In Vermont schools, asthma remains a persistent barrier to success — researchers are seeking to combat it.

Asthma affects approximately 10% of Vermont children, posing significant challenges during the school day. Coughing, wheezing, and fatigue associated with asthma can make learning and participating fully in school activities difficult. The condition also disrupts sleep, which may lower academic performance and lead to missed school days. Sleepless nights for children often mean sleepless nights for parents, who face their own challenges as a result.

Current asthma treatment protocols place the responsibility for medication and management on individuals throughout the day—an approach that can be difficult for children to follow in school. Maintaining a consistent schedule with inhalers and other medications is challenging when school routines are constantly shifting, and nurses are often under-resourced. Without regular adherence to treatment, children continue to suffer the effects of asthma.

Still, according to Dr. Stephen Teach, a pediatrician at UVM’s Larner College of Medicine, “These outcomes are eminently preventable with good asthma care.”

With support from UVM’s Leahy Institute for Rural Partnerships, Dr. Teach is piloting a new asthma treatment protocol in collaboration with school nurses that emphasizes consistency in both schedule and location. The regimen, known as School-Based Asthma Therapy (SBAT), significantly reduced the impact of persistent asthma in young children in the Washington, D.C. area. In that DC study, school nurses located children and administered asthma controller treatments every morning, achieving a 95% adherence rate for daily doses. This level of consistency can make a meaningful difference in children’s daily lives.

 

Can the SBAT approach work in rural Vermont?

 

The Leahy Institute grant is funding research into asthma treatment challenges specific to rural Vermont schools and exploring how the SBAT model might be adapted for local students. Key challenges include limited insurance coverage for regular asthma care, schools with part-time nurses who may not be available to administer doses consistently, and parents who commute long distances from their children’s schools. 

According to Haysal Jones, president of the Vermont State School Nurses’ Association, “SBAT faces true barriers in Vermont’s rural schools, but hopefully we can overcome these.  School nurses can assist parents and their children in reducing asthma symptoms while increasing school attendance and performance.” 

Students writing
Photo by Sally McCay

This year, Dr. Teach is also building the partnerships necessary to support protocol changes. Collaborators include the Vermont State School Nurses’ Association, UVM’s Departments of Pediatrics and Family Medicine, the College of Nursing and Health Sciences, the Vermont Child Health Improvement Program (VCHIP), the Asthma Program at the Vermont Department of Health, and several professional medical associations.

“Persistent asthma impacts so many aspects of a family's life. Fixing it really rocks the family's world in a positive way”  — Dr. Stephen Teach

Next steps in Dr. Teach’s work will involve piloting SBAT in Vermont schools in collaboration with school nurses, parents, and health care providers. With more consistent care, Vermont children will have greater opportunities to grow and thrive in school.