Evaluation and Sustainability of the Healthy Learners Asthma Initiative

Abstract

The Healthy Learners Asthma Initiative (HLAI) involved collaboration between Minneapolis Public Schools (MPS), local health care providers/payors, parents, and other partners. The intervention included development of enhanced asthma care in school health offices and clinic performance improvement projects to foster adoption of National Institutes of Health asthma guidelines. Goals were to improve asthma management among school children and reduce asthma‐related school absences, hospitalizations, and emergency department visits. The effectiveness evaluation utilized a randomized community trial design with 16 elementary and middle schools matched and randomly assigned to either an intervention or a control group. Outcomes investigated were (a) school health office impacts and (b) school attendance. Data sources included school health office records, district attendance, enrollment, and demographics files. Following implementation of the HLAI, asthma visits to health offices were significantly lower in intervention schools compared to control schools (91 vs 121 visits per 100 students with asthma per month), and intervention schools had greater availability of medication and asthma action plans and more peakflow measurements, asthma education, and parent communication. Clinics initiated significantly more asthma action plans and sent them to MPS. Attendance differences between groups were limited to students who received asthma care through the school health office. Monitoring of asthma management activities provided through school health offices from 2002 to 2005 indicates sustained implementation of enhanced asthma care in schools and increased asthma communication between school, parents, and health care providers. (J Sch Health. 2006;76(6):276‐282)

School-based asthma programs

“…Second, school health staff attempt to obtain written asthma treatment plans for each student's overall asthma management from the provider and family, thus both ensuring the development of such a plan and establishing some degree of partnership among the school, the family, and the provider. [26][27][28][29] Most efforts to establish or improve access to continuing care for asthma in the community by school nurses or other health personnel have not been very successful. 27 Although case detection efforts have been shown to increase awareness of asthma cases by school staff, most schools have found it difficult to influence the relationship between family and health care providers beyond providing instructions for rescue care during the school day.…”

The Healthy Learner Model for Student Chronic Condition Management—Part I

“…The successful implementation and continuation of the HLAI demonstrated that a comprehensive community-based model of care that includes schools can improve the management of pediatric asthma in a community (Erickson et al, 2006 [this issue, p. 319]; Splett et al, 2006). Positive evaluation data provided evidence to justify continuation of the HLAI in MPS.…”

The international school nurse asthma project: barriers related to asthma management in schools

“…However, research suggests that if children receive evidence‐based care that includes school health services, the rate of school attendance among children with asthma can equal that of children without asthma (Splett et al . , Millard et al . ).…”