Asthma, Indoor Air Quality and Tribal Schools in

MontanaA rural state’s

perspective

•Asthma is a common disease among Montana children affecting over 17,000 children aged 0-17.

•6.3% of children aged 0-18 and 10.4% of high school students in MT report current asthma

•Asthma affects school attendance and performance.

•With planning, asthma can be controlled in the school setting.

Asthma in Montana Youth

Asthma among American Indian Youth

•MT has 7 American Indian reservations and 12 Tribal Nations represented in the state•11.4 % of students in Montana public schools are American Indian (Source: OPI)•10.3% of American Indians aged 0-17 in Montana report current asthma (2008-2009 BRFSS)•Smoking and Environmental Tobacco Smoke exposure are of greater concern in tribal populations

What is asthma?

•Chronic disease

•No Cure

•Can be CONTROLLED

•Underlying Inflammation (Silent component)

•Muscle tightening (During attack)

How is asthma controlled?

Medical management•Proper medication•Self-management education

How is asthma controlled?

ENVIRONMENTAL CONTROL: Reduce exposure to things that trigger attacks

Asthma in Montana: Carlene’s Story

Special challenges related to working in Montana schools

•Difficulty with working across 429 separate school districts

•Many MT schools are very small (69% have <500 students)

•Importance of local control

•Unique perspective and needs of tribal schools

•Need for interventions to be low/no costs and for man power required to be minimal

Organizations working on asthma in MT schools

Montana Association of School Nurses

Montana Team Asthma

Key activities

•“Creating Asthma Friendly Schools” resource guide

• School administrator’s surveys- 2008 and 2011

•In-person training to school office staff on using the resource guide (600+ school staff trained)

•School nurse mini-grants

•New AsthmaMontana website with free online training

www.asthmamontana.com

7 Steps to creating an asthma friendly school

Identify students with asthma

Allow students easy access to their inhalers

Enable students with asthma to participate in activities

Educate staff parents and students about asthma

Collaborate with families, students, staff and health providers

Identify and reduce common asthma triggers1Create a school wide protocol for handling worsening

asthma234567

Results of School Administrator Survey, 2008 and 2011

46

28 27

62

20 18

0102030405060708090

100

Agree or strongly agree Neutral Disagree or strongly disagree

Perc

ent

Asthma is a serious health concern at my school

2008 2011

Results of School Administrator Survey, 2008 and 2011

64

1422

61

2711

0

20

40

60

80

100

Agree or strongly agree

Neutral Disagree or strongly disagree

Perc

ent

My school is adequately prepared to handle asthma

2008 2011

Results of School Administrator Survey 2011

59

23

43

0102030405060708090

100

Staff received a copy of the resource guide, "Creating Asthma Friendly Schools in

Montana"

Staff received training on using the "Creating

Asthma Friendly Schools in Montana"

resource guide

Used the guide to make changes in

policies or procedures related to asthma at

your schools

Pe

rce

nt

Reported receipt and use of guide in the last three years, 2011

Step 1: Identify students with asthma

70 7373 77

020406080

100

School has a process to identify students with asthma at the

beginning of each school year

School collects "Montana Authorization to Carry and Self-Administer Asthma Medication" forms for students with asthma

Perc

ent

Step 1

2008 2011

Step 4: Identify and reduce common asthma triggers

36 41

0

20

40

60

80

100

School has a process to recognize and reduce common asthma triggers inside and outside the school

Perc

ent

Step 4

2008 2011

Goal #6: Provide education to personnel, parents and students 

36 39 31 3044

33 34 31

020406080

100

Yes Agree or strongly agree

Neutral Disagree or strongly disagree

School provides training for teachers and other staff on how to intervene

when a student has an asthma attack

My staff has sufficient training about how to handle asthma in the school setting

Perc

ent

Step 6

2008 2011

Step 4: Identify and reduce common asthma triggers

Resource guide recommendations:

•First and foremost, know your school and your students (eg peanut allergy)

•Focus on the triggers most important in Montana and in your school settings

Step 4: Identify and reduce common asthma triggers

Resource guide recommendations:

•Reduce school bus idling•Enact a comprehensive tobacco free school policy•Consider pet free policies if necessary•Utilize Integrated Pest Management•Reduce strong odors and sprays•Accommodate weather changes•Respond to allergens•Utilize your janitorial staff and keep HVAC/building inspections up to date•Control respirator y infections

School nurse mini-grant projects

Assessing asthma friendly policies and practices:

Reduce asthma triggers

Request free resources and training:

www.asthmamontana.com

Conclusion: Making your school more asthma friendly 

• Utilize the resources provided free of charge by the Montana Asthma Control Program

• Do an assessment (potentially through the school nurse mini-grant program) of what simple steps could be taken to improve your school environment

• Know your setting and students-every school is unique

• Utilize comprehensive resources like Tools for Schools if feasible

• Contact Montana Team AsthmaKatie Loveland, MPH, MSWkloveland@mt.gov406-444-7304

Questions?