Form 7 F - Indicators for School Health Programs: Asthma Manage

Indicators of the Performance of Local and State Education Agencies in HIV Prevention and Coordinated School Health Program Activities for Adolescent and School Health Programs

Attachment F (Asthma - FY2008-FY2010)

Indicators for School Health Programs: Asthma Management (LEA)

OMB: 0920-0672

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0672 can be found here:

2011-04-12 - Revision of a currently approved collection

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Attachment F
Indicators for School Health Programs: Asthma Management, Local Education Agencies
(FY2008-FY2010)

Form Approved
OMB No. 0920-0672
Exp. Date xx/xx/xxxx

Indicators for School Health Programs:
Asthma Management (AM)
Local Education Agencies
Fiscal Year: March 1, 2008 – February 28, 2009
Division of Adolescent and School Health
Funding Opportunity Number: CDC-RFA-DP08-801:
Improving Health and Educational Outcomes of Young People
Instructions
This set of indicators describes the performance in eight areas of your asthma management project: (1) project
planning; (2) joint activities of the Local Education Agency and Local Health Agency; (3) policy; (4) health
promotion and environmental approaches; (5) asthma-related education; (6) health services; (7) external
collaboration; (8) reducing disparities among populations of youth at disproportionate risk for asthma episodes
and absences; and (9) other information and activities.
A glossary of terms is included at the end of the Indicators.
Activities to be reported are those for which any amount of DASH funds were used, or in which staff time to
develop, implement, or evaluate activities was funded in any amount by DASH. These questions apply only to
priority health risk behaviors addressed in Funding Opportunity Announcement DP08-801, excluding
supplementary funding.
Please answer each question carefully and accurately. Not all items or activities may reflect the emphasis
of your plan for the current fiscal year, and therefore you may report that you have not performed
activities in those areas by entering zeros. Additionally, you may not currently collect information
about some activities. If so, please leave the answer blank. Please be sure to include materials for those
items requesting attachments.
Public reporting burden of this collection of information is estimated to average 7.2 hours per response, including the time
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a
collection of information unless it displays a current valid OMB control number. Send comments regarding this burden estimate
or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports
Clearance Officer; 1600 Clifton Road NE, MS-D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0672).

For further questions or assistance with completing this report,
please contact your CDC project officer.
Person completing the Indicators:
Name:____________________________________________________________________________
Title:_____________________________________________________________________________
State:_____________________________________

Phone:________________________________

Email:____________________________________________________________________________

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
CENTERS FOR DISEASE CONTROL AND PREVENTION

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

I. PROJECT PLANNING
1.

How many schools do you have in your district? ______ TOTAL

In FY 2008, which of the following planning and evaluation activities did your project carry out?
YES
NO
{
{
A. Conduct or review Program Inventory
B. Develop or revise a five-year strategic plan
{
{
{
{
C. Conduct formative evaluation
D. Create or revise a logic model
{
{
E. Write SMART objectives
{
{
F. Conduct process evaluation
{
{
G. Conduct outcome evaluation
{
{
H. Develop success stories
{
{
I. Other
{
{
Please specify____________________________________

In FY 2008, did you integrate your asthma management activities into any of the following
school health components?
YES
NO
A.
Counseling/psychological/social services
{
{
B.
Health education
{
{
C.
Health services
{
{
D.
Healthy school environment/policy
{
{
{
{
E.
Nutrition services
F.
Parent/community involvement
{
{
G.
Physical education
{
{
H.
Staff health promotion
{
{

In FY 2008, what strategies did your asthma management project use to address asthma within a
coordinated school health program?
YES
NO
A.
Establish management and support systems for
{
{
asthma-friendly schools.
B.
Provide appropriate school health and mental health services
for students with asthma.
{
{
C.
Provide asthma education and awareness programs for
{
{
students and school staff.
D.
Provide a safe and healthy school environment to reduce
asthma triggers.
{
{
E.
Provide safe, enjoyable physical education and activity
{
{
opportunities for students with asthma.
F.
Coordinate school, family, and community efforts to better
manage asthma symptoms and reduce school absences
among students with asthma.
{
{

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ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

II. JOINT ACTIVITIES OF THE LOCAL EDUCATION AGENCY (LEA)
AND LOCAL HEALTH AGENCY (LHA)
5.

Currently, does your asthma management project employ one person at 100% time designated to
carry out asthma management activities?
{
{

During FY 2008, did the LEA and LHA have a formal agreement (e.g., a current memorandum of
understanding) to collaboratively establish complementary roles and activities for asthma
management in schools?
{
{

YES
NO

During FY 2008, what asthma management activities did the LEA and LHA collaborate on?
A.
B.
C.
D.
E.
F.
G.
H.

YES
NO

Seek additional funding
Conduct asthma management needs assessment
Develop or implement asthma management activities
Develop or revise asthma management policies
Develop or revise protocols to provide asthma
management nursing services for students
Share asthma management resources
Provide professional development on asthma
management to district or school staff
Evaluate asthma management activities

YES

{
{
{
{
{

{
{

{

During FY 2008, did your project have any funding other than DASH funding for school asthma
management programs? (May include federal, state, district, and/or private funding) (Choose
one.)
{
{

YES
NOÆ Skip to 9
If YES:
a.

What is the total dollar amount of the funding you received other than DASH
funding for school asthma management programs? (Please include federal, state,
district, and private funding): $__________

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FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

III. POLICY
9.

During FY 2008, did your asthma management project DEVELOP (or revise or assist in
developing) model policies, policy guidance, or other policy materials on the following topics?

Policy topic
(Choose one for each policy topic)
A.
B.

C.
D.
E.
F.
G.
H.

I.
J.
K.
L.

10.

Immediate access to quick-relief asthma
medications
Student possession and self-administration of
prescribed quick-relief asthma medications
(with parent and health provider permission)
Appropriate provision of asthma-related school
health services by qualified personnel
Keeping asthma action plans on file
Asthma awareness education for all students
Asthma management education for students
with asthma
Required asthma basics and emergency
response education for all school staff
Elimination of tobacco smoke from all school
buildings, grounds, vehicles, and schoolsponsored events at all times
Identification and reduction of other
environmental asthma triggers
Development or implementation of an
Environmental Management Plan
Full participation in physical activity when
students are well
Other model policies, policy guidance, or other
policy materials
Please specify:__________________________

NO—we have such
policies but did
not develop them
during FY 2008

NO—we do
not have
such
policies

{

{
{
{

{

YES

During FY 2008, did your asthma management project DISTRIBUTE established or model
policies, policy guidance, or other policy materials on the following topics? (Choose one for each
topic.)
A.

