Asthma is the most common chronic disease among children and a leading cause of school absenteeism. In St. Louis, nine percent of children ages 0 - 18 are currently living with asthma and the respiratory disease is one of the primary reasons for emergency room visits and the number one cause of patient admissions. Schools in the region noted asthma in up to 25% of children.

Recognizing the need for asthma interventions among school-aged children in the area, St. Louis Children's Hospital created the free Healthy Kids Express - Asthma (HKEA) program. The program is a partnership between the hospital, area physicians and school districts located in zip codes with high emergency room visits and hospitalizations due to asthma. Healthy Kids Express - Asthma seeks to give children with asthma and their caregivers the education and tools necessary to control asthma symptoms. Participants receive personalized asthma care at their respective schools, including spirometry, a spacer(s) to be used with an inhaler, a pillow and a mattress cover. Each participant and school worker is given a flu shot and asthma education material is provided to students, school staff and parents.

The mission of the Healthy Kids Express Asthma Program is to provide quality asthma care and education to children with asthma and their caretakers in a school environment to work towards goals set by Healthy People 2020 and the National Asthma Education and Prevention Program (NAEPP).

The Healthy Kids Express Asthma Program serves approximately 600 children a year, improving inhaler technique and asthma knowledge among participants. Children enrolled in the program for two consecutive years have lower school absentee rates and hospitalizations due to asthma.

In the 2012-2013 school year, Healthy Kids Express - Asthma (HKEA) was implemented in 11 schools and served 536 children with asthma. Spirometry services were provided to 86% of children in the program. Children were also given a test on their inhaler technique throughout the program using a 10 point scale - 94% of children received at least 3 technique checks and 69% have shown an improvement in skill from the first to last check. A paired samples t-test was performed to compare the mean first and last technique check scores for 490 students. The average increase in scores was 2 points (95% CI: 1.8-2.3, p <0.01). Participants in education classes were given a pre and posttest to measure knowledge gained. A paired samples t-test showed a mean increase in knowledge score of 12.9% (95% CI: 11.1% -14.6%, p <0.01).

Teachers and school staff also received asthma education. In 2012-2013, 172 teachers showed an increase in knowledge score of 6.2% (95% CI: 3.2%-9.1%, p <0.001) when pre and posttest mean scores were compared using a paired t-test. Children's school absentee rates and hospitalization rates are tracked for participants who are enrolled in two consecutive years of the program. These participants had school attendance rates of 94% (or 9.8 days missed). This is 1.6 days fewer than the general school population (93% ADA or 11.4 days missed) of schools where HKEA is implemented. Hospitalizations from both the emergency department and inpatient admissions decreased by 10.4% among HKEA participants enrolled over a two year period.

Healthy Kids Express Asthma Program has been highlighted as a promising practice at regional and national conferences including The American Academy of Asthma, Allergy and Immunology, The Asthma Educators Association and National Assembly of School-based Health Care.