Background: Asthma is a common pediatric lung disease in the United States. Children in rural schools face unique environmental asthma triggers and longer distances to medical services than do urban children. Although Illinois law permits schools to carry undesignated rescue inhalers for respiratory distress, few rural schools participate.
Objective: To develop a rural school engagement strategy for stock inhaler programming.
Methods: An initial engagement strategy was derived from a rural qualitative inquiry through semi-structured interviews and presented for feedback. A two-hour focus group was conducted with eight partners who work within or with rural schools related to school health. Participants were identified through purposeful and snowball sampling. The discussion was transcribed, and key themes were identified using rapid qualitative analysis.
Results: Three themes emerged from the analysis: Building Policy Awareness and Assessing Local Needs, Building Rapport and Support for Rural School Programming, and Unique Considerations for Rural Schools. Engagement strategy suggestions included working with a community health champion and conducting a needs assessment before proposing an intervention. Communication suggestions included concise top-down messaging tailored to rural communities with personal storytelling. Unique rural school characteristics identified were isolation, strong sense of community, insularity, and generosity. Barriers such as communication, liability concerns, and lack of school nurses and physicians were described. This feedback refined the rural engagement strategy.
Conclusion: A carefully selected focus group with diverse perspectives helped elucidate the best engagement and implementation strategies for rural school health interventions. Addressing the unique challenges faced may improve health outcomes for rural children.
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