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Article

Teacher Comfort in Managing Asthma: A Two-State Study

by
Yvette Q. Getch
1,
Ethan Schilling
2,
Stacey M. Neuharth-Pritchett
3,* and
Sofia Hirt
3
1
Department of Counseling and Instructional Sciences, College of Education and Professional Studies, University of South Alabama, Mobile, AL 36688, USA
2
Children’s Hospital of Richmond, Richmond, VA 23219, USA
3
Department of Educational Psychology, Mary Frances Early College of Education, University of Georgia, Athens, GA 30602, USA
*
Author to whom correspondence should be addressed.
Allergies 2024, 4(4), 181-191; https://doi.org/10.3390/allergies4040013
Submission received: 31 August 2024 / Revised: 3 October 2024 / Accepted: 11 October 2024 / Published: 12 October 2024
(This article belongs to the Section Asthma/Respiratory)
Versions Notes

Abstract

Background/Objectives: This study assessed teacher comfort in supporting the medical management of children with asthma in elementary and middle schools in two southern states in the U.S. Teacher comfort in asthma management is a largely underexplored area yet holds promise to support medical management in schools. Methods: Using survey methods, data were gathered from a random sample of teachers in two southern U.S. states (n = 574). Data from the Teacher Capability and School Resource Scale for Asthma Management scale were used to assess teacher comfort and capability in managing stressful asthma management episodes. Results: Teachers expressed comfort in supporting children with asthma in their classrooms. On the Teacher Capability in Social and Emotional Aspects of Asthma Management (SEAM) factor, the mean rating was 3.89 (SD = 0.83) out of 5, and the mean rating for the School Resources/Institutional Capability for Asthma Management factor was 3.77 (SD = 0.99) out of 5. Conclusions: The findings demonstrate that access to school, community, and medical resources; coordinated school-based asthma care plans; and pre-service preparation improve teacher comfort. School nursing support is needed for teacher education.

1. Introduction

In American schools, teachers serve daily as the responsible adults called upon to assist with children’s acute asthmatic exacerbations [1,2,3,4]. The assistance teachers provide includes medication administration and surveillance for an individual child’s triggers or symptoms for an impending episode [5]. Teachers not only need asthma knowledge but also to feel comfortable supporting children with asthma [1,4,6,7]. Nationally, there are concerns with the integration of asthma management policies and programs in schools [8]. It is not ideal for non-medically trained personnel to be centrally engaged in managing chronic illness in the classroom. Nevertheless, the U.S. national recommendation for school nurse ratios is 750 students to 1 school nurse [9]. Unfortunately, almost 60% of schools across the U.S. do not have full-time nursing services within suggested ratios. Moreover, only 39.3% of U.S. schools employed a full-time school nurse, 35.3% employed a part-time school nurse, and 25.2% did not employ a school nurse [10]. Given the variability of nurses employed and the high student-to-nurse ratios, teachers play an increasingly vital role as members of a child’s care team in schools [11].
Within the asthma education literature, studies on teacher asthma knowledge are plentiful, while those on teacher comfort in intervening with asthma exacerbations are sparse. Wheeler and colleagues [5] found that teachers who received formal asthma management training demonstrated better knowledge about the disease. Further, teachers who received formal asthma education also demonstrated a higher level of knowledge than those who gathered their information from other sources. The authors also noted that personal experience supporting a child managing asthma was a key contributor to asthma knowledge. Interestingly, the authors found that a personal history of asthma or history of asthma in a close relative was not significantly associated with a higher level of knowledge among the teachers. Other studies have documented similar strengths with formal teacher training in asthma management, including perceptions of teachers as trustworthy and knowledgeable in their abilities to support asthma management [12,13,14,15].
In its guidance document for managing asthma in schools, the U.S. National Asthma Education and Prevention Program [NAEPP] noted a goal to “educate students, staff, parents, and guardians about asthma” [16]. As teachers might express concerns regarding comfort in assisting children with their asthma management, the national guidelines on employing a team approach to asthma management offer benefits to teachers [17]. These guidelines provide a structure to support the child with asthma and set a context for helping other children in the classroom understand and accept a student who is managing an asthma condition [18,19,20].
Within these U.S. national guidelines, facilitating family–school connections is sometimes challenging but a focus on how parental involvement contributes to the success of chronic disease management can help promote the success of family–school partnerships and teacher comfort [21,22,23,24,25,26]. The work by Kornbilt et al. [27] noted that families express concern about school-based asthma management for their children. They found that parents would rather keep their children at home when addressing exacerbations because of inadequate training of school personnel on asthma management, implementation of school policies surrounding medication administration including self-carry, and access to knowledgeable and confident adults in various school activities such as after-school programs.
A school’s connection to the family helps facilitate communication of health information to school personnel including teachers, particularly when parents are an important part of the care team [28,29]. Families who perceive good communication with schools are more comfortable sending their children to school when experiencing asthma symptom exacerbations or frequent episodes. Although there are recommendations to approach chronic disease management with a team approach, some studies noted that such management practices appear to be burdensome when accommodations are challenging to implement, including execution of aspects of U.S. law-mandated 504 plans [30,31,32,33,34,35]. Such plans are designed to provide access and support to children who have disabilities but whose disabilities do not rise to the level of needing a formal individualized education plan [36]. In sum, asthma can be suboptimally treated by not following national guidelines for management and not including families in educating teachers about their child’s asthma management whereas following guidelines can contribute to enhancing teacher comfort or confidence in supporting children with managing children’s asthma at school [37].

