Established in 1996, the Community Preventive Services Task Force (CPSTF) releases evidence-based findings and recommendations about community preventive services, programs and interventions with the goal of improving the health of our communities and our country. Available at The Community Guide, the most recent findings recommend school-based, self-management interventions to reduce hospitalizations and emergency room visits among children and adolescents with asthma.
Dr. Neuzil, a Fellow of the American Association of Nurse Practitioners (FAANP), assisted in the development of these recommendations with CPSTF. “With asthma, the sooner we can motivate people and get them treatment, the less disease progression we will see,” he says. “In my view, anything we can do as health care providers to prevent the progression of the disease is a good thing.”
According to CPSTF, evidence shows that these asthma interventions are effective when delivered by trained school staff, nurses and health educators in elementary, middle and high schools that serve diverse populations.
“As part of an international study group of experts, we looked at various studies of school-aged children and adolescents with asthma and whether interventions were found to diminish disease symptoms,” Dr. Neuzil says.
“Interventions in schools — whether health-related courses, one-on-one meetings with the school nurse or teacher or other outreach—can train children and adolescents in the use of medications, or the parents in the disease process and disease management. What is key from our findings is the fact that interventions of any kind were found to make a difference. It allows health care providers a greater opportunity to address the disease in early stages versus later stages.”
These interventions can help school-aged children with asthma learn to recognize and manage symptoms, to use medications and inhalers properly and to avoid asthma triggers. Interventions can also offer guidance on how to monitor for signs of asthma, find stress relief and implement an asthma action plan. CPSTF also notes that interventions may aid in promoting health equity when they are implemented in schools in low-income or minority communities.
“When we look at lower socioeconomic groups, medications may not always be an option and disease may be more prevalent,” Dr. Neuzil explains. “These studies gave us information on how to best address asthma to intervene and improve patient outcomes across the board.”
Dr. Neuzil points out that, with the medical model, a patient may come in wheezing, be given an inhaler and be told to come back if they have any problems: “NPs are more apt to look at other factors, such as the patient’s surroundings, environment, socioeconomic status and more beyond the disease process. Each patient requires their own special focus, and NPs are trained to treat the whole patient.”
As owner of his own practice in Florida, Dr. Neuzil understands firsthand how NPs can be leaders in health care. With a family history of allergies and as an allergy sufferer himself, Dr. Neuzil says it often seems like fate that led him to this field.
“My patients really become my family,” he says. “In this area, 80% of the patients I see are covered by Medicare, and I’m able to see the difference between appropriate treatment or lack thereof. Dr. Loretta Ford [co-creator of the NP role], who lives nearby, continues to encourage me and inspire me to go further in my role as a NP. I am blessed to be able to precept NP students and, through them, I get to encourage what I think is the need for NPs to expand their role and develop independent practice.”
“It was both challenging and exciting to be a part of something like this with CPSTF. As NPs, when we are invited to participate in programs such as this, it’s important that we give our input and demonstrate our capabilities. We need to give voice to what we do on a daily basis in practice.”
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