Covid-19 Impact On Participant Engagement With A School-Centered Asthma Navigator Program

The COVID-19 pandemic has made an impact on how health care/support services are accessed with up to 60% decline in visits to primary care providers. This study evaluated the impact of COVID-19 on participant engagement with asthma navigators and asthma outcomes in a school-centered asthma program. Step Up Asthma program is implemented in 40 Colorado schools. Asthma navigators enrolled 2 cohorts (Cohort 1/2018-2019 and Cohort 2/2019-2020) of students with poorly controlled asthma to participate in a comprehensive asthma navigator program. Study visits were scheduled every 3 months over a 12-month period. Due to COVID-19 school closures, we transitioned to telehealth visits beginning in March 2020. We compared participation rates and indicators of asthma control (ACT score, ED and hospitalizations) before and during the COVID-19 crisis to identify if there was an impact on program engagement. We compared rates for participation at 3-time points: start of school year, mid-year, and end of school year. Cohort 1 (n=113) had participation rates of 100%, 99.1% and 88.5% respectively and Cohort 2 (n=119) had rates of 100%, 87.4% and 70.6%. The results demonstrate an 11.5% decline from start of year to end of year for Cohort 1, compared to a 29.4% decline for Cohort 2 during the COVID-19 crisis. No change in asthma outcomes was noted. Our school-centered asthma program maintained high levels of participant engagement through telehealth mechanisms. This study demonstrates the effectiveness of asthma navigators in maintaining close monitoring. Anecdotally, families expressed how important these outreach visits were to them.