Teacher Comfort

It is important to foster a teacher’s comfort with asthma management in schools as childhood asthma contributes to high rates of absenteeism [38]. Lucas, Anderson, and Hill found that about a third of teachers felt unsure about their capabilities to manage asthma episodes, while Nabors and colleagues noted that a teacher’s comfort is a function of a teacher’s familiarity with and knowledge about chronic illness and that they lack sufficient strategies to implement accommodations for children with chronic illness in their classrooms [12,39]. McCarthy, Williams, and Eidahl [13] also highlight concerns from teachers in generally managing students’ medical concerns in classrooms.
Brief interventions can improve a teacher’s comfort with asthma management. Using a one-hour didactic instruction and video instruction to support teacher development of asthma management expertise and comfort, researchers found that teacher comfort in recognizing symptoms of asthma and comfort with asthma medications increased from pre-test to post-test [40]. Additionally, following a brief intervention, authors found that comfort increased regarding addressing medical emergencies, medication administration, and consideration of liability that might stem from intervening with a resulting negative outcome [41]. These authors further noted that post-intervention childcare provider and teacher ratings ranged from comfortable to very comfortable in assisting children with social and emotional needs surrounding asthma management, helping the child’s peers understand the asthma episode, administering medications, and including a child with asthma in their classroom. Comfort was also found in teacher solicitation of school resources to assist with asthma management. The increases in teacher comfort level in asthma management following brief interventions are encouraging given that brief interventions may be added to professional development activities for teachers with relative ease.
Other studies have found that teachers need to develop confidence to assist with asthma management [42]. Cain and Reznik [8] discovered that teachers lacked confidence in addressing a hypothetical asthma attack in the classroom and that their recognition of asthma symptoms was poor. Walders, McQuaid, and Dickstein [42], in a sample of preschool teachers in the Early Head Start and Head Start program, noted moderate comfort in administering asthma medications and responding to an asthma attack. Other studies have documented teacher discomfort, lack of confidence, and perceptions of limited abilities to assist with asthma management [43,44].
The simple provision of asthma education can increase teacher knowledge and confidence in managing asthma [45]. In Australian samples from childcare and school settings, researchers found increases in a teacher’s self-reported confidence in managing acute asthma episodes and asthma management following professional development addressing this topic [46,47,48,49].
Therefore, the current descriptive study examines teacher ratings of comfort to intervene and support asthma management in school classrooms in two U.S. southern states, Georgia and Kentucky, including any differences in levels of perceived comfort.