Immediate access to quick-relief asthma medications (Choose one.)

{
{

YES
NO Æ Skip to 10B
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______
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ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

Student possession and self-administration of prescribed quick-relief asthma medications
(with parent and health care provider permission) (Choose one.)

{
{

YES
NO Æ Skip to 10C
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Appropriate provision of asthma-related school health services by qualified personnel
(Choose one.)

{
{

YES
NO Æ Skip to 10D
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Keeping asthma action plans on file (Choose one.)

{
{

YES
NO Æ Skip to 10E
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Asthma awareness education for all students (Choose one.)

{
{

YES
NO Æ Skip to 10F
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Please continue on the next page Æ

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

Asthma awareness education for students with asthma (Choose one.)

{
{

YES
NO Æ Skip to 10G
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Required asthma basics and emergency response education for all school staff (Choose
one.)

{
{

YES
NO Æ Skip to 10H
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Elimination of tobacco smoke from all school buildings, grounds, vehicles, and schoolsponsored events at all times (Choose one.)

{
{

YES
NO Æ Skip to 10I
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Identification and reduction of other environmental asthma triggers (Choose one.)

{
{

YES
NO Æ Skip to 10J
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

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ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

Development or implementation of an Environmental Management Plan (Choose one.)

{
{

YES
NO Æ Skip to 10K
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Full participation in physical activity when students are well (Choose one.)

{
{

YES
NO Æ Skip to 10L
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Other model policies, policy guidance, or other policy materials (Choose one.)

{
{

YES
NO Æ Skip to 11
IF YES,
1. Specify policy topic____________________
2. Number of schools reached directly ______
3. Number of hits on web site ______
4. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

11.

During FY 2008, did your asthma management project provide PROFESSIONAL
DEVELOPMENT (not to include presentations) that included information on established or
model policies, policy guidance, or other policy materials?
{
{

YES
NOÆ Skip to 12

If YES, provide the total:
A.
Number of professional development events including asthma management
policy ______
B.
Number of participants in professional development events including asthma
management policy ______
C.
Number of professional development events including asthma management policy for
which you conducted follow-up support ______
D.
Number of schools reached directly ______
E.
Number of external agency partners reached directly ______

Please continue on the next page Æ

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

12.

During FY 2008, did your asthma management project provide TECHNICAL ASSISTANCE
on established or model policies, policy guidance, or other policy materials?
{
{

YES
NOÆ Skip to 13

If YES, provide the total:
A.
Number of schools reached directly ______
B.
Number of external agency partners reached directly ______
13.

If you directly reached external agency partners, to what types of external agency partners did
you DISTRIBUTE, provide PROFESSIONAL DEVELOPMENT on, or provide TECHNICAL
ASSISTANCE on established or model policies, policy guidance, or other policy materials?
(Mark all that apply.)
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{

14.

Does your district have a comprehensive asthma management policy?
{
{

15.

Not Applicable – We did not reach external agency partners
Regional Environmental Protection Agency (EPA)
Health care providers/physicians
Hospitals
Insurance companies or managed care organizations (e.g., Blue Cross/Blue Shield, Kaiser
Permanente, Medicaid)
Legislators/lawmakers
Local asthma coalition
Local- or county-level health agencies/departments of health
National non-governmental organizations (NGOs) (including local, regional, or state
affiliates)
Parents/guardians/caregivers (including those reached through PTAs/PTOs)
State-level education agencies
State-level health agencies/departments of health
Universities/colleges/institutions of higher education
Youth-serving organizations
Other – Please specify type______________________________________

YES
NO

Does your district’s wellness policy include language on asthma management?
{
{

YES
NO

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ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

IV. HEALTH PROMOTION AND ENVIRONMENTAL APPROACHES
16.

During FY 2008, did your asthma management project participate in any of the following
activities to help school staff to assess, plan, or coordinate asthma management activities?
A.

DISTRIBUTE to school staff the School Health Index or similar tool to help assess and
plan asthma management activities.

{
{

YES
NOÆ Skip to 16B
If YES, what tool(s) were distributed? (Choose all that apply.)

{
{

The School Health Index

Provide PROFESSIONAL DEVELOPMENT (not to include presentations) to school
staff on the School Health Index or similar tool to help assess and plan asthma
management activities.

{
{

YES
NOÆ Skip to 16C

Other
Please specify_____________________________________

If YES, provide the total:
1.
Number of professional development events ______
2.
Number of participants in professional development events ______
3.
Number of professional development events for which you conducted follow-up
support ______
4.
Number of schools reached directly ______
C.

Provide TECHNICAL ASSISTANCE to school staff on the School Health Index or
similar tool to help assess and plan asthma management activities.

{
{

YES
NOÆ Skip to 17
If YES, provide the total:
1.
Number of schools reached directly ______

Please continue on the next page Æ

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

17.

During FY 2008, did your asthma management project engage in any of the following activities
to help district or school staff promote asthma management?
A.

DEVELOP (or revise or assist in developing) model programs, guidance,
implementation strategies, or other resource materials (not to include policy materials)
to promote asthma management through any of the following:

Model programs, guidance, implementation strategies,
or other resource materials
(Choose one for each topic)
A. Writing or implementing an environmental
management plan
B. Preventing indoor air quality problems by
reducing or eliminating allergens and irritants,
including tobacco smoke; dust and debris from
construction and remodeling; and dust mites,
molds, furred and feathered animals, cockroaches,
and other pests
C. Using integrated pest management (IPM)
techniques to control pests
D. Having a designated and secure storage location
for quick-relief asthma medications that is
accessible at all times by the nurse or his/her
designee
E. Promoting ongoing communication among
students, parents, teachers, nurses, and health care
providers to ensure that students’ asthma is wellmanaged at school
F. Having an emergency plan for assessing,
managing, and referring students experiencing an
asthma-related medical emergency to the
appropriate level of care
G. Obtaining administrative support for asthma
management programs

NO—we have such
materials but did
not develop them
during FY 2008

NO—we
do not
have such
materials

{

YES

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ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

DISTRIBUTE model programs, guidance, implementation strategies, or other resource
materials (not to include policy materials) to promote asthma management through any
of the following:

