Health navigators are an effective strategy to bridge the gap for school-aged children at risk for asthma disparities

Asthma is a leading cause of hospitalizations, emergency room visits and missed school days that disproportionately affects minority children. This study evaluated the effectiveness of health navigators in the school setting to address unmet needs for students with poorly controlled asthma. The Colorado Step Up Asthma program is a school-centered asthma program implemented in 32 low income schools in 5 Colorado urban school districts. Health navigators trained in asthma self-management, motivational interviewing and behavior change skills provided asthma education, tailored environmental counseling, care coordination and linkage to community resources to students at risk for an asthma exacerbation during one school year. The navigators enrolled 585 students with uncontrolled asthma defined as either: ≥2 exacerbations requiring systemic steroid therapy, ≥1 hospitalizations, Asthma Control Test <20, or >5 missed school days in the past 12 months. Demographics: 74.0% non-white, 82.1% Medicaid, and mean age 8.54 years. Average inhaler technique scores improved [as mean (SD)] 2.07 (1.35) to 4.03 (1.04) with maximum 5.0 (paired sample t-test, p<=.001) and asthma control test scores 20.5 (3.56) to 22.4 (3.08) (paired sample t-test, p