Los Angeles Unified School District Comprehensive Asthma Program

The Los Angeles Unified School District is made up of 8 school districts and totals 704 square miles, an area that includes the City of Los Angeles and all or parts of 28 other cities

• 694,288 students K-12
• 73% of students are Hispanic, 11% African American, 9% White
• Over 60% of students use a language other than English in the home
• 70% of students receive Title I services

*as of 2007

At the end of the four year grant, LAUSD Comprehensive Asthma Program expects the following outcomes:

• Asthma Friendly Schools in LAUSD
• Increased School attendance among students with asthma
• Improved student academic performance
• Improved access to quality health care
• Increased asthma awareness among students, school staff, and general public
• Asthma-safe home environments for students and families
• Decreased ER visits and hospitalizations for uncontrolled asthma
• Reduced disparities in childhood asthma outcomes
• Enhanced quality of life for students with asthma

Objective 1: Improve access to and quality of asthma health care services for children

• Case management (by nurses) for children with excessive absences and/or ED use, children are linked with asthma care provider either through free clinic or Breathmobile
• Children in case management assisted in enrolling in insurance programs through the LAUSD Children’s Health Access Medi-Cal Program (CHAMP)
• Collaborate with partners to deliver provider education using the PACE model

Sample process/outcome measures: pre/post testing of health care providers on asthma knowledge use of action plans; # of students in case management; reduction in ER visits and hospitalizations; reduction in missed school days

Objective 2: Improve knowledge about asthma among affected individuals and the general public

• Open Airways in Schools used to enforce self management skills for kids, and improve knowledge amongst school staff 
• Work with Asthma Coalition of Los Angeles to promote asthma management activities in other school districts

Sample process/outcome measures: # of OAS classes conducted; # of students enrolled; pre/post evaluation of students; pre/post assessment of school staffs’ skills and attitudes

Objective 3: Make schools and communities more asthma friendly

• Pilot age appropriate asthma curricula aligned with Health Education Standards for the State of California in elementary/middle/high schools
• Implement Tools for Schools and educate about Integrated Pest Management
• Participation and attendance at local asthma coalition meetings and events and presentations and dissemination of educational materials at local health fairs

Sample process/outcome measures: pre/post program evaluations; pre/post school surveys for elimination of environmental triggers; increased use of Asthma Action Plans and adherence to asthma friendly policies

Objective 4: Promote asthma-safe home environments

• In-home assessments, education and enviornmental mitigation by nurse case managers using LA CASA Teaching Manual, distribution of mattress/pillow covers; referrals for other services (smoking cessation, low interest home improvement loans)
• Collaborations with community and government agencies to educate about safe indoor air quality

Sample process/outcome measures: (baseline and 3, 6, and 12- month follow-up): % of families successfully reducing environmental triggers; reduction of symptoms; reduction in ER visits and hospitalizations

Objective 5: Reduce disparities in childhood asthma outcomes

• Establish case-management tracking system that captures ethnic and social-economic status information and other data such as ER visits, days of school missed
• Identify culturally and linguistically appropriate asthma materials

Sample process/outcome measures: decrease in overall number of ER visits and days of school missed due to asthma for low-income, racial and ethnic minority students targeted by the program compared to baseline

The LAUSD Comprehensive Asthma Program collects information on their participants using the Health Centric Assessment System, an electronic tool developed and validated by Dr. Craig Jones, former Assistant Professor of Pediatrics at USC Keck School of Medicine and Chief of the Division of Allergy and Immunology.  They have collected five quarters of data since July 2006, and now will be able to compare the outcomes they are observing in their program's participants with the outcomes of the other Breathmobile patients in California, a rich comparison that will undoubtedly yield interesting results.  So far in its program participants, LAUSD has seen a significant reduction in ER use for acute asthma episodes, a reduction in daytime and nighttime symptoms and an improvement in asthma control between baseline and 3 month follow-up (n= 161).