2. Materials and Methods

Participants. Participants in the current study derive from a larger study that examined teacher experiences with asthma management in elementary and middle school classrooms. Using a random sample, we collected data on teachers in two southern states, Georgia and Kentucky (n = 574). Teachers were distributed by grade level: kindergarten (n = 93), first (n = 73), second (n = 71), third (n = 82), fourth (n = 73), fifth (n = 68), sixth (n = 8), seventh (n = 49), eighth (n = 26), special education (n = 11), and multiple grades (n = 20). Teachers were generally very experienced, with a mean number of years of teaching of 16.4 years (SD = 8.55; range 1–44). Teachers self-identified their race, with 504 identifying as White (87.8%), 63 as African American/Black (11.0%), 4 as Latino (0.7%), 3 as Native American (0.5%), 1 as Asian American (0.2%), and 3 as not listed/other (0.5%). The sample was primarily female (96.7%). The teacher-reported highest level of education was 17.9% bachelor’s, 54.7% master’s, 19.7% specialist [a degree between master’s and doctorate], and 2.3% doctorate degrees. Information on education level was missing for 1.7%, and 3.7% noted that they had other education experiences.
The size of the communities of the teachers varied, with most teaching teaching in small (29.6%), medium (36.6%), and large communities (29.8%). Data were missing for 4%. The school size in terms of the number of students was small (5.9%; 1–250 children), medium (38.0%; 251–500 children), large (34.5%; 501–750 children), and very large (20.7%; 750+ children). Five teachers did not provide information about the number of students in their schools. We also asked teachers for their chronic health status (12.2%), allergies (62.9%), and asthma (13.8%), with most indicating mild severity (61.7%) or moderate severity (34.6%). Information about the specific allergens that teachers reacted to was not asked.
Learning Environments. Teachers also self-reported the medical processes within their schools. Of the responses, 81.7% of children were medically supported but fewer children with asthma had action plans (38.4%). Many teachers (46.2%) did not know if children in their schools had action plans. Regarding the control of asthma, 86.0% reported that children had conditions that were pretty well controlled. Teachers also noted that children with asthma had an IEP (8.2%) or a 504 plan (19.2%). Only 4.5% of teachers indicated that children with asthma had worse academic performance than their classmates.
Study Design. In Fall 2015, participants in this study completed the Asthma and Other Chronic Diseases in School survey. Collected and validated from 3223 elementary and middle school teachers, teachers responded to items on children with asthma or chronic medical needs, teacher training and preparation, school policies, and demographics. The survey and the study were approved by the Institutional Review Boards at the authors’ affiliated universities and participating school districts. Using either mail or an internet-based delivery, we garnered a 22% response rate, with close to 83% of teachers completing the full survey (n = 574).
Instrument. Embedded within the Asthma and Other Chronic Diseases in School survey were items from the Teacher Capability and School Resource Scale for Asthma Management [50]. On this scale, teachers complete 10 questions on comfort and capability in managing stressful asthma management episodes in the classrooms. Specific questions focused on teacher actions in assisting students and concerns teachers might have about policies, regulations, or liabilities associated with intervention. Items were rated using a five-point scale (1 = very uncomfortable, 5 = very comfortable). For the Teacher Capability in Social and Emotional Aspects of Asthma Management (SEAM) factor, the alpha value for the original scale was 0.83. For the School Resources/Institutional Capability for Asthma Management (SRIC) factor, the value of Cronbach’s alpha was 0.86. For the current study, the Cronbach’s alpha was 0.86 for both the SEAM and SRIC factors, indicating good levels of internal consistency.