A.
B.

C.
D.

YES
{
Writing or implementing an environmental management plan
Preventing indoor air quality problems by reducing or
eliminating allergens and irritants, including tobacco smoke;
dust and debris from construction and remodeling; and dust
mites, molds, furred and feathered animals, cockroaches, and
other pests
{
Using integrated pest management (IPM) techniques to
{
control pests
Having a designated and secure storage location for quick-relief
asthma medications that is accessible at all times by the school
nurse or his/her designee
{
Promoting ongoing communication among students, parents,
teachers, nurses, and health care providers to ensure
{
that students’ asthma is well-managed at school
Having an emergency plan for assessing, managing, and
referring students experiencing an asthma-related
medical emergency to the appropriate level of care
{
Obtaining administrative support for asthma management
{
programs

NO
{

{
{

{

{
{

(If NO to all of the above, skip to 17C.)
If YES to any of the above, provide the total:
1.
Number of schools reached directly ______
2.
Number of hits on web site ______
3.
Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used)
______
4.
Number of external agency partners reached directly ______

Please continue on the next page Æ
11

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

Provide PROFESSIONAL DEVELOPMENT (not to include presentations) on model
programs, guidance, implementation strategies, or other resource materials (not to
include policy materials) to promote asthma management through any of the following:

A.
B.

C.
D.

YES
Writing or implementing an environmental management plan
{
Preventing indoor air quality problems by reducing or
eliminating allergens and irritants, including tobacco smoke;
dust and debris from construction and remodeling; dust and
mites, molds, furred and feathered animals, cockroaches, and
other pests
{
Using integrated pest management (IPM) techniques to
{
control pests
Having a designated and secure storage location for quick-relief
asthma medications that is accessible at all times by the school
nurse or his/her designee
{
Promoting ongoing communication among students, parents,
teachers, nurses, and health care providers to ensure
{
that students’ asthma is well-managed at school
Having an emergency plan for assessing, managing, and
referring students experiencing an asthma-related
medical emergency to the appropriate level of care
{
Obtaining administrative support for asthma management
{
programs

NO
{

{
{

{

{
{

(If NO to all of the above, skip to 17D.)
If YES to any of the above, provide the total:
1.
Number of professional development events including model programs,
guidance, implementation strategies, or other resource materials ______
2.
Number of participants in professional development events including model
programs, guidance, implementation strategies, or other resource materials
______
3.
Number of professional development events for which you conducted follow-up
support ______
4.
Number of schools reached directly ______
5.
Number of external agency partners reached directly ______

Please continue on the next page Æ

ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

Provide TECHNICAL ASSISTANCE to promote asthma management (i.e.
implementing model programs or using resource materials) through any of the following:

A.
B.

C.
D.

NO
{

{
{

{

{
{

(If NO to all of the above, skip to 17E.)
If YES to any of the above, provide the total:
1.
Number of schools reached directly ______
2.
Number of external partners reached directly ______

Please continue on the next page Æ

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

If you directly reached external agency partners, to what types of external agency
partners did you DISTRIBUTE, provide PROFESSIONAL DEVELOPMENT on, or
provide TECHNICAL ASSISTANCE on model programs, guidance, implementation
strategies, or other resource materials (not to include policy materials) to promote
asthma management? (Mark all that apply.)
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{

18.

Not Applicable – We did not reach external agency partners
Regional Environmental Protection Agency (EPA)
Health care providers/physicians
Hospitals
Insurance companies or managed care organizations (e.g., Blue Cross/Blue
Shield, Kaiser Permanente, Medicaid)
Legislators/lawmakers
Local asthma coalition
Local- or county-level health agencies/departments of health
National non-governmental organizations (NGOs) (including local, regional, or
state affiliates)
Parents/guardians/caregivers (including those reached through PTAs/PTOs)
State-level education agencies
State-level health agencies/departments of health
Universities/colleges/institutions of higher education
Youth-serving organizations
Other – Please specify type______________________________________

During FY 2008, did your asthma management project work to obtain or maintain district- or
school-level administrative support for asthma management activities?
{
{

YES
NO

Please continue on the next page Æ

ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

V. ASTHMA-RELATED EDUCATION
19.

During FY 2008, did your asthma management project engage in any of the following activities
to promote asthma management education?
A.

DEVELOP (or revise or assist in developing) model programs, curricula, guidance,
implementation strategies, or other resource materials (not to include policy materials)
to promote asthma management education through any of the following:

Model programs, curricula, guidance, implementation
strategies, or other resource materials
(Choose one for each topic)
A. Providing staff education on asthma basics and
emergency response
B. Integrating asthma awareness and lung health
education lessons into health education curricula
C. Delivering asthma management education for
students with asthma
D. Providing awareness-raising or educational events
about managing asthma for families of students
with asthma
E. Providing asthma programs that are culturally and
linguistically appropriate
B.

NO—we have such
materials but did
not develop them
during FY 2008

NO—we
do not
have such
materials

{

YES

DISTRIBUTE model programs, curricula, guidance, implementation strategies, or other
resource materials (not to include policy materials) to promote asthma management
through any of the following:

A.
B.
C.
D.
E.

YES
Providing staff education on asthma basics and emergency
{
response
Integrating asthma awareness and lung health education
lessons into health education curricula
{
Delivering asthma management education for students
{
with asthma
Providing awareness-raising or educational events about
managing asthma for families of students with asthma
{
Providing asthma programs that are culturally and linguistically
{
appropriate

NO
{
{
{
{
{

Please continue on the next page Æ

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

(If NO to all of the above, skip to 19C.)
If YES to any of the above, provide the total:
1.
Number of schools reached directly ______
2.
Number of hits on web site ______
3.
Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used)
______
4.
Number of external agency partners reached directly ______
C.

Provide PROFESSIONAL DEVELOPMENT (not to include presentations) on model
programs, curricula, guidance, implementation strategies, or other resource materials (not
to include policy materials) to promote asthma management through any of the
following:

A.
B.
C.
D.
E.

NO
{
{
{
{
{

(If NO to all of the above, skip to 19D.)
If YES to any of the above, provide the total:
1.
Number of professional development events including model programs,
guidance, implementation strategies, or other resource materials ______
2.
Number of participants in professional development events including model
programs, guidance, implementation strategies, or other resource materials
______
3.
Number of professional development events for which you conducted follow-up
support ______
4.
Number of schools reached directly ______
5.
Number of external agency partners reached directly ______

Please continue on the next page Æ

ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

Provide TECHNICAL ASSISTANCE to promote asthma management (i.e. developing
curricula or selecting resource materials) through any of the following:

A.
B.
C.
D.
E.

NO
{
{
{
{
{

(If NO to all of the above, skip to 19E.)
If YES to any of the above, provide the total:
1.
Number of schools reached directly ______
2.
Number of external partners reached directly ______
E.

