ABSTRACT:
With an estimated 63,000 students with asthma in the Los Angeles Unified School District (LAUSD), PE teachers face a huge challenge of keeping all their students physically active. In a joint effort of the LAUSD District Nursing Services Asthma Program and the American Lung Association in California (ALAC) over 1000 PE teachers have been trained on how to help their students with asthma stay physically active. PE teachers have reported a greater ability to identify asthma triggers and more confidence about what to do in an asthma emergency as a result of these trainings. The improvements in knowledge will have the long term outcome of PE teachers who are more able to address the needs of students with asthma so that they are more active and fit.
The Los Angeles Unified School District (LAUSD) has over 688,000 students. An estimated 63,000 of them have asthma. The 2009 Youth Risk Behavior Survey (YRBS) for Los Angeles states that 0.9% of the high school students who responded to the YRBS reported going to the emergency room or urgent care 10 or more times in the last 12 months for asthma. In a District the size of LAUSD with over 168,000 high school students this 0.9% could translate into over 1,512 students who have been to the emergency room or urgent care 10 or more times in the past 12 months for asthma.
The LAUSD Asthma Program works to improve the asthma management of all students with asthma. Students with a high risk of negative health and academic outcomes due to asthma are targeted for case management by one of the asthma nurses. However, there are always areas that need improvement. In an effort to identify areas of need within LAUSD, the Asthma Program enthusiastically entered into a partnership with the American Lung Association in California (ALAC) on their Asthma Friendly Schools Initiative (AFSI). A needs assessment, based on the Centers for Disease Control and Prevention (CDC) School Health Index was conducted with a variety of school and community stakeholders. This assessment identified Physical Education teachers as needing additional help on how to keep their kids with asthma active. Keeping students physically active will help reduce obesity rates. Obesity is a co-morbidity of asthma.
In 2007 the LAUSD Asthma Program collaborated with ALAC on this initiative. The AFSI started with a needs assessment to identify a focus area for the work plan. An experienced and representative group of stakeholders that included community organization such as Blue Cross, the Los Angeles County Department of Public Health, and ALAC as well as LAUSD employees from schools, school mental health, the dropout prevention program and nursing was assembled to complete the needs assessment. After the initial assessment the data was analyzed and several areas needing improvement were identified. These were then prioritized in terms of the degree of need and how realistic it would be to work on them. Based on this data, the area of work indentified was improving PE teachers’ knowledge of asthma so they can better meet the needs of their students.
A meeting was set-up with the PE Advisor for the LAUSD. As luck would have it, he had just received a grant to roll out new PE Standards and was enthusiastic to have asthma education be a part of his trainings. The first year we designed a narrated presentation for the PE department chairs to use to train the staff at their schools. The goal was for the Asthma Program and ALAC to train the department chairs and provide them with what they needed to easily train their PE staff with fidelity.
The next year we had access to approximately 800 PE teachers in the LAUSD. We modified the Exercise and Asthma training to meet their needs. Evaluation of the pre/post tests indicated a substantial improvement in attitudes and knowledge regarding asthma. PE teachers expressed more confidence in knowing what to do in an asthma emergency and more ability to identify asthma triggers. Some of the other program/activity outcomes from this partnership were:
- A 12% increase in the ability of PE Teachers to identify the symptoms of an asthma episode.
- A 7% increase in the number of PE Teachers who identified asthma as a chronic disease that can be controlled with medication.
- A 23% increase in the number of PE Teachers who felt “very” comfortable identifying asthma triggers.
- A 24% increase in the number of PE Teachers who felt “very” comfortable with what they should do during an asthma episode.
These improvements in knowledge and confidence in identifying triggers and what to do in emergencies translate into PE teachers who are more comfortable keeping their students with asthma fully participating in PE class when appropriate. The trainings last school year were scenario based so that teachers had the opportunity to share best practices on how to modify PE activities when necessary. The trainings also incorporated a component to help students self monitor their asthma and empower them.
We feel very proud of this joint effort in identifying and addressing the needs of students with asthma in the Los Angeles Unified School District. Our collaborative efforts are strong and we will continue to work to improve the asthma management and academic achievement of our students.
Raymond Kohl is a Teacher Advisor with the LAUSD Asthma Program (
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