Att F - Indicators for School Health Programs: Asthma Management (LEA)

asthma management programs, local education agencies

I

Form Approved

OMB No.: 0920-0672

Expiration Date: 06/30/2011

ndicators for School Health Programs:

Asthma Management (AM)

Local Education Agencies

Fiscal Year: March 1, 2010 – February 28, 2011

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 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

I. PROJECT PLANNING

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

2. In FY 2010, 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____________________________________

3. In FY 2010, 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  

4. In FY 2010, 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.  

Please continue on the next page 

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?

 YES

 NO

6. During FY 2010, 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

7. During FY 2010, what asthma management activities did the LEA and LHA collaborate on?

YES NO

A. Seek additional funding  

B. Conduct asthma management needs assessment  

C. Develop or implement asthma management activities  

D. Develop or revise asthma management policies  

E. Develop or revise protocols to provide asthma  

management nursing services for students

F. Share asthma management resources  

G. Provide professional development on asthma  

management to district or school staff

H. Evaluate asthma management activities  

8. During FY 2010, 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

 NO 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): $__________

Please continue on the next page 

III. POLICY

9. During FY 2010, 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)		YES	NO—we have such policies but did not develop them during FY 2010	NO—we do not have such policies
A.	Immediate access to quick-relief asthma medications			
B.	Student possession and self-administration of prescribed quick-relief asthma medications (with parent and health provider permission)			
C.	Appropriate provision of asthma-related school health services by qualified personnel			
D.	Keeping asthma action plans on file			
E.	Asthma awareness education for all students			
F.	Asthma management education for students with asthma			
G.	Required asthma basics and emergency response education for all school staff			
H.	Elimination of tobacco smoke from all school buildings, grounds, vehicles, and school-sponsored events at all times			
I.	Identification and reduction of other environmental asthma triggers			
J.	Development or implementation of an Environmental Management Plan			
K.	Full participation in physical activity when students are well			
L.	Other model policies, policy guidance, or other policy materials Please specify:__________________________			

10. During FY 2010, 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.)

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

 YES

 NO  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) ______

Please continue on the next page 

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

 YES

 NO  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) ______

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

 YES

 NO  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) ______

4. Keeping asthma action plans on file (Choose one.)

 YES

 NO  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) ______

5. Asthma awareness education for all students (Choose one.)

 YES

 NO  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 

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

 YES

 NO  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) ______

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

 YES

 NO  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) ______

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

 YES

 NO  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) ______

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

 YES

 NO  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) ______

Please continue on the next page 

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

 YES

 NO  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) ______

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

 YES

 NO  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) ______

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

 YES

 NO  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 2010, did your asthma management project provide PROFESSIONAL DEVELOPMENT (not to include information sessions) that included information on established or model policies, policy guidance, or other policy materials?

 YES

 NO 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 

12. During FY 2010, did your asthma management project provide TECHNICAL ASSISTANCE on established or model policies, policy guidance, or other policy materials?

 YES

 NO 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.)

� 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______________________________________

14. Does your district have a comprehensive asthma management policy?

 YES

• NO

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

 YES

 NO

Please continue on the next page 

IV. HEALTH PROMOTION AND ENVIRONMENTAL APPROACHES

16. During FY 2010, 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

 NO Skip to 16B

If YES, what tool(s) were distributed? (Choose all that apply.)

 The School Health Index

 Other

Please specify_____________________________________

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

 YES

 NO Skip to 16C

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

 NO Skip to 17

If YES, provide the total:

1. Number of schools reached directly ______

Please continue on the next page 

17. During FY 2010, 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)		YES	NO—we have such materials but did not develop them during FY 2010	NO—we do not have such materials
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 well-managed 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			

Please continue on the next page 

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

YES NO

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 school

nurse or his/her designee  

E. Promoting ongoing communication among students, parents,

teachers, nurses, and health care providers to ensure

that students’ asthma is well-managed 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  

(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 

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

YES NO

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; dust and

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 school

nurse or his/her designee  

E. Promoting ongoing communication among students, parents,

teachers, nurses, and health care providers to ensure

that students’ asthma is well-managed 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  

(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 

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

YES NO

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 school

nurse or his/her designee  

E. Promoting ongoing communication among students, parents,

teachers, nurses, and health care providers to ensure

that students’ asthma is well-managed 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  

(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 

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, 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______________________________________

18. During FY 2010, 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 

V. ASTHMA-RELATED EDUCATION

19. During FY 2010, 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)		YES	NO—we have such materials but did not develop them during FY 2010	NO—we do not have such materials
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. 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:

YES NO

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  

Please continue on the next page 

(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 information sessions) 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:

YES NO

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  

(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 

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

YES NO

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  

(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 agency 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 

20. During FY 2010, did your asthma management project provide information sessions directly to district or school staff on asthma basics and emergency response?

 YES

 NO  Skip to 22

21. During FY 2010, were the following programs or materials used in your district for asthma management education for staff?

Program or materials		YES	NO
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. During FY 2010, did your asthma management project provide asthma-related professional development directly to nurses?

 YES

 NO  Skip to 24

23. During FY 2010, were the following programs or materials used in your district for asthma-related professional development for nurses?

Program or materials		YES	NO
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 2010, 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  Skip to 26

Please continue on the next page 

25. During FY 2010, were the following programs or materials used in your district for asthma management education for students with asthma?