If you directly reached external agency partners, to what types of external agency
partners did you DISTRIBUTE, provide PROFESSIONAL DEVELOPMENT on, or
provide TECHNICAL ASSISTANCE on model programs, curricula, guidance,
implementation strategies, or other resource materials (not to include policy materials)
to promote asthma management? (Mark all that apply.)
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{

Not Applicable – We did not reach external agency partners
Regional Environmental Protection Agency (EPA)
Health care providers/physicians
Hospitals
Insurance companies or managed care organizations (e.g., Blue Cross/Blue
Shield, Kaiser Permanente, Medicaid)
Legislators/lawmakers
Local asthma coalition
Local- or county-level health agencies/departments of health
National non-governmental organizations (NGOs) (including local, regional, or
state affiliates)
Parents/guardians/caregivers (including those reached through PTAs/PTOs)
State-level education agencies
State-level health agencies/departments of health
Universities/colleges/institutions of higher education
Youth-serving organizations
Other – Please specify type______________________________________

Please continue on the next page Æ

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

20.

During FY 2008, did your asthma management project provide presentations directly to district
or school staff on asthma basics and emergency response?
{
{

21.

YES
NO Æ Skip to 22

During FY 2008, were the following programs or materials used in your district for asthma
management education for staff?
Program or materials
A. Asthma 101
B. Asthma and Allergy Foundation of America’s
(AAFA) Meeting in a Box
C. Coach’s Clipboard
D. National Asthma Education and Prevention
Program’s (NAEPP) Asthma Basics for Schools
PowerPoint Slide Sets
E. Other
Please specify ______________________________

22.

{
{

{

YES
NO Æ Skip to 24

During FY 2008, were the following programs or materials used in your district for asthmarelated professional development for nurses?
Program or materials
A. American Academy of Asthma Allergy and
Immunology’s (AAAAI) School Nurse Toolkit
B. National Association of School Nurses’ (NASN)
School Nurse Asthma Management Project
C. Other
Please specify ______________________________

24.

{
{

During FY 2008, did your asthma management project provide asthma-related professional
development directly to nurses?
{
{

23.

YES

{

During FY 2008, did your asthma management project deliver asthma management education
directly to students with asthma in schools or facilitate the delivery of asthma management
education directly to students with asthma with other agencies?
{
{

YES
NO Æ Skip to 26

Please continue on the next page Æ

ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

25.

During FY 2008, were the following programs or materials used in your district for asthma
management education for students with asthma?
Program or materials
A. Open Airways for Schools, English version
B. Open Airways for Schools, Spanish version
C. PowerBreathing
D. Quest for the Code
E. Roaring Adventures of Puff
F. Other
Please specify ______________________________

26.

YES

{
{
{
{
{
{

During FY 2008, did your asthma management project coordinate asthma management activities
with tobacco use prevention programs or tobacco cessation programs?
{
{

YES
NO

Please continue on the next page Æ

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

VI. HEALTH SERVICES
27.

During FY 2008, did your asthma management project engage in any of the following activities
to promote asthma management?
A.

DEVELOP (or revise or assist in developing) protocols, model programs, guidance,
implementation strategies, or other resource materials (not to include policy materials)
to promote asthma management through any of the following:

Protocols, model programs, guidance, implementation
strategies, or other resource materials
(Choose one for each topic)
A. Using or adapting school health records to
identify all students with diagnosed asthma
B. Using health room and attendance records to track
students with asthma
C. Obtaining written asthma action plans for all
students with asthma
D. Using 504 Plans or Individualized Education
Plans (IEPs), as appropriate, especially for health
services and physical activity modifications
E. Ensuring students with asthma have immediate
access to quick-relief medications during the
school day
F. Ensuring access to quick-relief medications before
physical activity to prevent an asthma episode
G. Using a standard emergency protocol for students
in respiratory distress if they do not have their
asthma action plan
H. Having a full-time registered nurse all day, every
day for each school
I.
Referring students without a primary healthcare
provider to child health insurance programs and
providers
J. Providing intensive case management for students
with poorly controlled asthma at school
K. Providing school-based counseling,
psychological, or social services for students with
asthma, as appropriate.

NO—we have such
materials but did
not develop them
during FY 2008

NO—we
do not
have such
materials

{

YES

Please continue on the next page Æ

ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

DISTRIBUTE protocols, model programs, guidance, implementation strategies, or other
resource materials (not to include policy materials) to promote asthma management
through any of the following:

A.
B.
C.
D.

E.
F.
G.
H.
I.
J.
K.

YES
Using or adapting school health records to identify all
{
students with diagnosed asthma
Using health room and attendance records to track students
with asthma
{
Obtaining written asthma action plans for all students with
{
asthma
Using 504 Plans or Individualized Education Plans (IEPs),
as appropriate, especially for health services and physical
activity modifications
{
Ensuring students with asthma have immediate access to
{
quick-relief medications during the school day
Ensuring access to quick-relief medications before physical
activity to prevent an asthma episode
{
Using a standard emergency protocol for students in respiratory
{
distress if they do not have their asthma action plan
Having a full-time registered nurse all day, every
day for each school
{
Referring students without a primary healthcare provider to
{
child health insurance programs and providers
Providing intensive case management for students with poorly
controlled asthma at school
{
Providing school-based counseling, psychological, or social
{
services for students with asthma, as appropriate.

