Researchers Study Delivery of Asthma Care for Children

Funded by the National Institute on Minority Health and Health Disparities of the National Institutes of Health, Project ASTHMA (Aligning with Schools to Help Manage Asthma and Decrease Health Inequities) was developed by researchers in the Department of Pediatrics in the Jacobs School of Medicine and Biomedical Sciences and in the School of Public Health and Health Professions.

Lucy C. Holmes, MD, clinical associate professor of pediatrics in the Jacobs School, is principal investigator.

The project began as a pilot study funded by UB’s Clinical and Translational Science Institute (CTSI).

“Project ASTHMA is a clear example of exactly how our continued funding from the NIH works to directly improve the quality of the lives of Western New Yorkers,” says Timothy F. Murphy, MD, SUNY Distinguished Professor of medicine and director of the CTSI and the Community Health Equity Research Institute. “The success of the pilot study is what led to the full funding that Dr. Holmes has received, which will provide real benefits to children with asthma in the Buffalo Public Schools.”

Project ASTHMA is a research program supporting school-based asthma care for students aged 4-13 years who are living below the poverty line.

“Our hypothesis is that we can improve the health of these kids who have uncontrolled asthma by giving them high-quality health care in the schools through school-based health centers,” says Holmes, who is also a physician with UBMD Pediatrics and at Oishei Children’s Hospital. She is also medical director of the asthma clinic at Niagara Street Pediatrics.

School-based health centers are primary care clinics based at elementary and secondary school campuses and are distinct from the school nurse’s office. There are more than 3,000 school-based health centers throughout the U.S. There are 10 such centers in the Buffalo Public Schools.

“Novel ways of providing top-quality medical care for asthma to children in economically disadvantaged communities are needed to help decrease health inequities,” says Holmes. “School-based health centers are led by advanced practice providers who can be trained to deliver high-quality asthma care to their patients.”

One of the goals of the project is to provide evidence that school-based health centers can actually improve outcomes.

“While observational studies show that these centers across the country are associated with improved health, there are few randomized controlled studies that prove improved outcomes and there are none in chronic asthma,” says Holmes. “That’s what Project ASTHMA is designed to do. With over 3,000 school-based health centers across the United States, they are a potentially cost-effective method to improve the health of children with chronic diseases.”

Asthma is the most common chronic disease among children in Buffalo. According to data from the New York State Department of Health, children living in economically disadvantaged communities are 10 to 15 times more likely to have an asthma attack that results in an emergency room visit or hospitalization than those in the suburbs. As a result, these children often have a poorer quality of life and frequently miss school days, decreasing their educational opportunities.

“Building a stronger and healthier future for kids and families in Western New York begins with reducing barriers to basic needs like health care,” says U.S. Rep. Brian Higgins. “Asthma often has the greatest impact on the most vulnerable children in our community, with symptoms that require emergency medical care and prevent them from attending school. Thanks to federal funding from the National Institutes of Health, UB is using a school-based approach to asthma care in Buffalo, ensuring this chronic disease will not prevent students from being in the classroom each day.”

“Congratulations to Dr. Holmes on receiving this prestigious award from the NIH’s National Institute on Minority Health and Health Disparities (NIMHD),” says Allison Brashear, MD, MBA, vice president for health sciences and dean of the Jacobs School. “Dr. Holmes’ groundbreaking scholarship to help manage asthma via school-based interventions contributes directly to the NIMHD’s mission to develop interventions to encourage elimination of health disparities. This well-deserved recognition is a testament to her groundbreaking research and her passion for helping children with asthma. Her work is essential to ensuring that all children have access to the care they need to thrive.”  

Working with Holmes on Project ASTHMA is a multidisciplinary team of investigators, including Heather K. Lehman, MD, clinical associate professor in the Department of Pediatrics and chief of its Division of Allergy/Immunology and Rheumatology in the Jacobs School, as well as faculty from the School of Public Health and Health Professions: Heather Orom, PhD, associate professor, Department of Community Health and Health Behavior; Ekaterina “Katia” Noyes, PhD, professor and associate dean for translational and team science, Department of Epidemiology and Environmental Health; and Gregory Wilding, PhD, professor of biostatistics.

Collaborators from other institutions are Jill Halterman of the Department of Pediatrics, University of Rochester; Stacie Lampkin of the School of Pharmacy at D’Youville University; and Susan Butler with the Catholic Health System.