The North East Independent School District (NEISD) is a large urban district that serves 67,000 students, including more than 8,000 with asthma. In 2006, NEISD hired a registered respiratory therapist/certified asthma educator (RRT/AE-C) to launch an asthma management program to improve students’ asthma control and attendance in order to positively contribute to the district’s academic performance.
NEISD’s investment in the Asthma Awareness Education Program (AAEP) reflects its leadership’s recognition that asthma control is fundamental to student achievement. The AAEP’s evaluation data have demonstrated that comprehensive school-based asthma management programs can improve disease management, reduce emergency health care utilization, and increase school attendance, thus impacting academic performance and generating a return on investment. In Texas, as in a handful of other states, average daily attendance rates are at the foundation of the state’s formula for distributing school revenue. An effective school-based asthma control program like NEISD’s can quickly increase attendance and thereby pay for itself.
The AAEP provides education, disease management tools, and other support to help school nurses identify and monitor students with asthma and to improve communication with clinical staff. NEISD also provides case management services for children with hard-to-control asthma, including RRT/AE-C-led home visits, personalized counseling and coordination with asthma specialist physicians. The Asthma Blow Out (ABO) is the AAEP’s community engagement component, which is delivered in areas with the largest disparities in asthma outcomes. The ABO brings RRT/AE-Cs and physician partners to local schools where they explain disease management strategies and medication use, dispense flu vaccines and provide age-appropriate asthma education to students, parents and caregivers. To decrease healthcare barriers, where indicated, NEISD provides bus transportation to and from the schools, free meals, English-Spanish translation services, and offers academic incentives for students to attend the ABO events.
The AAEP addresses environmental asthma triggers in schools through training for custodial staff, principals and teachers, as well as through monthly meetings with facilities staff. The district also incorporates an asthma management component in the high school’s Healthy Lifestyles course; has implemented an air quality health alert policy to ensure the campus community knows when unhealthy outdoor air conditions occur; and conducts regular monitoring of asthma symptoms and possible environmental exposures in schools. The AAEP also promotes environmental asthma management at home.
In the six and a half years since the program’s launch, the AAEP has reduced asthma symptoms in school as measured by declines in rescue/reliever medication use. For example, inhaler use declined by 50 percent during the first six weeks of school from the first year to the next. Emergency medical service transports during the school day also decreased from 80 transports per year to 24 transports per year. The AAEP has delivered asthma education to every district campus by reaching every physical education teacher, nurse and campus administrator. ABO survey results also demonstrate improved student and parent understanding of appropriate asthma management strategies – 95 percent of parent attendees surveyed said they would recommend the ABO program to a friend. Additionally, the district has seen yearly attendance averages increase from 95.3 percent to 96.1 percent since the AAEP’s inception, including significant increases during flu season. NEISD has achieved state recognition for its academic performance four years in a row. There is widespread agreement that the AAEP-led environmental improvements and involvement in student health contributed to improved student performance and the district’s academic accomplishments.