NO
{
{
{

{
{
{
{
{
{
{
{

(If NO to all of the above, skip to 27C.)
If YES to any of the above, provide the total:
1.
Number of schools reached directly ______
2.
Number of hits on web site ______
3.
Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used)
______
4.
Number of external agency partners reached directly ______

Please continue on the next page Æ
21

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

Provide PROFESSIONAL DEVELOPMENT (not to include presentations) on
protocols, model programs, guidance, implementation strategies, or other resource
materials (not to include policy materials) to promote asthma management through any
of the following:

A.
B.
C.
D.

E.
F.
G.
H.
I.
J.
K.

NO
{
{
{

{
{
{
{
{
{
{
{

(If NO to all of the above, skip to 27D.)
If YES to any of the above, provide the total:
1.
Number of professional development events including model programs,
guidance, implementation strategies, or other resource materials ______
2.
Number of participants in professional development events including model
programs, guidance, implementation strategies, or other resource materials
______
3.
Number of professional development events for which you conducted follow-up
support ______
4.
Number of schools reached directly ______
5.
Number of external agency partners reached directly ______

Please continue on the next page Æ

ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

Provide TECHNICAL ASSISTANCE to promote asthma management (i.e. developing
protocols or selecting resource materials) through any of the following:

A.
B.
C.
D.

E.
F.
G.
H.
I.
J.
K.

NO
{
{
{

{
{
{
{
{
{
{
{

(If NO to all of the above, skip to 27E.)
If YES to any of the above, provide the total:
1.
Number of schools reached directly ______
2.
Number of external partners reached directly ______

Please continue on the next page Æ

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

If you directly reached external agency partners, to what types of external agency
partners did you DISTRIBUTE, provide PROFESSIONAL DEVELOPMENT on, or
provide TECHNICAL ASSISTANCE on protocols, model programs, guidance,
implementation strategies, or other resource materials (not to include policy materials)
to promote asthma management? (Mark all that apply.)
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{

Not Applicable – We did not reach external agency partners
Regional Environmental Protection Agency (EPA)
Health care providers/physicians
Hospitals
Insurance companies or managed care organizations (e.g., Blue Cross/Blue
Shield, Kaiser Permanente, Medicaid)
Legislators/lawmakers
Local asthma coalition
Local- or county-level health agencies/departments of health
National non-governmental organizations (NGOs) (including local, regional, or
state affiliates)
Parents/guardians/caregivers (including those reached through PTAs/PTOs)
State-level education agencies
State-level health agencies/departments of health
Universities/colleges/institutions of higher education
Youth-serving organizations
Other – Please specify type______________________________________

Please continue on the next page Æ

ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

28.

During FY 2008, did your asthma management project:
YES
A.
B.
C.

D.
E.

F.
G.
H.
I.
J.
K.
L.

Use or adapt school health records to identify all
students with diagnosed asthma?
Use health room and attendance records to track students
with asthma?
Focus program efforts on students with poorly managed
asthma as demonstrated by frequent school absences, school
health office visits, emergency room visits, or hospitalizations?
Obtain written asthma action plans for all students with
asthma?
Use 504 Plans or Individualized Education Plans (IEPs),
as appropriate, especially for health services and physical
activity modifications?
Ensure students with asthma have immediate access to
quick-relief medications during the school day?
Ensure access to quick-relief medications before physical
activity to prevent an asthma episode?
Use a standard emergency protocol for students in respiratory
distress if they do not have their asthma action plan?
Have a full-time registered nurse all day, every
day for each school?
Refer students without a primary healthcare provider to
child health insurance programs and providers?
Provide intensive case management for students with poorly
controlled asthma at school?
Provide school-based counseling, psychological, or social
services for students with asthma, as appropriate?

{

Please continue on the next page Æ

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

VII. EXTERNAL COLLABORATION
29.

During FY 2008, did your asthma management project COLLABORATE with any external
agency partners?
{
{

YES
NOÆ Skip to 30

If YES, choose YES or NO for each of the following external agency partners:
A.
B.
C.
D.

E.
F.
G.
H.
I.
J.
K.
L.
M.
N.
O.
P.
Q.
R.
S.
T.
U.
V.
W.
X.
Y.

YES
Businesses
{
CDC-funded local education agency asthma management projects
{
Community organizations serving parents and families
{
(this does not include internal school parent groups such as the PTA)
Community organizations with an asthma focus (e.g., American Lung
Association, Asthma and Allergy Foundation of America, Allergy &
Asthma Network Mothers of Asthmatics)
{
Education organizations (e.g., advocacy, service, professional, or
{
membership associations)
Faith-based organizations
{
{
Foundations (private or non-profit)
Health care providers/physicians
{
Health organizations (e.g., advocacy, service, professional, or
{
membership associations)
Insurance companies or managed care organizations (e.g., Blue Cross/
Blue Shield, Kaiser Permanente, Medicaid)
{
{
Local asthma coalitions
Local health coalitions or networks
{
{
Local- or county-level education agencies
Local- or county-level health agencies
{
National non-governmental organizations (NGOs) (including state and
{
local affiliates)
Parents/guardians/caregivers (including those reached through
PTAs/PTOs)
{
{
Social service agencies
State asthma coalitions
{
{
State health coalitions or networks
State-level education agencies
{
{
State-level health agencies
Universities/colleges/institutions of higher education
{
{
Youth (representing schools or communities)
Youth-serving community organizations
{
{
Other types of external agency partners not listed above
Please specify ____________________________________________
(If additional space is needed to list “other types of external agency partners
not listed above,” please label them Z-CC.)

NO
{
{
{

{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{

Please continue on the next page Æ

ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

VIII. REDUCING DISPARITIES AMONG POPULATIONS OF YOUTH AT
DISPROPORTIONATE RISK FOR ASTHMA EPISODES AND ABSENCES
30.

What kinds of data has your project reviewed to identify schools with a higher prevalence of
youth with severe persistent or poorly controlled asthma?
YES
NO
A.
School health office records
{
{
{
{
B.
Absentee data among students with asthma
C.
Hospitalization data among students with asthma
{
{
{
{
D.
Emergency room data among students with asthma
E.
Other
{
{
Please specify_______________________________________
(If NO to all of the above, skip to 32.)

31.

Did your project focus asthma management activities on the schools you identified with a higher
prevalence of youth with severe persistent or poorly controlled asthma?
{
{

YES
NO

IX. OTHER INFORMATION AND ACTIVITIES
32.

In FY 2008, did you conduct INFORMATION SESSIONS (not to include professional
development) that focused on asthma management?
{
{

YES
NOÆ Skip to 33

If YES:
A.

