RA ED

MT ENT OF HEA LTH & HUM N ERVICE •U A 

P 

A S 

S S DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

Strategies for 

Addressing Asthma 

Within a Coordinated School Health Program 
National Center for Chronic Disease Prevention and Health Promotion 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Addressing Asthma


Within a Coordinated


School Health Program


l 

1. Management 

& Support 

Systems 

Students 

with Asthma 

6. School, 

Family, & 

Community 

Efforts 

5. Physical 

Education 

& Activity 

4. Healthy 

School 

Environment 

3. Asthma 

Education 

2. Health & 

Mental Health 

Services 

Strategies for Addressing Asthma 

Coordinated Schoo Health Program 

Counseling, 

Psychological, 

& Social 

Services 

Health 

Promotion 

for Staff 

Healthy School 

Environment 

Health 

Services 

Nutrition 

Services 

Family/ 

Community 

Involvement 

Physical 

Education 

Health 

Education 

Suggested Citation 

Centers for Disease Control and Prevention. Strategies for Addressing Asthma Within a Coordinated 

School Health Program. Atlanta, Georgia: Centers for Disease Control and Prevention, National 

Center for Chronic Disease Prevention and Health Promotion, 2002. Available at www.cdc.gov/ 

healthyyouth/healthtopics/asthma 
Strategies for Addressing Asthma Within a Coordinated School Health Program 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Ahealthy student is a student ready to 

learn. Asthma-friendly schools are those 

that make the effort to create safe and 

supportive learning environments for students 

with asthma. They have policies and procedures 

that allow students to successfully manage their 

asthma. Chances for success are better when the 

whole school community takes part—school 

administrators, teachers, and staff, as well as students and parents. 

The Centers for Disease Control and Prevention 

(CDC) has identified six strategies for schools 

and districts to consider when addressing asthma 

within a coordinated school health program. 

These strategies can be effective whether your 

program is for the entire school district or just 

one school. 

1.	 Establish management and support 

systems for asthma-friendly schools. 

2.	 Provide appropriate school health and 

mental health services for students with 

asthma. 

3.	 Provide asthma education and awareness 

programs for students and school staff. 

4.	 Provide a safe and healthy school 

environment to reduce asthma triggers. 

5.	 Provide safe, enjoyable physical 

education and activity opportunities for 

students with asthma. 

6.	 Coordinate school, family, and 

community efforts to better manage 

asthma symptoms and reduce school 

absences among students with asthma. 

Strategy Development 

These strategies are based on six key 

elements of school-based education and 

intervention developed by expert panelists at the November 2000 national conference, 

“Asthma Prevention, Management, and 

Treatment: Community-Based Approaches for 

the New Millennium,” sponsored by Kaiser 

Permanente and the American Lung 

Association.1 Two National Asthma Education 

and Prevention Program (NAEPP) documents, 

Resolution on Asthma Management at School 2

 and 

How Asthma-Friendly is Your School? ,3

 were used 

to develop these school-focused elements. CDC’s 

school asthma strategies also incorporate the 

eight interactive components of the coordinated 

school health program, a model used by the 

CDC and many state education agencies and 

school districts.4 The figure on the facing page 

illustrates how the six strategies for addressing 

asthma fit within the eight components of a coordinated school health program. 

Strategy Implementation 

I

mplementation of the strategies will require a 

team effort that involves all school administrators, faculty, and staff, as well as students 

and parents. These strategies can be used to 

develop a plan for addressing asthma within a 

coordinated school health program. They 

complement NAEPP’s Managing Asthma: A 

Guide for Schools,5 which provides specific action 

steps for school staff members. 

Every strategy is not appropriate or feasible for 

every school to implement. Schools and districts 

should determine which strategies have the 

highest priority on the basis of the needs of the 

school and available resources. 

Schools and districts should, whenever possible, 

initially focus their asthma programs on students 

with poorly managed, moderate-to-severe persistent asthma as demonstrated by frequent school 

absences, school health office visits, emergency 

department visits, or hospitalizations. Lowincome, minority populations and inner-city 

residents experience more emergency department 

visits, hospitalizations, and deaths due to asthma 

than the general population.6,7 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 1 
National Center for Chronic Disease Prevention and Health Promotion 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


The Six Strategies 

1.	 Establish management and support systems 

for asthma-friendly schools. 

•	 Identify your school’s or district’s existing 

asthma needs, resources for meeting 

those needs, and potential barriers. 

•	 Designate a person to coordinate asthma 

activities at the district and school levels. 

