An initiative headed by the Ernest Mario School of Pharmacy aims to use education to end pediatric asthma deaths in Newark and beyond
When two children died from asthma-related complications at the same Newark, N.J., school in 2016 and 2019, caregivers wanted answers. When the asthma deaths didn't stop, doctors and health advocates demanded action.
"No child should die from an asthma attack," said Denise Rodgers, vice chancellor for interprofessional programs at Rutgers Health.
To address this health crisis, Rodgers and colleagues launched Asthma Corps, a partnership between the Ernest Mario School of Pharmacy and the Rutgers Health Service Corps (RHSC), a community health service and training organization for students, faculty and staff.
"By working with the departments of pediatrics at University Hospital and Newark Beth Israel Medical Center, and in collaboration with other Rutgers Health departments, we've created a community health education program involving students to decrease incidences of these preventable deaths," Rodgers said.
By working with the departments of pediatrics at University Hospital and Newark Beth Israel Medical Center, and in collaboration with other Rutgers Health departments, we've created a community health education program involving students to decrease incidences of these preventable deaths.
Denise Rodgers
Vice Chancellor for Interprofessional Programs, Rutgers Health
A critical goal of the program is to help parents and caregivers understand the importance of getting emergency care if routine treatments don't control their child's asthma attack, Rodgers said. Another is to help parents and caregivers - and children themselves - better manage pediatric asthma.
Working with the Greater Newark Health Care Coalition (GNHCC), a nonprofit organization, Asthma Corps volunteers conduct online and in-person training in community centers. Pharmacy doctoral students share personal experiences with asthma and teach asthma basics - from identifying what causes an attack to using proper medication.
"Asthma Corps' students are teaching community members how to identify triggers, what resources are available for long-term care and how to create asthma action plans, such as what to do in an acute attack," said Ebonie Steele, program manager for child and adolescent health at GNHCC. "With Rutgers, we recognize that we have something great here."
Throughout the United States, pediatric asthma is a persistent problem, particularly in cities, where air pollution poses a constant irritant to young lungs. In Newark, it is estimated that 1 in 4 children has asthma, far outpacing the national average of 1 in 11. Rates of asthma are only expected to climb further as higher temperatures linked to climate change are fueling conditions that can spark asthma attacks.
In New Jersey, children die every year from asthma-related complications. The risks are greater for children of color. The New Jersey State Health Assessment estimates that the mortality rate among Black and Hispanic children is a combined 4.9 per 100,000 people. For white children, it's less than 1 per 100,000.
Far more common are adverse consequences of poorly managed asthma, such as school absenteeism, lower academic performance and reduced physical activity.
Through outreach and education, the Asthma Corps - officially known as Clearing the AIR about Asthma: Awareness, Information and Resources - is empowering children and caregivers to bring asthma under control. Training topics include identifying asthma symptoms, exercising with asthma and avoiding over-the-counter medications that are ineffective in treating an asthma attack.
About 100 Newark-area parents and caregivers have received the training since the program launched in May, and hundreds more are in the pipeline.
John "Jack" Hemphill, a program manager in the Rutgers Office of Population Health and co-convenor of Asthma Corps, said the idea for the program began in the "trenches of COVID." A vaccine program run out of the pharmacy school had achieved high marks for vaccination rates and its ability to connect experts across Rutgers schools.
"We did all this amazing interprofessional work during the pandemic, and we wanted to bottle that up, cultivate that and move beyond the vaccination initiative," Hemphill said.
The VAX Corps, as it was known, eventually evolved into RHSC, which Hemphill co-leads. After the second child asthma death in Newark in 2019, the service corps and pharmacy faculty teamed up with Rodgers and the Rutgers Office of Interprofessional Programs to create the Asthma Corps, bringing together public health experts, pharmacy students and faculty. The initiative is supported with funding from RHSC and private donations.
Among the facilitators are Rupal Mansukhani, a clinical professor at the pharmacy school, who produced much of the training material; Lucio Volino, a professor of pharmacy and Nina Raps, a curriculum field manager, who helped develop and deliver programs; and Donna Feudo, associate dean for experiential education at the School of Pharmacy.
As Asthma Corps matures, we're bringing in students from other programs, like the school of nursing. The interprofessional nature is what makes this program so special for our students.
Donna Feudo
Associate Dean for Experiential Education, Rutgers Ernest Mario School of Pharmacy
"As Asthma Corps matures, we're bringing in students from other programs, like the school of nursing," Feudo said. "The interprofessional nature is what makes this program so special for our students."
Placing the program within the pharmacy school makes sense, said Vince Silenzio, a professor at Rutgers School of Public Health and another Asthma Corps co-convenor. As a first point of contact, pharmacists serve as a vital lifeline for young asthma sufferers.
"There's a whole set of reasons why caregivers might not seek asthma care for their kids, even if they have access to a clinician," Silenzio said. "Pharmacists can often be a more convenient touch point in many communities."
So, too, can future pharmacists.
"It's been working beautifully so far, having the students facilitate the workshops," Steele said of the Newark health care coalition. "We all have the same goal - to ensure that not another child dies from asthma."
