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Teaming Up for Asthma Control: EPR-3 Compliant School Program in Missouri Is Effective and Cost-Efficient


Of the 522 Missouri school superintendents and districts that were eligible in 2010 and 2011, 28 school superintendents and 54 school nurses serving 61 schools consented to participate in the study. Forty-two of the school nurses completed the online asthma training, and 12 completed the instructor-led asthma training. All school nurses identified children using the Identifying Persistent Asthma Checklist. Of the children with asthma identified, 178 families consented to participate in the study (with children assenting). At enrollment, 124 children had uncontrolled asthma. Expert evaluators obtained student participants’ preassessments and postassessments before and after the 3 asthma checkups by the school nurse, and the assessments were compared. Thirty-four of the school nurses assessed the recommended 3 students and were included in the skills assessment. Health care costs were assessed using Medicaid administrative claims data. Of the students participating in TUAC, 85 were enrolled in MHN and 73 were continuously enrolled to capture total care utilization cost. The 64 students participating in TUAC and enrolled in MHN group were compared to a non–TUAC MHN recipients group matched on age (standard deviation, 1.5 y), race (white, African American, or other), sex, and 12-month preintervention total health care utilization cost within $1,000 to assess the impact of the intervention on health care utilization cost.

Figure 1. Teaming Up for Asthma Control schematic diagram, Missouri, 2011–2014.

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Figure 2. Health care utilization cost among students in the Teaming Up for Asthma Control program compared with MO HealthNet matched control group, Missouri, 2011–2014.

Group Health Care Utilization, Average Cost Per Person, $
Preintervention Postintervention Difference
Teaming Up for Asthma Control 3,669.18 2,320.70 −1,348.48
MO HealthNet matched control group 2,327.47 2,410.16 82.69

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Page last reviewed: June 1, 2017