If your school or district has a health 

coordinator, determine if asthma 

coordination can be integrated into his or 

her activities. 

•


• 

• 

• 

•	 Share these strategies with the district 

health council and school health team if 

they exist. If you do not have a council or 

team, help create them. Ensure that • 

school-based asthma management is 

addressed as a high priority.8 

• 

•	 Develop and implement written policies 

and procedures regarding asthma 

education and management. Promote 

asthma programs that are culturally and 

linguistically appropriate.9,10 

Use or adapt existing school health 

records to identify all students with 

diagnosed asthma. Use health room and 

attendance records to track students with 

asthma. Focus particularly on students 

with poorly managed asthma as 

demonstrated by frequent school 

absences, school health office visits, 

emergency room visits, or 

hospitalizations. Avoid mass screening* 

and mass case detection†

 as methods for 

routine identification. These methods 

have not been shown to meet the World 

Health Organization’s or American 

Academy of Pediatrics’s criteria for 

population or school screening 

programs.11–16 

Use 504 Plans or Individualized 

Education Plans (IEPs), as appropriate, 

especially for health services and physical 

activity modifications. 

Obtain administrative support and seek 

support from others in the school and 

community for addressing asthma within 

a coordinated school health program. 

Develop systems to promote ongoing 

communication among students, parents, 

teachers, school nurses, and health care 

providers to ensure that students’ asthma 

is well-managed at school. 

Seek available federal, state, and private 

funding for school asthma programs. 

Evaluate asthma program strategies and 

policies annually. Use this information to 

improve programs. 

* Screening for asthma (spirometry) can identify students who, in 

a test situation, exhibit signs and symptoms of asthma. These 

students may or may not truly have asthma. 

† Case detection (symptom questionnaires) can identify students 

with asthma symptoms who may or may not have the disease. 

Only testing and evaluation by a health professional can confirm 

which students truly have asthma. 

2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Strategies for Addressing Asthma Within a Coordinated School Health Program 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


2.	 Provide appropriate school health and 

mental health services for students with 

asthma. 

•	 Obtain a written 

asthma action plan 

for all students with 

asthma. The plan 

should be developed 

by a primary care 

provider and be 

provided by parents. 

It should include 

individualized 

emergency protocol, 

medications, peak flow monitoring, 

environmental triggers, and emergency 

contact information.17–19 Share the plan 

with appropriate faculty and staff in 

accordance with the Family Educational 

Rights and Privacy Act (FERPA) 

guidelines or with parental permission.20 

•	 Ensure that at all times students have 

immediate access to medications, as 

prescribed by a physician and approved 

by parents. Specific options, such as 

allowing students to self-carry and selfadminister medications, should be 

determined on a case-by-case basis with 

input from the physician, parent, and 

school.21 

•	 Use standard emergency protocols for 

students in respiratory distress if they do 

not have their own asthma action plan.1 

•	 Ensure that case management‡ is 

provided for students with frequent 

school absences, school health office 

visits, emergency department visits, or 

hospitalizations due to asthma.22 

•	 Provide a full-time registered nurse all 

day, every day for each school.1 

•	 Ensure access to a consulting physician 

for each school.1 

•	 Refer students without a primary care 

provider to child health insurance 

programs and providers.23,24 

•	 Provide and coordinate school-based 

counseling, psychological, and social 

services for students with asthma, as 

appropriate. Coordinate with community 

services.18,22,25 

3.	 Provide asthma education and awareness 

programs for students and school staff. 

•	 Ensure that students with asthma receive 

education on asthma basics, asthma 

management, and emergency response. 

Encourage parents to participate in these 

programs.19,26–30 

•	 Provide school staff with education on 

asthma basics, asthma management, and 

emergency response as part of their 

professional development activities. 

Include classroom teachers, physical 

education teachers, coaches, secretaries, 

administrative assistants, principals, 

facility and maintenance staff, food 

service staff, and bus drivers.31–35 

•	 Integrate asthma awareness and lung 

health education 

lessons into health 

education curricula.36 

•	 Provide and/or 

support smoking 

prevention and 

students and staff.37 

cessation programs for 

4.	 Provide a safe and healthy school 

environment to reduce asthma triggers. 