3. Results

Examining the entire sample, teachers expressed comfort in supporting children with asthma in their classrooms. On the SEAM factor, the mean rating across 574 teachers was 3.89 (SD = 0.83) out of 5, and the mean rating for the School Resources/Institutional Capability for Asthma Management factor was 3.77 (SD = 0.99) out of 5. Frequency, mean, and standard deviation information for the individual items within the two factors are displayed in Table 1.
Analysis of variance tests were conducted with the two comfort subscales and teacher responses to items asking about aspects of their classrooms. General comfort with supporting a child with asthma was found for teachers who had taught children with chronic illness across their years of teaching. When asked specifically about teaching children with asthma, a significant difference was found on the social and emotional subscale of the comfort scale, yet post hoc analyses did not reveal differences among teachers who replied yes, no, or unsure.
Regarding whether teachers perceived that they could access general resources or links to agencies and physicians that could assist a teacher with asthma management, teachers who responded yes expressed more comfort than a teacher who did not receive such information. Post hoc differences were found on the social and emotional management of asthma for those who responded yes to access and those who responded no (p < 0.001). On the school and institutional resources subscale, a teacher who responded yes who also had access to general resources of agencies/physicians expressed more comfort than either a teacher who responded no or who was unsure (p < 0.001).
When asked if teachers believed that teacher licensing policies prepared them to teach students with chronic health conditions in the classroom, significant differences were found for both comfort subscales. On both subscales, we compared teachers who responded that their state’s requirements prepared them to support children with health conditions against teachers who did not perceive that their state had requirements to support children with chronic conditions or who were unsure (p < 0.001). A similar pattern was found when asked about teacher certification requirements and preparation to specifically teach children with asthma. On the social and emotional subscale of the comfort measure, teachers who responded that they were prepared to support children with asthma were more comfortable than either a teacher who was not or who was unsure (p < 0.001). In addition, teachers who replied no differed from teachers who were unsure, with teachers who were unsure expressing a bit more comfort in supporting children with asthma in their classrooms (p < 0.001). On the school resource and institutional capability subscale of the comfort scale, a statistically significant difference was found overall with teachers who were prepared through state requirements expressing the most comfort. Post hoc analyses indicated that the “yes” group differed from both those teachers who responded no or unsure (p < 0.001).
Three additional yes or no questions were asked of teachers about their comfort. On all three questions, teachers who indicated that they knew the signs of an asthma attack had higher ratings on comfort with social and emotional aspects of asthma management (p < 0.001) and comfort with school resources/institutional capability (p = 0.007). If teachers indicated students with asthma had an asthma action plan, teachers also expressed comfort on both comfort subscales (p = 0.02, p < 0.001, respectively). However, it should be noted that about half (53%) reported that asthma action plans were in use in their schools.
Finally, teachers responded to an item about whether they had been diagnosed with asthma. Although most teachers (86.1%) indicated that they did not have asthma, teachers who disclosed their diagnosis of asthma expressed more comfort in managing asthma in their classrooms. A statistically significant difference was noted for teachers who had an asthma diagnosis and their comfort in their capabilities to support the social and emotional aspects of children’s asthma management (p = 0.03). Teachers with asthma also expressed more comfort with their school’s resources and institutional capability to support asthma in the classroom (p < 0.001). Table 2 displays the means, standard deviations, and statistical comparisons for the comfort measure.

