Proper planning, strong partnerships and a thorough school assessment form the foundation of a sustainable, long-term asthma management plan. Since each community has its own unique needs and resources, there is no one-size-fits-all approach to establishing an asthma-friendly school. This makes planning even more important!
The Asthma-Friendly Schools Initiative (AFSI) Toolkit is based on the premise that successful, long-term programs that are grounded in a structured planning process positively impact students with asthma. There are many ways to plan, but this toolkit presents one suggested planning system organized in Four Action Steps.
All resources provided to guide local planning are based on real-life experience among coalitions and schools. Many of the resources are based on the experience of American Lung Association staff and coalition members who piloted the Toolkit. Before you get started, review the AFSI Planning Challenges & Tips.
Below is a brief summary of the Four Action Steps, including tools and templates to support your activities.
Action Step 1: Organize Stakeholders
AFSI was designed to be planned and implemented by a community-school coalition of engaged partners. As with any coalition effort, leaders will emerge, individual strengths and resources should be maximized, responsibilities should be specifically assigned and partners should be accountable for their share of the work. Remember, a school must agree to full participation and support to ensure a successful program.
Coalition-building is a dynamic process that changes as needs are identified and analyzed, membership grows and programs are implemented. Local groups can tap into a range of existing resources for guidance on coalition building. Be sure to include representation from a diverse group, both in populations served and function (health, business, youth services, etc.). As your coalition begins to work together, evaluate the effectiveness of the coalition and make adjustments as needed.
After putting in place a diverse group of coalition members, review the group's goals and establish the project planning process. Although goals and processes may be refined following the needs assessment, AFSI pilot sites found that having a general direction from the beginning was helpful for coalition members.
Action Step 2: Conduct a Needs Assessment
In order to create an effective long-term asthma management plan for schools, the AFSI coalition will need to identify needs, gaps in information and resources, areas of opportunities and available resources.
A needs assessment may be more easily accomplished by a small work group or a subset of the larger coalition focused on the specific task. A completed assessment will inform the overall direction of the AFSI project and serve other roles moving forward, including:
- Document a detailed picture of the school or district needs and community resources
- Serve as baseline data for interim and long-term evaluation
- Increase the level of data to build evidence of asthma as a major health concern
- Document needs of school staff, which will bolster efforts to initiate the project within schools
The primary activities in this phase will be to: (1) review existing assessment tool, (2) assign data collection responsibilities, (3) analyze data and prioritize needs and (4) summarize needs assessment results.
- Tip Sheet: Data Collection Instruments
- Tip Sheet: Policies & Legislative Issues Affecting Asthma in Schools
- How Asthma-Friendly Is your School?
- School Needs Assessment
- Using the CDC's School Health Index for AFSI
- AFSI School Health Index
- Powerful Practices: A Checklist for School Districts Addressing the Needs of Students with Asthma
- Sample: Wicomico County School Asthma Survey for School Nurses
- Sample: Cleveland Municipal School District's Needs Assessment Details
- Asthma treatment and Services Community Assessment
- Using a Numerical Ranking System to Prioritize Needs
- Sample: Sonoma County Prioritization Matrix
Remember: Needs assessment results present objective data that will be reviewed as you set goals, objectives, and activities related to asthma education, health services, healthy school environments, and physical education and activity. Information should be presented in an unbiased manner that is both clear to read and reference.
Action Step 3: Create a 5-year Plan
Once the needs assessment is completed and the results have been compiled, it is time to begin creating a long-term plan. In many cases, a separate work group will need to be created to take on the task of brainstorming and outlining the plan.
A strong, long-term plan will consist of the following items in each year:
- Goals: A set of aims that align with the AFSI project's long-term direction.
- SMART Objectives: Levels of achievement measures which are Specific, Measurable, Achievable, Realistic and Timely.
- Activities: Necessary actions to meet objectives and work toward long-term goals.
- Outcomes: Measurable changes that ultimately affect students (i.e. student absentee rates, academic achievement, disease management)
- Evaluation: The process of monitoring your progress in meeting objectives and achieving desired outcomes, which may involve modifying plans moving forward.
The most effective way to establish a sustainable asthma management plan is to include a focus on school policies and practices. Once a policy is adopted within a school or district, staff turnover and time will no longer directly impact whether efforts to address asthma management in the school continues. When drafting the 5-year plan, be sure to set long-term policy goals and remember that change of this magnitude takes time. Policy change will not likely happen in year one; however, the groundwork for policy change can be established in the early years through needs assessment and program evaluation results that show the impact of an asthma management plan.
Creating a logic model can provide a visual roadmap that illustrates the relationship between project inputs and long-term outcomes, incorporating evaluation and measurement. A logic model helps to visualize the plan and is the recommended system for public health projects.
A tailored planning grid, based on the logic model, is suggested for all AFSI coalitions building a 5-year plan. This tool helps to provide a framework for program activities, outcomes, evaluation, and will be the foundation for yearly task plans.
- Tip Sheet: Integrating Evaluation in 5-Year Planning
- Grid for Integrating Evaluation in 5-Year Planning Sample
- Grid for Integrating Evaluation in 5-Year Planning Template
- Tip Sheet: Budget & Fund Planning
After the 5-year plan has been drafted, share the draft with key stakeholders and the coalition-at-large for feedback. Presentations may be needed to address a specific audience, such as a school administrator or potential funder. After modifications are made to the plan, taking into consideration reviewer responses, distribute the plan to all coalition members.
Action Step 4: Create a Year One Work Plan
A year one work plan is a task-specific, detailed action plan that aligns with goals and objectives in the 5-year plan. This could be another task for a specific work group, depending on the size of the coalition. A complete plan will include a timeline for each activity, steps needed to complete each activity and an assigned individual or group responsible for the activity. Make sure to include outcomes with result indicators and methods to measure progress.
Budget planning is also a key to a successful work plan. Consider the resources needed to complete the activities outlined in the plan, including staff time, print materials, meeting expenses, staff trainings and incentives.
Once the year one work plan and budget is drafted, have the larger coalition review and provide feedback. By the end of year one, it's time to revisit the long-term, asthma management plan and to begin planning for year two.