Asthma management in New York City schools: A physical education teacher perspective

OBJECTIVE: Physical education (PE) teachers may be the first to assist students with asthma attacks during PE class. This study explores the PE teachers’ perspectives on in-school asthma management and barriers to physical activity (PA) in children with asthma attending urban elementary schools. METHODS: We conducted qualitative semi-structured interviews with 16 PE teachers from 10 Bronx, NY elementary schools. Interviews were recorded, transcribed and independently coded. Content analysis was used to identify 10 major themes common across interviews which were then categorized into 3 domains. RESULTS: Three domains were identified: 1) school procedures and policies for asthma management; 2) role of PE teachers in asthma management; and 3) barriers to PA for students. Most PE teachers were unaware of written procedures for acute asthma management and did not receive asthma-specific training. Many PE teachers expressed confidence regarding asthma management. PE teachers identified students with asthma most commonly through communication with students. The PE teachers utilized various methods to manage asthma but all relied on the nurse to handle acute asthma symptoms. Several barriers to PA were determined, including PE teachers’ unawareness of NYS PE requirements, lack of gym facilities, inclement weather, inconsistent PE class time, asthma diagnosis, and having no asthma inhalers at the nurse’s office. CONCLUSIONS: PE teachers’ perspectives on asthma management may influence the way asthma is handled at school. The results from this study highlight several barriers that can be targeted in future interventions to improve asthma management.