4. Discussion

One finding was the overall comfort expressed by teachers in supporting children with asthma in their classrooms. Perhaps because teachers noted children overwhelmingly (81.7%) were supported medically, strategies for greater inclusion of children with medical needs are becoming more prevalent in schools. Despite attention to children’s medical needs, only 38.4% of children with asthma, in the classrooms of the teachers in this study, had an asthma action plan However, this should also be contrasted with the finding that only about half of teachers (53.0%) surveyed noted that asthma action plans were used for students in their schools. In addition, comfort might have been found in teacher abilities to support children with asthma given the high level of reported childhood asthma control in classrooms (86%). Our findings of overall high levels of comfort vary from prior work [8,12,42] where teachers in those studies did not express as high a level of comfort in their efforts to support asthma management in classrooms.
The findings from this study are consistent with prior studies [39,45] that note that teacher experiences over time in supporting children with chronic medical conditions and asthma contribute to increased comfort in supporting future exacerbations of the condition in their classrooms. This experience was highlighted in teacher responses to addressing the social and emotional aspects of asthma management.
A novel finding from our analyses was the linkage of teacher comfort to access to general resources for information seeking such as school resources, community agencies, or physicians. This finding speaks to the need for coordinated school-based asthma management advanced by the U.S. NAEPP [16]. Although also connected with asthma education, the current study found that as the amount of information shared among key stakeholders in the asthma management process increased, so did the comfort level of teachers in their abilities to assist children in their classrooms. Information sharing as recommended by [NAEPP] (2014) is likely key when increasing teacher comfort in asthma management in the classroom. Coordinating these efforts becomes key, with the school nurse being the logical coordinator. Unfortunately, given the ratio of students to school nurses, the likelihood of all schools having nurses available to coordinate these efforts is unlikely [8,9]. Designating a person to facilitate and coordinate the sharing of asthma information is imperative, particularly when the school nurse is either overloaded or unavailable [10,11]. Local health partners might be powerful contacts.
Interestingly, teachers who reported that asthma action plans were in use at their schools expressed higher comfort than those teachers who did not report the use of asthma action plans [38]. Advocating for the development and use of asthma action plans while emphasizing the importance of these plans for reducing asthma exacerbations and improving asthma management may increase asthma action plan use in school while also likely increasing teacher comfort in managing asthma in the classroom [12].
Teachers in this study noted greater levels of comfort when their state’s requirements for regular classroom certification included professional learning on chronic disease management, specifically asthma management. This finding is consistent with several studies, highlighting the role of comfort as an outcome of asthma education [40,41,45].
This study adds to the literature, highlighting the importance of asthma education and the importance of teacher comfort in assisting children with asthma in school. The findings from the present study demonstrate that access to school, community, and medical resources; coordinated school-based asthma care plans; and pre-service preparation improve teacher comfort. Furthermore, teachers who are comfortable supporting children with asthma in the classroom are likely to contribute to a reduction in asthma triggers, which might result in an overall decrease in asthma symptom episodes at school [41]. An increased effort to provide teachers with connections to asthma and chronic illness resources in and out of school may be particularly important in improving the outcomes of students with asthma.
An interesting finding from this study was that teachers appeared more comfortable supporting children with asthma than in previous work; however, it is concerning that far fewer children than expected reportedly had asthma action plans in place or had teachers who knew about such plans when one considers the overall care for students with asthma. The use of asthma action plans has been found to reduce asthma exacerbations [51], and as such, widespread knowledge of and ability to follow through on asthma action plans is critical. Due to the nature of teacher self-report as a method of collecting data related to the prevalence of such action plans in schools, future research should attempt to corroborate these data with a future review of school records. Including the importance of asthma action plans in pre-service and in-service training for teachers may also highlight the importance of these plans and prompt teachers to look for them when they encounter students with asthma in their classrooms.
Finally, statistically significant differences were found among teachers who had chronic disease or asthma management professional learning compared to teachers who did not have such training or were unsure about their prior training. When teachers recognize the signs of an impending exacerbation or if the child had an asthma action plan, the teachers expressed greater comfort. Additionally, teachers who had been diagnosed with asthma felt comfort in intervening. Given these findings, schools might consider leveraging experiences from teachers with such training or teachers who have asthma as they plan for coordinated asthma education with key community stakeholders.

Study Limitations

Although the current study adds much to the literature regarding the identification of factors related to teacher comfort levels in managing asthma in the classroom, several limitations exist. First, this study included a sample of teachers from two Southern states. Therefore, it is unclear whether the findings are generalizable to teachers and schools in other areas of the U.S. with different demographic characteristics. In addition, the data from the current study, particularly regarding asthma management practices in U.S. schools, were gathered based on teacher self-report and were not corroborated through a review of school records. Future studies should continue to examine these important issues in broader samples of teachers as well as utilize a variety of additional data collection methods to provide a clearer picture of school-based asthma management practices.
Although understandable, it is somewhat concerning that teachers who had previously been diagnosed with asthma were more comfortable intervening in asthma management than those without asthma. One additional limitation present was that the survey items did not poll teachers who had noted that they have allergies about what specific triggers exacerbated those allergies. Such documentation could have provided some additional insight into understanding what teachers know about environmental triggers that can prompt asthma episodes.
A teacher’s personal experience alone might not serve as the only source of knowledge and empathy needed to assist students with asthma in the classroom. Furthermore, just because a teacher is more comfortable intervening due to their personal experiences with asthma, this does not equate to having current asthma knowledge and skills to manage asthma in the classroom. The most current information regarding triggers, treatment, and management changes frequently over time, and non-medical personnel intervening in asthma management without such updated knowledge and training may lead to inefficient/ineffective asthma management practices [52]. However, it is important to capitalize on those teachers whose current levels of comfort are high as they might be able to assist in providing training to others who demonstrate lower levels of comfort. This same suggestion can be made for teachers with prior experience managing asthma in the classroom, as they also reported increased comfort in the current study.