How many information sessions did you conduct focused on asthma management?
_________

How many information sessions did you conduct on asthma management in the context
of coordinated school health programs?______________

Please continue on the next page Æ
27

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

Please check all audiences for whom you conducted information sessions in FY 2008:
___ District-level staff or administrators
___ School-level staff or administrators
___ District school board members or superintendent
___ Staff or students at universities, colleges, or other institutions of higher education
___ Community-based organization staff
___ State health officer
___ State or local health agency staff
___ State education agency staff
___ Legislators/lawmakers
___ Parents/parent groups
___ School-aged youth
___ Other
Please specify____________________________________________

33.

Is there information that we asked for in this year’s Indicators that you estimated or guessed at?
{
{

YES
NOÆ Skip to 34

A. What kind of information did you estimate or guess at? (Mark all that apply.)
_____ Distribution of print materials
_____ Distribution of materials on web sites, listservs, Internet mailing lists, or discussion
boards
_____ Professional development events
_____ Follow-up support for professional development events
_____ Technical assistance
_____ Information sessions
_____ Pre-service learning events
B. On what topics did you estimate or guess at information? (Mark all that apply.)
_____
_____
_____
_____
34.

Project planning
Policies
Curricula and instruction
Health services

Is there information that we asked for in this year’s Indicators that you did not collect at all?
{
{

YES
NOÆ Skip to 35

Please continue on the next page Æ

ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

A. What kind of information did you not collect at all? (Mark all that apply.)
_____ Distribution of print materials
_____ Distribution of materials on web sites, listservs, Internet mailing lists, or discussion
boards
_____ Professional development events
_____ Follow-up support for professional development events
_____ Technical assistance
_____ Information sessions
_____ Pre-service learning events
B. On what topics did you not collect information at all? (Mark all that apply.)
_____
_____
_____
_____

35.

Project planning
Policies
Curricula and instruction
Health services

Please provide information about any additional activities not captured by the questions above.
In particular, please report on any additional activities to improve asthma management policies,
curricula, instruction, health services, or collaborations and any activities for which you could not
collect information on participants or recipients of materials.

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

36.

Please provide any additional general comments or information in the space below.

__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

THANK YOU FOR YOUR RESPONSES. PLEASE RETURN THE INDICATORS.

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

GLOSSARY
Please refer to the following definitions when answering the questions.
504 PLANS – A plan that describes the modifications to school activities or the school environment that
must be made and the educational programs and related aids and services that must be provided to meet
the individual education needs of students with disabilities. Section 504 plans are also called
accommodation plans.
ALLERGENS – Substances including pollen, mold spores, dust mites, animal dander, and cockroaches
and other pests that cause people with allergies or asthma to sneeze, cough, wheeze, or experience other
symptoms of respiratory distress.
ASTHMA ACTION PLANS – A written, individual disease management plan prepared by a health care
provider or school nurse for easy and convenient use by a patient, family, school personnel, and other
caregivers. The plan typically provides clear instructions for routine asthma monitoring, lists prescribed
medications including dosages and timing, notes specific triggers that can start an asthma episode,
describes the signs and symptoms of an asthma attack, details emergency response steps for asthma
episodes, and includes emergency contact information. Asthma Action Plans are also sometimes called
Asthma Management Plans, Written Asthma Management Plans, and Medical Orders.
ASTHMA AWARENESS – General knowledge about asthma (basic facts), common asthma triggers and
how to minimize exposure to them, and emergency procedures to follow if a person experiences a serious
asthma episode.
ASTHMA EPISODE – The acute occurrence of asthma symptoms such as coughing, wheezing, chest
tightness, or shortness of breath.
ASTHMA MANAGEMENT EDUCATION – The provision of knowledge and skills for students with
asthma on topics such as basic facts about asthma; adhering to asthma action plans; identifying and
avoiding triggers; signs and symptoms of an asthma episode; medication information; self-management
skills (e.g., monitoring asthma, use of peak flow meter, proper use of inhalers); when and how to take
emergency actions; maintaining physical activity.
ASTHMA MANAGEMENT PROJECT – Any activities of personnel that are funded, in part or whole,
through DASH cooperative agreement funds for the asthma management project. It is the work of
contract or other staff hired to provide services for DASH Funding Opportunity Announcement DP08801, priority #4.
CASE MANAGEMENT – A comprehensive set of services provided by either an individual or a team of
medical professionals, school staff, and/or social work staff. These services could include providing
referrals to primary healthcare providers; ensuring an appropriate written asthma action plan is obtained;
ensuring access to and appropriate use of asthma medications, spacers, and peak flow meters at home and
at school; offering asthma education for the student and family; facilitating environmental modifications
at home and at school; identifying and addressing psychosocial issues related to asthma; providing
additional support services as needed.
COLLABORATE – Two or more partners actively engage in planning, implementing, and evaluating
programs, practices, and policy activities with defined roles and responsibilities.

ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

COMPREHENSIVE ASTHMA MANAGEMENT POLICY – A written policy that includes the
following key elements: asthma awareness education for all students, specialized education sessions for
students with asthma, procedures for identifying students with significant asthma morbidity,
individualized asthma action plans, appropriate school health services, storage and administration of
prescribed medications (including self-carry and self-administration, as appropriate), professional
development for all school personnel in asthma awareness and emergency procedures, elimination of
tobacco smoke everywhere on school grounds, and maintenance of clean indoor air and school grounds
free of common asthma triggers.
COORDINATED SCHOOL HEALTH PROGRAM (CSHP) – A coordinated school health program is
a planned and organized set of courses, services, policies, and interventions designed to meet the health
and safety needs of K-12 students. Schools promote optimal physical, emotional, social, and educational
development of students by providing health education; physical education; health services; nutrition
services; counseling, psychological and social services; and a healthy and safe environment; and by
promoting parent/community involvement and staff wellness. A successful and well-coordinated school
health program is characterized by administrators, teachers, and school board members who view health
protection and promotion as an essential part of the school’s mission; a school health council comprised
of school, family, and community representatives to ensure a planning process for continuous
improvement; a school health coordinator responsible for organizing and managing the school health
program; and school staff who help plan and implement a full array of school health courses, services,
policies, and interventions.
CURRICULUM – An educational plan incorporating a structured, developmentally appropriate series of
intended learning outcomes and associated learning experiences for students; generally organized as a
related combination or series of school-based materials, content, and events.
DEVELOPMENT – The process of bringing into being, making active, available, or effective, asthmarelated materials, plans, policies, or activities.
DIRECTLY TO – The provision of training, asthma management education, or services to a specified
audience (i.e., school nurses, district or school staff, or students). This excludes training of trainers or
cadres.
DISTRIBUTE – Putting materials in the hands of appropriate personnel. Distribution may occur in
response to requests for materials or through proactive sharing of information.
ENVIRONMENTAL APPROACHES – Those policies and programs that are intended to affect
physical surroundings and the psychosocial climate and culture of the school. Environmental approaches
include policies, programs, and services that reinforce school health education and physical education
curricula as well as contribute to health outcomes for students and staff.
ENVIRONMENTAL MANAGEMENT PLAN (EMP) – A written strategy to optimize conditions for
learning and minimize human exposure to indoor and outdoor hazardous chemicals, allergens, irritants,
and pollutants.
ENVIRONMENTAL TRIGGERS – Substances that cause the body to respond with allergy or asthma
symptoms.
EVALUATION PLAN – A written evaluation plan may include process evaluation, to determine if
activities were as planned and how well they were conducted, as well as outcome evaluation, to determine
the impact of an activity or program on program objectives.