•	 Prohibit tobacco use at all times, on all 

school property (including all buildings, 

facilities, and school grounds), in any 

form of school transportation, and at 

school-sponsored events on and off 

school property (for example, field 

trips).37–41 

‡ Case management by a trained professional includes 

assessing needs and planning a continuum of care for students 

and families. 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 3 
National Center for Chronic Disease Prevention and Health Promotion 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


• 

• 

• 

•	 Prevent indoor air quality problems by 

reducing or eliminating allergens and 

irritants, including tobacco smoke; dust 

and debris from construction and 

remodeling; dust mites, molds, warmblooded animals, cockroaches, and other 

pests.42–45 

•	 Use integrated pest management (IPM)§ 

techniques to control pests.46,47 

5.	 Provide safe, enjoyable physical education 

and activity opportunities for students with 

asthma. 

•	 Encourage full participation in physical 

activities when students are well.48,49 

•	 Provide modified activities as indicated 

by a student’s asthma action plan, 504 

Plan, and/or IEP, as appropriate.1 

•	 Ensure that students have access to 

preventive medications before activity and 

immediate access to emergency 

medications during activity.50–52 

6.	 Coordinate school, family, and community 

efforts to better manage asthma symptoms 

and reduce school absences among students 

with asthma. 

Obtain written parental permission for 

school health staff and primary care 

providers to share student health 

information.53 

Educate, support, and involve family 

members in efforts to reduce students’ 

asthma symptoms and school 

absences.33,54 

Work with local community programs. 

Coordinate school and community 

services, including community health care 

providers, community asthma programs 

and coalitions, community counselors, 

social workers, case managers, and 

before- and after-school programs. 

Encourage interested school staff to 

participate in community asthma 

coalitions. 

§ IPM is a proactive approach to pest management that includes 

looking for signs of pests, controlling water and food sources, 

removing pest pathways and shelters, and safely using pest 

control products as needed. 

4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Strategies for Addressing Asthma Within a Coordinated School Health Program 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Resources 

Coordinated School Health Programs 

•	 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of 

Adolescent and School Health, Atlanta, Georgia. Web site located at www.cdc.gov/healthyyouth 

•	 Council of Chief State School Officers. School health starter kit. Washington, DC: Council of Chief State School Officers, 1999. Available 

at www.ccsso.org/starterkit.html 

• Education Development Center, Inc. Talking about health is academic. New York, New York: Teachers College Press, 1999. 

•	 Education Development Center, Inc., Newton, Massachusetts. Making health academic: creating coordinated school health programs. Web page 

located at www2.edc.org/MakingHealthAcademic 

• Fetro J. Step by step to health-promoting schools. Santa Cruz, California: ETR Associates, 1998. 

•	 Marx E, Wooley SF, Northrop D, eds. Health is academic: a guide to coordinated school health programs. New York, New York: Teachers 

College Press, 1998. 

•	 Tyson H. Special report: a load off the teachers’ backs: coordinated school health programs. Phi Delta Kappan January 1999. Available at 

www.pdkintl.org/kappan/ktys9901.htm 

Asthma 

•	 Allies Against Asthma, University of Michigan, School of Public Health, Ann Arbor, Michigan. Resource bank. Web page located at 

www.asthma.umich.edu/resources/resourcebank.html 

• Allergy and Asthma Network Mothers of Asthmatics, Fairfax, Virginia. Resources include 

• School house: keeping healthy at school. Available at www.aanma.org/schoolhouse 

• School information packet. Available at www.aanma.org/generalstore/catalog.asp?id=BG8&qt=1&sec=schoolchild 

•	 American School Health Association. Resolution on school-based asthma management. In: American School Health Association compendium of 

resolutions. Kent, Ohio: American School Health Association, 2002. Available at www.ashaweb.org/resolutions1.html#diseases 

• Centers for Disease Control and Prevention, National Center for Environmental Health, Atlanta, Georgia. Resources include 

• Asthma Web site located at www.cdc.gov/asthma 

• State asthma contacts and programs. Web page and links located at www.cdc.gov/nceh/airpollution/asthma/contacts/default.htm 

• Asthma Initiative of Michigan, Lansing, Michigan. Web site located at www.getasthmahelp.org 

•	 National Asthma Education and Prevention Program, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, 

Maryland. Web site located at www.nhlbi.nih.gov/about/naepp. Resources include 

• Asthma management model system. Available at www.nhlbisupport.com/asthma/index.html 

•	 Coalition exchange, a forum for community discussion around asthma. Web page located at www.nhlbisupport.com/asthma/ 

coalitioncorner/coalition.htm 

• How asthma-friendly is your school? Available at www.nhlbi.nih.gov/health/public/lung/asthma/friendhi.htm 