5. Conclusions

Taken together, the results of the current study first support the need to continue to advocate for the use of best practices in the asthma management of students in schools. Second, the results support the importance of providing teachers with information regarding the skills and knowledge they need to effectively implement these practices and help students with asthma. It is recommended this information first be delivered at the pre-service level within the course of teacher educational training. Next, continued in-service training provided by school nurses around related topics including skills practice is also needed to ensure that teachers have the most up-to-date information regarding how they can assist best in asthma management at school. This will likely ultimately lead to teachers feeling higher levels of comfort in this effort.
Previous work has highlighted the efficacy of brief asthma education interventions in the development of teacher knowledge. Effective interventions include providing information about warning signs and triggers, ways to reduce triggers in the classroom, how to respond during an asthma attack, how to use and manage asthma medications (nebulizers and inhalers), etc. [41,53]. Not only are such interventions likely to lead to increased teacher knowledge, but brief interventions are likely to enhance teacher comfort and self-efficacy, which might further reduce the frequency of episodes in trained teacher classrooms. Brief asthma interventions should explicitly address the issue of teacher comfort in asthma management practices by including opportunities to practice these skills (e.g., using inhalers with spacers in the classroom, recognizing the presence of emergency inhalers, and identifying and removing common asthma triggers). Future research that documents the efficacy of these interventions will be helpful to the field.

Author Contributions

Conceptualization, Y.Q.G., E.S., S.M.N.-P. and S.H. Methodology: Y.Q.G., E.S., S.M.N.-P. and S.H. Formal Analysis: S.M.N.-P. and S.H. Investigation: Y.Q.G. and S.M.N.-P. Resources: Y.Q.G., E.S., S.M.N.-P. and S.H. Data Curation: S.M.N.-P. Writing—Original Draft Preparation: Y.Q.G., E.S., S.M.N.-P. and S.H. Writing—Review and Editing: Y.Q.G., E.S., S.M.N.-P. and S.H. Visualization: Y.Q.G., E.S., S.M.N.-P. and S.H. Project Administration: Y.Q.G. and S.M.N.-P. Funding Acquisition: Y.Q.G. and S.M.N.-P. All authors have read and agreed to the published version of the manuscript.

Funding

This work was supported by the University of Georgia.

Institutional Review Board Statement

This study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board (or Ethics Committee) of the University of Georgia (Study00000650 and 1 October 2014).

Informed Consent Statement

Informed consent was obtained from all subjects involved in this study.

Data Availability Statement

The datasets presented in this article are not readily available because the data are part of an ongoing study. Requests to access the datasets should be directed to sneuhart@uga.edu.

Conflicts of Interest

The authors declare no conflicts of interest.

