Partnerships with Chicago Schools

According to the Centers for Disease Control (CDC), asthma accounts for 14 million days of school absences annually in the United States.

Here in Chicago, asthma is the number one reason for excused school absences. In fact, 15% of students who received Mobile C.A.R.E. services reported missing 5 or more school days in the 6 months prior to their first Mobile C.A.R.E. Asthma Van visit. Severely ill students had missed weeks of school.

These are just a few of the many discouraging facts about asthma and its impact on student access to education. As a chronic and incurable (but highly treatable) respiratory disease, asthma can be frustrating to get under control, especially if the family has limited access to medical care.

To combat the problem, Mobile C.A.R.E. has formed partnerships with dozens of Chicago schools. Our experience proves that with a little help from educators and school administrators, we can provide an effective community-based asthma management program.

How Does Asthma Affect Learning?

In addition to frequent school absences, poorly controlled asthma can make daily school achievement difficult. Some common problems associated with asthma include:

• Sleepiness: Students who cough and wheeze at night do not get enough sleep, leaving them sleepy and inattentive the next day.
• Low Energy: Decreased oxygen intake due to asthma can make it difficult for students to function at their peak. Work takes longer to complete.
• Poor Physical Fitness: Exercise-induced asthma, if untreated, can make it impossible for students to participate fully in physical education and to stay fit.

It can be hard for educators and school nurses to identify asthma in the classroom. Is Johnny shy, quiet, and "low energy"? Is he tired because he has been staying up too late? Are "colds" the reason that he is frequently coughing or home sick? Or is the real problem asthma? The best way to figure out is to conduct an asthma exam at a clinic like Mobile C.A.R.E.

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Does Treatment Help?

The answer is, Yes! Although no one has found a cure for asthma, anyone with asthma can follow standard treatment guidelines and use approved asthma medications to lead a healthy, generally symptom-free life.

But for Chicago children, the problem is not only the type of treatment, but also the type of service delivery. Key features that make Mobile C.A.R.E. service delivery effective include:

• School Locations: We bring asthma doctors to the students, parking mobile clinics at school locations, instead of expecting families to find a remote clinic.
• Bilingual: Our doctors and nurses are bilingual, to help families who speak Spanish receive all the information they need about their child's asthma.
• Available to All: All services and medications are free and confidential.
• Follow-Up: We provide ongoing support and follow-up visits to help families stick to their asthma treatment plan.
• School Survey: We get help from schools in distributing surveys to identify which students need help. And we provide the school nurse and administrators with data on the asthma rate at the school.

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Outcomes in the Classroom

Mobile C.A.R.E. has already collected some encouraging feedback and statistics about the benefits of its asthma management program for both students and schools:

• Decrease in Absences: After just six month in our program (an average of 2 visits), our patients experience an average 60 percent reduction in school absences due to asthma.
• Better Sleep: Students report fewer nights interrupted by coughing attacks and other asthma symptoms, which in turn results in students feeling more alert and better able to concentrate during school.
• Exercise is Easier: After four Mobile C.A.R.E. visits, the percentage of students who never experience asthma symptoms during mild exercise improved by 37 percent. More exercise means improved overall physical fitness.
• Less Medical Care: Students miss less time for a Mobile C.A.R.E. visit (20-45 minutes) than for a standard doctor's appointment (several hours or more), and students treated by Mobile C.A.R.E. report fewer emergency room visits and hospital stays, which can interrupt schooling.
• Families Empowered: Parents feel empowered when they learn how to manage their children's asthma; they miss less work, which helps them financially. Families are in a better position to support their children's education.

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Getting Started is Easy

Mobile C.A.R.E. provides all the management and expertise that is required to operate its asthma care program at your school. However, schools can enhance the effectiveness of the program by playing a small but important role in the process.

The next list provides an overview of the four basic steps involved in working with Mobile C.A.R.E. (The role of school educators and administrators is in bold.)

1. Planning:
   • School administrators complete a Letter of Intent (downloaded using links, above left) and send it to the Mobile C.A.R.E. business office.
   • Mobile C.A.R.E. and school administrators meet briefly to make plans.
2. Surveying the Students:
   • Mobile C.A.R.E. provides the school with an informational brochure and a five-question asthma survey.
   • Teachers distribute brochures and surveys to the students, then collect the completed surveys.
   • Mobile C.A.R.E. reviews each survey and reports the data back to the school nurse and administrator. Mobile C.A.R.E. schedules appointments for students and families who are interested in using Mobile C.A.R.E. services.
3. Preparing for the Van:
   • Teachers and other school staff receive a one-hour asthma education session from the American Lung Association (a Mobile C.A.R.E. partner).
   • Mobile C.A.R.E. provides the school with copies of the Mobile C.A.R.E. monthly van schedule and a schedule of the appointments for the upcoming visit.
   • Schools remind students that it's important to keep their upcoming Mobile C.A.R.E. appointments.
   • Students visit the van during the school day, accompanied by a parent or guardian, missing only 20 to 45 minutes of class time to receive the exam, medication and education.
4. Following Up:
   • Mobile C.A.R.E. revisits the school on a regular basis, scheduling follow-up appointments as often as needed, depending on the severity of each individual's asthma. (Mobile C.A.R.E., in partnership with the University of Illinois at Chicago School of Public Health, can also provide in-home consultations to identify asthma triggers in the home.)
   • School staff remind students and families about upcoming van visits using posters, letters, a school newsletter, or announcements.
   • Schools have the option of scheduling additional asthma education sessions from the American Lung Association for asthmatic children at the school.

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Web site created by Karleen Stevens McAllester
Photography by Deno J. Andrews