Each year, more children are living with asthma.1 In response to this worrisome situation, innovative community-based approaches are sought to elucidate best practices to improve asthma outcomes. An article in the May 2004 issue of the ARCHIVES “Benefits of a School-Based Asthma Treatment Program in the Absence of Secondhand Smoke Exposure” by Halterman et al2 described a system-change approach comparing the effectiveness of school-based delivery of inhaled corticosteroids, facilitated by school nurses, with corticosteroids delivered at home. We appreciate this innovative and important study and agree that system change is needed to address escalating asthma rates.
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