Program or materials		YES	NO
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. During FY 2010, did your asthma management project coordinate asthma management activities with tobacco use prevention programs or tobacco cessation programs?

 YES

• NO

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VI. HEALTH SERVICES

27. During FY 2010, 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)		YES	NO—we have such materials but did not develop them during FY 2010	NO—we do not have such materials
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.			

Please continue on the next page 

B. 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:

YES NO

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.  

(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 

C. Provide PROFESSIONAL DEVELOPMENT (not to include information sessions) 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:

YES NO

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.  

(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 

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

YES NO

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.  

(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 

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 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 

28. During FY 2010, did your asthma management project:

YES NO

A. Use or adapt school health records to identify all

students with diagnosed asthma?  

B. Use health room and attendance records to track students

with asthma?  

C. Focus program efforts on students with poorly managed

asthma as demonstrated by frequent school absences, school

health office visits, emergency room visits, or hospitalizations?  

D. Obtain written asthma action plans for all students with

asthma?  

E. Use 504 Plans or Individualized Education Plans (IEPs),

as appropriate, especially for health services and physical

activity modifications?  

F. Ensure students with asthma have immediate access to

quick-relief medications during the school day?  

G. Ensure access to quick-relief medications before physical

activity to prevent an asthma episode?  

H. Use a standard emergency protocol for students in respiratory

distress if they do not have their asthma action plan?  

I. Have a full-time registered nurse all day, every

day for each school?  

J. Refer students without a primary healthcare provider to

child health insurance programs and providers?  

K. Provide intensive case management for students with poorly

controlled asthma at school?  

L. Provide school-based counseling, psychological, or social

services for students with asthma, as appropriate?  

Please continue on the next page 

VII. EXTERNAL COLLABORATION

29. During FY 2010, did your asthma management project COLLABORATE with any external agency partners?

 YES

 NO Skip to 30

If YES, choose YES or NO for each of the following external agency partners:

YES NO

A. Businesses  

B. CDC-funded local education agency asthma management projects  

C. Community organizations serving parents and families

(this does not include internal school parent groups such as the PTA)  

D. Community organizations with an asthma focus (e.g., American Lung

Association, Asthma and Allergy Foundation of America, Allergy &

Asthma Network Mothers of Asthmatics)  

E. Education organizations (e.g., advocacy, service, professional, or

membership associations)  

F. Faith-based organizations  

G. Foundations (private or non-profit)  

H. Health care providers/physicians � �

I. Health organizations (e.g., advocacy, service, professional, or

membership associations)  

J. Insurance companies or managed care organizations (e.g., Blue Cross/

Blue Shield, Kaiser Permanente, Medicaid)  

K. Local asthma coalitions  

L. Local health coalitions or networks  

M. Local- or county-level education agencies  

N. Local- or county-level health agencies  

O. National non-governmental organizations (NGOs) (including state and

local affiliates) � �

P. Parents/guardians/caregivers (including those reached through

PTAs/PTOs)  

Q. Social service agencies  

R. State asthma coalitions  

S. State health coalitions or networks  

T. State-level education agencies  

U. State-level health agencies  

V. Universities/colleges/institutions of higher education  

W. Youth (representing schools or communities)  

X. Youth-serving community organizations  

Y. 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.)

Please continue on the next page 

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 2010, did you conduct INFORMATION SESSIONS (not to include professional development) that focused on asthma management?

 YES

• NO Skip to 33

If YES:

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

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

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C. Please check all audiences for whom you conducted information sessions in FY 2010:

___ 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

• NO Skip to 34

1. What kind of information did you estimate or guess at? (Mark all that apply.)

		We DID estimate or guess	We did NOT estimate or guess	Not Applicable
1.	Distribution of print materials			
2.	Distribution of materials on web sites, listservs, Internet mailing lists, or discussion boards			
3.	Professional development events			
4.	Follow-up support for professional development events			
5.	Technical assistance			
6.	Information sessions			
7.	Pre-service learning events			

2. On what topics did you estimate or guess at information? (Mark all that apply.)

		We DID estimate or guess	We did NOT estimate or guess	Not Applicable
1.	Project planning			
2.	Policies			
3.	Health promotion and environmental approaches			
4.	Asthma-related education			
5.	Health Services			
6.	Reducing disparities among youth at disproportionate risk for asthma episodes and absences			

Please continue on the next page 

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

 YES

• NO Skip to 35

A. What kind of information did you not collect at all? (Mark all that apply.)

		We DID collect	We did NOT collect	Not Applicable
1.	Distribution of print materials			
2.	Distribution of materials on web sites, listservs, Internet mailing lists, or discussion boards			
3.	Professional development events			
4.	Follow-up support for professional development events			
5.	Technical assistance			
6.	Information sessions			
7.	Pre-service learning events			

B. On what topics did you not collect information at all? (Mark all that apply.)

		We DID collect	We did NOT collect	Not Applicable
1.	Project planning			
2.	Policies			
3.	Health promotion and environmental approaches			
4.	Asthma-related education			
5.	Health Services			
6.	Reducing disparities among youth at disproportionate risk for asthma episodes and absences			

35. 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.

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Please continue on the next page 

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

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

thank you for your responses. please return the 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 DP08-801, 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.

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, asthma-related 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.

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, 2010 to February 28, 2011, 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 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 asthma management 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 asthma management 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 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.

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 site-specific 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 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.

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