Publications by authors named "Lisa D Henry"

The St. Louis Children's Hospital Healthy Kids Express Asthma (HKEA) program was developed to improve asthma control in children who attend schools with the highest asthma prevalence in the metropolitan area. The HKEA program differs from other programs because unscheduled visits occur at school without parents present. To assess the effectiveness of the HKEA program a retrospective quality assurance study. A chart review was performed to evaluate the change in health-care utilization, absenteeism, staff and student education, inhaler technique checks, and parent satisfaction surveys before and after participation in the program. The Wilcoxon signed rank test, two-way analysis of variance, and descriptive statistics were used to analyze the data. The HKEA program recruited 1076 participants ages 5-15 years during 3 school years, from 2008 to 2011. The participants showed a reduction in emergency department visits (36.9% to 14.2%) and hospitalizations (7.1% to 5.0%) from the year before beginning the program to the third year of the program. Absenteeism was significantly improved, from 59.1% to 27.1%. Staff and student knowledge of asthma improved significantly after completing asthma education programs. More than 90% of participants completed three technique checks of their inhaler and spacer technique and showed significant improvement in their tech check (an inhaler/aero chamber technique check) scores. Parent satisfaction with the HKEA program was rated excellent or very good by 96.9% of the parents. The HKEA program is a novel school-based asthma clinic that is well accepted by parents, and results in less health-care utilization and school absences as well as improved asthma knowledge in participants and the school staff.

Objective: To examine the relationship between body mass index (BMI), gender, age, controller medication use, household smoke exposure, season, and allergic rhinitis status with asthma control in a group of lower income, African American children. We hypothesized that non-obese children would have better asthma control.

Methods: Baseline data from a longitudinal study of children in a school-based asthma program in a Midwest urban area were analyzed. 360 children, ages 4-15 years, who were enrolled in either the 2012-2013 or 2013-2014 program were included. Asthma control was classified using criteria from the 2007 National Asthma Education and Prevention Program. Multiple ordinal regression was performed.

Results: The median age was 9 years, 61% had well-controlled asthma, and 29% were obese. The model included all main effects plus two interaction terms and was significant (χ(7) = 22.17, p =.002). Females who were normal weight (OR, 2.78; 95% CI, 1.38-5.60, p =.004) or overweight (OR, 3.12; 95% CI, 1.26-7.72, p =.014) had better asthma control than obese females. For males, there were no differences by BMI category but males without allergic rhinitis had significantly better asthma control (OR, 2.23; 95% CI, 1.25-3.97, p =.006) than those with allergic rhinitis.

Conclusions: Non-obese girls and non-allergic males had better asthma control. Promotion of healthy activity and nutrition as well as management of allergic rhinitis should be part of the asthma plan in school-based programs in low income urban areas. Innovative approaches to address asthma care in low income populations are essential.

Introduction: In 1994, pediatric nurse practitioners (PNPs) at St. Louis Children's Hospital developed a program to improve the care of children admitted with asthma. In the Asthma Intervention Model, PNPs directly manage the care of children hospitalized with asthma and are instrumental in hospital-wide education. An evaluation study was conducted to measure effectiveness of this inpatient PNP role.

Methods: Attending physicians, interns, nurses, and families were surveyed regarding their perceptions of the PNPs as care manager and educator. A 16-item asthma knowledge test was administered to interns at the start and conclusion of their intern year. Length of stay, readmission rate, and cost were evaluated.

Results: PNPs were found to be effective in the inpatient asthma role by all participants. Significant gains were noted in intern knowledge and confidence in caring for asthma. Interns identified the PNPs as important contributors to their education. No significant differences occurred between interns and PNPs in length of stay, cost, readmissions, or severity of the condition of the asthma patients.

Discussion: PNPs in the inpatient asthma setting are effective care managers and educators.