• Managing asthma: a guide for schools. Can be ordered at emall.nhlbihin.net/dept2.asp?dept_id=ASTHMA 

• Resolution on asthma management at school. Available at www.nhlbi.nih.gov/health/public/lung/asthma/resolut.htm 

•	 National Education Association Health Information Network, Washington, DC. Asthma and schools. Web site located at 

www.asthmaandschools.org 

•	 National Library of Medicine, Bethesda, Maryland. Breath of life: an exhibition that examines the history of asthma, the experiences of people with 

asthma, and contemporary efforts to understand the disease. Web site located at www.nlm.nih.gov/hmd/breath/breathhome.html 

Strategy 1: Management and Support 

•	 American Academy of Pediatrics, Elk Grove Village, Illinois. School health: train the trainers kit. Establishing a school health coordinating 

council. Available at www.schoolhealth.org/trnthtrn/SECTION6/main6.html 

•	 American Cancer Society, Atlanta, Georgia. Healthy schools, healthy kids. Web site for parents, schools, and communities located at 

www.schoolhealth.info. Resources include 

• Improving school health: a guide to school health councils. 

• Improving school health: a guide to the role of the school health coordinator. 

•	 National Association of State Boards of Education. Fit, healthy and ready to learn. Alexandria, Virginia: National Association of State 

Boards of Education, 2000. Can be ordered at www.nasbe.org/NASBE_Bookstore/Safe_Healthy.html 

• National School Boards Association, Alexandria, Virginia. NSBA’s school health programs. Web page located at www.nsba.org/schoolhealth 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 5 
National Center for Chronic Disease Prevention and Health Promotion 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


•	 Centers for Disease Control and Prevention. Coordinated school health program infrastructure development: process evaluation manual. Atlanta, 

Georgia: Centers for Disease Control and Prevention, 1997. Available at www.cdc.gov/nccdphp/dash/program_evaluation/cshp/index.htm 

•	 Family Policy Compliance Office, U.S. Department of Education. Family Educational Rights and Privacy Act (FERPA) regulations. 

Washington, DC: U.S. Department of Education, 2002. Available at www.ed.gov/offices/OM/fpco/ferparegs.html or by calling 202-260-

3889. 

Strategy 2: Health and Mental Health 

•	 Asthma and Allergy Foundation of America, Washington, DC. Student asthma action card. Available at www.aafa.org/public/pdfs/ 

student.pdf 

•	 U.S. Department of Health and Human Services. Asthma objectives. Healthy people 2010. 2nd edition.Volume 2. Washington, DC: U.S. 

Government Printing Office, November 2000. Available at www.health.gov/healthypeople/Document/HTML/Volume2/ 

24Respiratory.htm#_Toc489704831 

• National Association of School Nurses, Castle Rock, Colorado. Resources include 

• Position statements. Available at www.nasn.org/positions/positions.htm 

• Issue briefs. Available at www.nasn.org/briefs/briefs.htm 

• Continuing education. Available at www.nasn.org/continuinged/continuing_ed.htm 

•	 National Assembly on School-Based Health Care, Washington, DC. Publications and order forms available at www.nasbhc.org/ 

nasbhc_%20resources.htm 

•	 National Asthma Education and Prevention Program. Expert panel report 2: guidelines for the diagnosis and management of asthma. Bethesda, 

Maryland: National Institutes of Health, National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program, 

1997. Available at www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm 

Strategy 3: Asthma Education 

•	 American Lung Association, Washington, DC. Open airways for schools, an education program for students with asthma. Available at 

www.lungusa.org/school/oas.html 

•	 Asthma and Allergy Foundation of America, Washington, DC. Asthma education programs and materials available at www.aafa.org/templ/ 

display.cfm?id=11&sub=178 

• Centers for Disease Control and Prevention, Atlanta, Georgia. Resources include 

• A speaker’s kit for healthcare professionals. Available at www.cdc.gov/nceh/airpollution/asthma/speakit/default.htm 

• Educational materials for parents, educators and youth group leaders. Available at www.cdc.gov/tobacco/edumat.htm 

•	 National Asthma Education and Prevention Program, Bethesda, Maryland. Web page located at www.nhlbi.nih.gov/about/naepp/ 

index.htm. Resources include 

• School asthma education slide set. Available at hin.nhlbi.nih.gov/naepp_slds/menu.htm#schl 

•	 Asthma awareness curriculum for the elementary classroom. Bethesda, Maryland: National Institutes of Health, National Heart, Lung, 

and Blood Institute, National Asthma Education and Prevention Program, 1993. Available at www.nhlbi.nih.gov/health/prof/lung/ 

asthma/school/index.htm 

• National Asthma Educator Certification Board, New York, New York. Web site located at www.naecb.org 

