; p < .001). The screening process has been used to conduct 27,526 surveys at inner city schools.

Conclusions: The Breathmobile case-detection process offers a validated, comprehensive, large-scale method with which to identify children with asthma at their school sites.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543