School-based asthma management policies and practices: a regional survey

Children with asthma may spend as much as one-third of their weekdays in the school setting. As one effort to evaluate and improve asthma care in the Dallas/Fort Worth area, the North Central Texas HEDIS Coalition surveyed 36 independent school districts (ISDs). Twenty-nine ISDs, representing 679,631 children, responded to questions on school health personnel, identification and monitoring of students with asthma, staff training in asthma care, policies for students carrying asthma medications, and campus smoking policies. Key findings were more positive than expected and included the following: (a) training in asthma management is fairly extensive, (b) students in 26 ISDs are allowed, upon physician request, to carry medihalers, and (c) smoking on school property is illegal in Texas. However, the absence of a fully developed strategy for implementing the survey findings may have hindered the continuous quality improvement efforts among schools, health plans, providers, and the community that could have evolved from this project.