Strategy 4: Healthy School Environment 

•	 Institute of Medicine. Clearing the air: asthma and indoor air exposures. Washington, DC: National Academy Press, 2000. Available at 

www.nap.edu/books/0309064961/html 

•	 IPM Technical Resource Center at Department of Entomology, Purdue University, West Lafayette, Indiana. Integrated pest management for 

schools and childcare facilities. Available at www.entm.purdue.edu/entomology/outreach/schoolipm 

•	 President’s Task Force on Environmental Health Risks and Safety Risks to Children. Asthma and the environment: a strategy to protect 

children. Washington, DC: President’s Task Force on Environmental Health Risks and Safety Risks to Children, May 2000. Available at 

www.epa.gov/children/whatwe/fin.pdf 

• University of Florida, Gainesville, Florida. School IPM: integrated pest management in schools. Web page located at schoolipm.ifas.ufl.edu 

• Centers for Disease Control and Prevention, Atlanta, Georgia. Resources include 

•	 Guidelines for school health programs to prevent tobacco use and addiction. Available at www.cdc.gov/nccdphp/dash/guidelines/ 

nutptua.htm 

•	 School health index for physical activity, healthy eating, and a tobacco-free lifestyle. Available at www.cdc.gov/nccdphp/dash/SHI/ 

index.htm 

6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Strategies for Addressing Asthma Within a Coordinated School Health Program 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


• U.S. Environmental Protection Agency. Resources include 

•	 Indoor air quality: tools for schools. December 2000. Available at www.epa.gov/iaq/schools/tools4s2.html or by calling 

800-438-4318. 

• Integrated pest management for schools: a how-to manual. June 1999. Available at www.epa.gov/region09/toxic/pest/school 

• Managing asthma in the school environment. Available at www.epa.gov/iaq/schools/tools4s2/index.html 

• Mold resources. Available at www.epa.gov/iaq/pubs/moldresources.html 

• Mold remediation in schools and commercial buildings. March 2001. Available at www.epa.gov/iaq/molds/mold_remediation.html 

Strategy 5: Physical Education and Activity 

•	 Block ME. A teacher’s guide to including students with disabilities in regular physical education. Baltimore, Maryland: Paul H. Brookes 

Publishing, 2000. 

•	 Centers for Disease Control and Prevention. Guidelines for school and community programs to promote lifelong physical activity among young 

people. Atlanta, Georgia: Centers for Disease Control and Prevention, 1997. Available at www.cdc.gov/nccdphp/dash/guidelines/ 

physact.htm 

•	 National Asthma Education and Prevention Program. Asthma and physical activity in the school. Bethesda, Maryland: National Institutes of 

Health, National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program, 1993. Available at 

www.nhlbi.nih.gov/health/public/lung/asthma/phy_asth.htm 

Strategy 6: Family and Community 

• Allergy and Asthma Network Mothers of Asthmatics, Fairfax, Virginia. Resources include 

•	 Welcome to Breatherville, USA. Community resources for parents of children with asthma available at www.aanma.org/ 

breatherville.htm 

• Toll-free hotline with trained staff to answer questions about asthma, 800-878-4403. 

•	 American Academy of Allergy, Asthma, & Immunology, Milwaukee, Wisconsin. Resources about pediatric asthma available at 

www.aaaai.org/patients/allergic_conditions/pediatric_asthma.stm 

• National Parent Information Network, Champaign, Illinois. NPIN virtual library. Web site located at www.npin.org/library.html 

References 

1.	 Kaiser Permanente/American Lung Association National Partnership on Asthma. National asthma conference: asthma prevention, 

management, and treatment: community-based approaches for the new millennium. Washington, DC: Kaiser Permanente, American Lung 

Association, November 2000. Available at www.lungusa.org/asthma/report01 

2.	 National Asthma Education and Prevention Program. Resolution on asthma management at school. Bethesda, Maryland: National Asthma 

Education and Prevention Program, National Heart, Lung, and Blood Institute, 1997. Available at www.nhlbi.nih.gov/health/public/ 

lung/asthma/resolut.htm 

3.	 National Asthma Education and Prevention Program. How asthma-friendly is your school? Bethesda, Maryland: National Asthma 

Education and Prevention Program, National Heart, Lung, and Blood Institute, 1997. Available at www.nhlbi.nih.gov/health/public/ 

lung/asthma/friendhi.htm 

4.	 Allensworth DD, Kolbe LJ. The comprehensive school health program: exploring an expanded concept. J Sch Health 1987;57(10): 

409–12. 