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

EXTERNAL AGENCY PARTNERS – Agencies, organizations, and groups outside your own agency
with which you collaborate or associate to further the goals of your asthma management project.
FISCAL YEAR (FY) – March 1, 2008 to February 28, 2009, the budget period for the cooperative
agreement.
FOLLOW-UP SUPPORT – Assistance provided to enhance participants’ abilities to use skills, tools and
techniques learned through professional development offerings. Follow-up support leads to a more
significant outcome than training alone by addressing challenges and sharing successes through a variety
of media (e.g., e-mail, conference calls, webcasts, site visits).
FORMATIVE EVALUATION – Gathering information during the early stages of your project or
program, with a focus on finding out whether your efforts are unfolding as planned, uncovering any
obstacles or unexpected opportunities that may have emerged, and identifying adjustments and
corrections to your program.
FRAMEWORK – An outline or plan that presents both the content (e.g., important concepts, skills, and
generalizations) and the process for developing curricula, instruction, and assessment.
GUIDANCE – A set of strategies that apply frameworks to develop policies, curricula, instruction, and
assessment.
HEALTH EDUCATION – Includes planned sequential materials, instructions, and educational
experiences delivered in the classroom setting that provide students with opportunities to acquire the
knowledge and skills necessary for making health promoting decisions and achieving health literacy.
Quality health education is based on sound theories of development and behavior change or empirically
supportive practices that result in increased knowledge and positive behavior change.
IMPLEMENTATION – To put into effect or accomplish plans, policies, or activities related to asthma
management projects.
INDIVIDUALIZED EDUCATION PLANS – A plan that describes special education and related
services for students with learning disabilities. IEPs are developed under the Individuals with Disabilities
Education Act (IDEA), a federal mandate that requires schools to provide specially designed instruction
for students not meeting educational requirements due to a variety of factors, one of which is health
issues, such as asthma, which significantly interfere with learning.
INFORMATION SESSION – Workshop, presentation or other instructional activities delivered in a
short period of time taking at least 30 minutes and no more than 3 hours that focuses on a specific public
health, curricular or coordinated school health program topic. Information sessions are tailored to specific
audiences such as school administration, faculty, education and health professionals, adolescents, parents,
college students, legislators or community groups.
INTEGRATED PEST MANAGEMENT – A planned program to reduce sources of food, water, and
shelter for pests in and around school buildings with procedural guidelines for pesticide application and
for the notification of parents/guardians and building occupants prior to the application.
IRRITANTS – Substances that can cause airway irritation or inflammation and lead to asthma
symptoms. These substances include inhaled and secondhand tobacco smoke; dust; chalk dust; perfumes
and other scented and unscented personal care products; pesticides; unvented fumes; diesel exhaust, air

ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

pollution; cold, dry air; and volatile organic chemicals (VOCs) such as those found in school laboratories,
marking pens, cleaning agents, disinfectants, air fresheners, paints, and solvents.
LOCAL HEALTH AGENCY – The local public health agency or local branch of the health department.
(This does not include hospitals or other local health-care organizations.)
LOGIC MODEL – A logic model is a pictorial diagram that shows the relationship between your
program components and activities and desired health outcomes. A logic model is a planning tool that
might describe your entire program or a particular program objective or initiative.
LUNG HEALTH EDUCATION – Provision of general knowledge about the lungs, how they work, and
what can prevent them from working effectively.
MATERIALS – Resources including written materials (e.g., curricula, training materials, and
pamphlets); audio visual materials (e.g., motion pictures and video tapes); pictorials (e.g., posters and
similar educational materials using photographs, slides, drawings, or paintings); and electronic resources
(e.g., Web sites, PDF files, and PowerPoint files).
MEMORANDUM OF UNDERSTANDING (MOU) – An agreement between agencies specifying the
process or procedures for collaborative development of infrastructure. May also be called a
Memorandum of Agreement.
MODEL POLICY – Model policies provide a framework to assist school officials in developing their
own state or local policies. They are written as statements of best practice which can be adapted to fit
local circumstances. Model policies reflect state-of-the-art, scientifically reliable information on what
constitutes effective school health programs and the expert opinions of many reviewers. Included in
model policies are excerpts or references to actual national, state, and local policies; a purpose or goals;
rationale; and definitions.
MODEL PROGRAM – A packaged, promising, evidence-based or science-based program that results in
positive outcomes.
NEEDS ASSESSMENT – An evaluation of the health risk behaviors that a program should address and
the need for the program.
NUMBER OF EXTERNAL AGENCY PARTNERS REACHED DIRECTLY – An external agency
partner is reached directly when one or more external partner’s staff receives materials, training, or
assistance from personnel funded by your CSHP project. Each external agency partner reached is
counted only once as being reached for a particular topic regardless of the number of external agency
partner staff from that external agency partner are reached or the number of times external partner staff
are reached.
NUMBER OF SCHOOLS REACHED DIRECTLY – A school is reached directly when one or more
school staff receives materials, training, or assistance from personnel funded by your CSHP project. Each
school reached is counted only once as being reached for a particular topic regardless of the number of
school staff from that school are reached or the number of times school staff are reached.
NUTRITION – Relates to the foods and beverages people consume.
OUTCOME EVALUATION – Evaluation undertaken to determine if the changes ascribed to a program
(e.g., changes in systems, collaborations, policies, or knowledge, attitudes, or behavior among

