University of Arizona receives $3.4 million grant to expand asthma inhaler program in schools

A University of Arizona Health Sciences-led program that provides schools with asthma inhalers to help students experiencing respiratory distress will be expanded and improved thanks to a $3.4 million grant from the National Heart, Lung and Blood Institute, a division of the National Institutes of Health.

In 2021, 38.7% of children ages 18 and younger who had asthma reported having one or more asthma attacks in the past year, according to the Centers for Disease Control and Prevention. Even though asthma is controllable, research from the National Asthma Control Program estimated that 44% of children with asthma have uncontrolled asthma.

Respiratory distress is the leading cause of 9-1-1 calls from schools, yet access to life-saving medications for emergency respiratory distress during school hours remains limited. Our goal with the Stock Inhaler for Schools program is to bridge the gap in access to life-saving medications and safeguard the well-being of our youth."

Ashley Lowe, PhD, assistant professor at the U of A College of Nursing and member of the U of A Health Sciences Asthma and Airway Disease Research Center

The Stock Inhaler for Schools program is a school-based stock albuterol program in Arizona that was launched in 2017 by researchers at the U of A Health Sciences in collaboration with Banner – University Medical Center Tucson and Thayer Medical Corporation. More than 800 schools across Arizona are enrolled in the program, which gives each school one albuterol inhaler and 10 spacers for administering the medication.

"Thanks to Lowe's efforts, Arizona became the first state to implement and publish data on a stock inhaler program in 2020, setting a national example," said Sheila Gephart, PhD, RN, professor and interim chair of the Advanced Nursing Practice and Science Division at the College of Nursing. "Her work is essential for reducing health disparities and creating a future where every child with asthma has safe and reliable access to care, not just in Arizona but across the nation."

The Stock Inhaler for Schools program is effective, but implementation challenges exist, particularly in rural areas. Lowe and the research team will test three implementation strategies with the goal of improving student health and safety nationwide.

The first two strategies are already in use in Arizona. One provides a toolkit that gives schools essential resources for program implementation. The other utilizes the toolkit and adds a nurse coach to provide personalized support to guide implementation. The third strategy adds practice facilitation to the toolkit and nurse coach implementation tools.

The goal of the study is to provide evidence-based recommendations, including relative cost-effectiveness of individual and combined strategies, that could be applied in Arizona and the other 21 states that have stock inhaler laws allowing schools to procure, stock and administer albuterol sulfate to any child experiencing respiratory distress.

"The proposed research represents a significant opportunity to empower policymakers, health care providers, and educators to improve student health and safety, ultimately bridging the gap in access to life-saving medications and safeguarding the well-being of our youth," Lowe said.

Laws in all 50 states allow students to carry their own inhalers, but limited access to these medications at school often leads to severe consequences, including increased absenteeism, higher health care utilization, and, in some cases, death.

"The Stock Inhalers for Schools program exemplifies the transformative impact that our faculty researchers can have on community health and safety," said Brian Ahn, PhD, dean of the College of Nursing. "This grant will enable Dr. Lowe to expand an initiative that addresses a critical, unmet need for students with asthma. We are proud to support such impactful research that serves not only Arizona but has the potential to influence national standards and policies."

Approximately 4.6 million children in the U.S. have asthma, according to the Centers for Disease Control and Prevention.

This research is supported in part by the National Heart, Lung and Blood Institute, a division of the National Institutes of Health, under award no. R01HL174599-01.