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Table 1. Frequencies, means, and standard deviations for items from the Teacher Capability in Social and Emotional Aspects of Asthma Management and School Resources/Institutional Capability for Asthma Management factors.
Table 1. Frequencies, means, and standard deviations for items from the Teacher Capability in Social and Emotional Aspects of Asthma Management and School Resources/Institutional Capability for Asthma Management factors.
ItemVU
f (%)		SU
f (%)		U
f (%)		SC
f (%)		VC
f (%)		Missing
f (%)		MSD
Having a child with asthma in your classroom 114
(2.4)		65
(11.3)		19 (3.3)233 (40.6)240 (41.8)3
(0.5)		4.091.06
Administering medications to a child with asthma 1107 (18.6)116 (20.2)54 (9.4)150 (26.1)139 (24.2)8
(1.4)		3.171.48
Your school’s adequacy of resources to assist with children with asthma 228
(4.9)		46
(8.0)		83
(14.5)		199
(34.7)		212
(36.9)		6
(1.0)		3.921.13
Your school district’s adequacy of resources to assist with children with asthma 224
(4.2)		45
(7.8)		151
(26.3)		196
(34.1)		151
(26.3)		7
(1.2)		3.711.07
School facilities to deal with asthma exacerbations 234
(5.9)		72
(12.5)		151
(26.3)		182
(31.7)		129
(22.5)		6
(1.0)		3.531.15
Interactions with parents of children with asthma and their child’s specific condition and treatment 121
(3.7)		28
(4.9)		56
(9.8)		246
(42.9)		218
(38.0)		5
(0.9)		4.081.00
Other children’s reactions to child with asthma 113
(2.3)		33
(5.7)		80
(13.9)		226
(39.4)		218
(38.0)		4
(0.7)		4.060.98
A child with asthma’s attitude toward the management of their condition 114
(2.5)		26
(4.6)		86
(15.0)		253
(44.1)		190
(33.1)		5
(0.9)		4.020.94
Potential social and emotional interaction problems for children with asthma 111
(1.9)		34
(5.9)		126
(22.0)		222
(38.7)		177
(30.8)		4
(0.7)		3.910.97
The availability of a school nurse to assist with the child’s management of their asthma 252
(9.1)		67
(11.7)		28
(4.9)		146
(25.4)		273
(47.6)		8
(1.4)		3.921.35
1 Teacher Capability in Social and Emotional Aspects of Asthma Management; 2 school resources/institutional capability for asthma management; VU (very uncomfortable), SU (somewhat uncomfortable), U (undecided), SC (somewhat comfortable), VC (very comfortable).
Table 2. Frequencies, means, standard deviations, and statistical comparisons for the comfort measure.
Table 2. Frequencies, means, standard deviations, and statistical comparisons for the comfort measure.
Comfort Rating on Teacher Capability in Social and Emotional Aspects of Asthma ManagementSchool Resource/Institutional Capability for Asthma Management
NoYesUnsureFNoYesUnsureF
Have you ever had a child in your classroom with a chronic disease?f57470402.3057470400.85
M (SD)3.84
(0.82)		3.91
(0.84)		3.63 (0.79)3.66
(0.98)		3.79
(0.99)		3.62
(1.02)
Have you had a child in your classroom within the last year with asthma?f7948283.93 *7918282.07
M (SD)3.84
(0.82)		3.91
(0.84)		3.63 (0.79)3.66
(0.98)		3.79
(0.99)		3.62
(1.02)
Does your school provide general resources or links to community agencies or physicians that may assist you with information or referral services for children with asthma? f1811672209.80 **18116722021.59 **
M (SD)3.70
(0.88)		4.09
(0.80)		3.89
(0.78)		3.41
(1.06)		4.08
(0.91)		3.83
(0.91)
Do you believe that your state’s requirements for regular classroom certification have adequately prepared you to teach students with chronic health conditions in the classroom? f28614913124.46 **28614913118.19 **
M (SD)3.72
(0.88)		4.28
(0.71)		3.80
(0.72)		3.55
(1.05)		4.44
(0.89)		3.82
(0.88)
Do you believe your state’s requirements for regular classroom certification have adequately prepared you to teach students with asthma in the classroom?f25320311234.24 **25320311227.64 **
M (SD)3.63
(0.86)		4.24
(0.74)		3.83
(0.71)		3.45
(1.07)		4.12
(0.74)		3.77
(1.00)
If a child in your class is having an asthma attack, do you know what the symptoms or signs of an attack look like? f38454 29.66 **38454 7.32 ***
M (SD)3.28
(0.70)		4.02
(0.82)		3.40
(0.80)		3.86
(1.01)
Do children with asthma in your school have an asthma action plan? f85219 5.62 *85219 21.93 **
M (SD)3.80
(0.83)		4.05
(0.85)		3.42
(1.05)		4.02
(0.97)
Do you have asthma? f48879 4.57 ****48879 7.42 ***
M (SD)3.86
(0.81)		4.08
(0.91)		3.82
(0.94)		3.49
(1.21)
* p = 0.02; ** p < 0.001; *** p = 0.007; **** p = 0.03.
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Getch, Y.Q.; Schilling, E.; Neuharth-Pritchett, S.M.; Hirt, S. Teacher Comfort in Managing Asthma: A Two-State Study. Allergies 2024, 4, 181-191. https://doi.org/10.3390/allergies4040013

AMA Style

Getch YQ, Schilling E, Neuharth-Pritchett SM, Hirt S. Teacher Comfort in Managing Asthma: A Two-State Study. Allergies. 2024; 4(4):181-191. https://doi.org/10.3390/allergies4040013

Chicago/Turabian Style

Getch, Yvette Q., Ethan Schilling, Stacey M. Neuharth-Pritchett, and Sofia Hirt. 2024. "Teacher Comfort in Managing Asthma: A Two-State Study" Allergies 4, no. 4: 181-191. https://doi.org/10.3390/allergies4040013

APA Style

Getch, Y. Q., Schilling, E., Neuharth-Pritchett, S. M., & Hirt, S. (2024). Teacher Comfort in Managing Asthma: A Two-State Study. Allergies, 4(4), 181-191. https://doi.org/10.3390/allergies4040013

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