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

administrators, teachers, school staff, community members, or youth) are associated with program
activities.
PARTNERSHIP PLAN – Jointly prepared plans between the state education agency and the state health
agency for coordinating administrative responsibilities, establishing reciprocal roles, and complementing
school and youth-related health programs across the two agencies.
PHYSICAL ACTIVITY – Any bodily movement produced by skeletal muscles which results in caloric
expenditure.
PHYSICAL EDUCATION – A planned and structured program of instruction and learning experiences
that enables students to develop the knowledge, attitudes, skills, behaviors, and confidence needed to be
physically active for life. Other health issues also may be included in physical education curricula, such
as nutrition, physical activity, and tobacco-use prevention.
POLICY – Any mandate issued or policies adopted by school district boards of education, the state
school board, state legislature, or other district or state agencies that affects the environment in schools
throughout the state. These include policies developed by your state or those based on model policies
developed elsewhere. Sample model policies for a school asthma program can be viewed at the National
Association of State Boards of Education’s website:
http://www.nasbe.org/healthy_schools/asthma_program.htm.
PRESENTATION – An informational and awareness raising activity taking at least 30 minutes and no
more than 3 hours that focuses on a set of specific public health, curricular, or coordinated school health
program topics. Presentations are tailored to specific audiences such as school administrators, faculty,
education or health professionals, adolescents, parents, legislators, or community groups.
PROCESS EVALUATION – Collecting and analyzing data to determine who, what, when, where, and
how much of program activities have been conducted. Process evaluation allows staff to assess how well
the program has been implemented.
PROFESSIONAL DEVELOPMENT – The systematic process used to strengthen the professional
knowledge, skills and attitudes of those who serve youth to improve the health, education, and well-being
of youth. Professional development is consciously designed to actively engage learners and includes the
planning, design, marketing, delivery, evaluation, and follow-up of professional development offerings
(events, information sessions, and technical assistance).
PROFESSIONAL DEVELOPMENT EVENT – A set of skill-building processes and activities
designed to assist targeted groups of participants in mastering specific learning objectives. Such events
are delivered in an adequate time span (at least 3 hours) and may include curriculum and other training,
workshops, conferences, and on-line or distance learning courses.
PROGRAM – A multi-faceted approach to decrease health risk behaviors that may include a
combination of strategies such as one-on-one interventions, policy and climate changes, advocacy, peer
interventions, mentoring programs, youth asset development, and outreach.
PROGRAM INVENTORY – A document that funded partners are required to fill out in the first and
fifth year of the 801 Cooperative Agreement that provides a snapshot of what their program currently is
doing or plans to do.
PROTOCOLS – Set of rules for medical treatment.

ASTHMA MANAGEMENT PROGRAMS, LOCAL EDUCATION AGENCIES

QUICK-RELIEF MEDICATIONS – Medications that act rapidly to open constricted airways.
REGISTERED NURSE – Direct health care provider who has graduated from a state-approved school
of nursing (either a four-year university program, a two-year associate degree program, or a three-year
diploma program) and has passed a state RN licensing examination called the National Council Licensure
Examination for Registered Nurses (NCLEX-RN).
SCHOOL – A division of the public school system consisting of students in one or more grades or other
identifiable groups organized to give instruction of a defined type. One school may share a building with
another school or one school may be housed in several buildings. Each school usually has an
identification number assigned by the state department of education for tracking purposes. Public schools
include charter schools, magnet schools, vocational schools, and alternative schools.
SCHOOL DISTRICT STAFF – Personnel hired by the school district or local health agency to provide
asthma management services. These staff members may work at the school level.
SCHOOL HEALTH INDEX – The School Health Index is a self-assessment and planning tool that
enables those who use it to identify the strengths and weaknesses of school health promotion policies and
programs; develop an action plan for improving student health; and involve teachers, parents, students,
and the community in improving school policies and programs. More information on the School Health
Index is available at: http://www.cdc.gov/healthyyouth/shi.
SCHOOL STAFF – Personnel hired by the school.
SMART OBJECTIVES – Objectives are statements that describe program results to be achieved and
how they will be achieved. Specific objectives include who will be targeted and what will be
accomplished. Measurable objectives include how much change is expected, specifically enough that
achievement of the objective can be measured through counting or documenting change. Achievable
objectives can be realistically accomplished given your program’s existing resources and constraints.
Realistic objectives address the scope of the health problem and propose reasonable programmatic steps.
Time-phased objectives provide a timeline indicating when the objective will be met.
STATE EDUCATION AGENCY (SEA) – The department of state or territorial government responsible
for public education policy, funding, monitoring, and training within that state or territory.
STATE HEALTH AGENCY (SHA) – The department of state or territorial government responsible for
public health policy, funding, monitoring, and training within that state or territory.
STRATEGIC PLAN – A program planning tool that provides a blueprint to strengthen program
activities, address areas for improvement, and move the program forward to new accomplishments.
SUCCESS STORIES – A narrative highlighting the achievements and progress of a program or activity.
TECHNICAL ASSISTANCE – Tailored guidance to meet the specific needs of a site or sites through
collaborative communication between a specialist and the site(s). Assistance takes into account sitespecific circumstances and culture and can be provided through phone, mail, e-mail, Internet, or in-person
meetings.
TOBACCO-USE PREVENTION – Interventions that prevent or delay the initiation of tobacco use or
reduce the prevalence of tobacco use, including tobacco-use cessation. Interventions may target

FISCAL YEAR 2008 SCHOOL HEALTH PROGRAM INDICATORS

individuals or groups of youth, in terms of policy and/or environmental changes and may occur in schools
or in partnership with community organizations.
WELLNESS POLICY – The Child Nutrition and WIC Reauthorization Act of 2004, Section 204 of the
Public Law 108-265 requires each school district participating in the National School Lunch Program
and/or School Breakfast Program to develop a local wellness policy that promotes the health of students
and addresses the growing problem of childhood obesity. The policy is required to contain goals for both
nutrition education and physical activity; provide nutrition guidelines for all foods available on school
campuses; and include a plan for measuring the implementation of the policy.
YOUTH AT DISPROPORTIONATE RISK FOR ASTHMA EPISODES AND ABSENCES – Young
people aged preK through 12 with severe persistent or poorly controlled asthma.

File Type	application/pdf
File Title	Microsoft Word - Attachment F _Asthma - FY2008-FY2010_.doc
Author	fhh6
File Modified	2008-02-15
File Created	2008-02-15