Purpose of the Implementation Blueprint
The Creating Asthma Friendly Schools Implementation Blueprint assists with the preparation and training of future implementers of the Creating Asthma Friendly Schools "program".
In our current model, public health nurses continue to be the primary implementers. However, there are other key individuals in the asthma community that are important to the success of asthma management in schools and who may play a key role. This Blueprint was written for those potential implementers.Future implementers of the Creating Asthma Friendly Schools "program" should have a general understanding of asthma and be familiar with the contents of this Blueprint,
Background to the Public Health School Asthma Project
In Ontario, asthma is:
- The most common chronic disease in children.
- Increasing in prevalence to a rate of 19% among children (To et al. 2004).
- The most common reason in children for hospitalizations and emergency room visits.
- A leading cause of school absenteeism.
In 2000, a coroner's inquest into the death of an Ontario adolescent from asthma led the Ontario's Ministry of Health and Long -Term Care to form an expert panel steering committee and three working groups to make recommendations for a phased-in approach to a provincial asthma strategy. These recommendations, announced in January 2002, resulted in an evidence-based plan—the Asthma Plan of Action(APA)—that supports best practice for asthma across a variety of settings, where people with asthma live, work and play.
The Public Health School Asthma Pilot Project was established as one of thirteen initiatives funded under the Asthma Plan of Action (APA) and fulfilled two of the coroner inquest's recommendations. These recommendations specifically identified the involvement of schools and public health:
- The Ministry of Health and Long Term Care develop a program to educate children in school regarding asthma, management and its treatment.
- Public health nurses play a role as resource persons in the schools and assist in the delivery of the asthma management program and other health-related matters.
The Public Health School Asthma Pilot Project was conducted from 2003-2006 to develop, implement and evaluate a school-based asthma education program for achieving asthma prevention and control, which targeted elementary school students with asthma and the school community. There were multiple parties involved in and supporting the pilot project: five Ontario Public Health Units(Sudbury, Durham, Hamilton, Halton, and Peel), over 200 school communities of principals, teachers, students (with and without asthma) and parents from participating health regions, and various community agencies, Ophea, the Ontario Lung Association (OLA), and community asthma centres).
The Public Health School Asthma Pilot Project had four specific objectives:
- To implement an elementary school-based asthma education program for children with asthma;
- To work with schools to create asthma friendly school environments;
- To evaluate the school-based asthma education program; and
- To document the program's activities to permit replication of program delivery.
In 2007, the Public Health School Asthma Pilot Project dropped the term "pilot" and was renamed the Public Health School Asthma Project to reflect its status as an effective project.
Creating Asthma Friendly Schools - The Interventions
To create asthma-friendly schools, a two-pronged intervention is provided, one targeting children with asthma in their schools and the other targeting the broader school community. For children with asthma, a public health nurse and, ideally a local certified asthma educator, co-facilitate a self-management asthma education program called the Roaring Adventures of Puff (McGhan et al. 1998) in the school once a week for six weeks. For the broader school community, the public health nurses support the implementation of the Creating Asthma Friendly Schools Resource Kit to create supportive school environments that enable children with asthma to successfully manage their condition and be full participants at school.
Creating Asthma Friendly Schools - The Evaluation
Successful implementation of Creating Asthma Friendly Schools can:
- Promote a supportive school environment for students with asthma
- Reduce school absenteeism related to asthma
- Reduce the number of days of limited activity related to asthma
- Prepare the school environment for identifying and managing worsening asthma
- Facilitate full participation in school activities for children with asthma including physical activity
- Improve communication between members of the school environment