5.	 National Asthma Education and Prevention Program. Managing asthma: a guide for schools. Bethesda, Maryland: National Asthma 

Education and Prevention Program, National Heart, Lung, and Blood Institute, 2002. 

6.	 Public Health Service. Action against asthma: a strategic plan for the Department of Health and Human Services. Washington, DC: U.S. 

Department of Health and Human Services, Public Health Service, May 2000: Available at www.aspe.hhs.gov/sp/asthma 

7.	 Lieu TA, Lozano P, Finkelstein JA, Chi FW, Jensvold NG, Capra AM. Racial/ethnic variation in asthma status and management 

practices among children in managed Medicaid. Pediatrics 2002;109:857–65. 

8.	 Coover L, Vega C, Persky V, Russell E, Blasé R, Wolf R. Collaborative model to enhance the functioning of the school child with 

asthma. Chest 1999;116(suppl 4):193S–5S. 

9.	 American Association for Health Education. Cultural awareness and sensitivity: guidelines for health educators. Reston, Virginia: American 

Association for Health Education, 1994. 

10.	 American Association for Health Education. Cultural awareness and sensitivity: resources for health educators. Reston, Virginia: American 

Association for Health Education, 1994. 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 7 
National Center for Chronic Disease Prevention and Health Promotion 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


11.	 Gerald LB, Redden D, Turner-Henson A, Feinstein R, Hemstreet MP, Hains C. A multi-stage asthma screening procedure for


elementary school children. J Asthma 2002;39(1):29–36.


12.	 Wilson JMG, Junger F. Principles and practice of screening for disease. Geneva, Switzerland: World Health Organization, 1968. Public


health papers no. 34.


13.	 American Academy of Pediatrics, Committee on School Health. School health policy and practice: criteria for successful screening. Elk Grove


Village, Illinois: American Academy of Pediatrics, 1993;89.


14.	 Yawn BP, Wollan P, Scanlon P, Kurland M. Are we ready for universal school-based asthma screening? An outcomes evaluation. Arch


Pediatr Adolesc Med 2002 (in press).


15.	 Yawn BP, Wollan P, Scanlon P, Kurland M. Outcome results of a school-based screening program for under-treated asthma. Ann


Allergy 2002 (in press).


16.	 Boss LP, Wheeler LSM, Williams PV, Bartholomew LK, Taggart VS, Redd SC. Population-based screening or case detection for


asthma: Are we ready? J Asthma 2002 (in press).


17.	 Abramson MJ, Bailey MJ, Couper FJ, Drummer OH, Forbes AB, McNeil JJ. Are asthma medications and management related to


deaths from asthma? Am J Respir Crit Care Med 2001;163:12–8.


Lwebuga-Mukasa J, Dunn-Georgiou E. A school-based asthma intervention program in the Buffalo, New York schools. J Sch Health


2002;72(1):27–32.


19.	 National Institutes of Health. Clinical practice guidelines: expert panel report 2: guidelines for the diagnosis and management of asthma.


Rockville, Maryland: U.S. Department of Health and Human Services, National Institutes of Health, 2002. NIH publication 97-4051.


20.	 U.S. Department of Education. Family Educational Rights and Privacy Act (FERPA) regulations. Washington, DC: U.S. Department of


Education, 2002. Available at www.ed.gov/offices/OM/fpco/ferparegs.html


21. Madden JA. Managing asthma at school. Educ Leader March 2000;57(6):50–2.


22.	 Evans R, Gergen PJ, Mitchell H, Kattan M, Kercsmar C, Crain E. A randomized clinical trial to reduce asthma morbidity among


inner-city children: results of the National Cooperative Inner-city Asthma Study. J Pediatr 1999;135(3):332–8.


23.	 Raskin L. Breathing easy: solutions in pediatric asthma. Washington, DC: National Center for Education in Maternal and Child Health,


Georgetown University, February 2000. Available at www.ncemch.org/policy/asthma.html


24.	 Lara M, Nicholas W, Morton SC, Vaiana M, Genovese B, Rachelefsky G. Improving childhood asthma outcomes in the United States:


a blueprint for policy action. Pediatrics 2002;109(5):919–30.


25.	 Fritz GK, McQuaid EL, Spirito A, Klein RB. Symptom perception in pediatric asthma: relationship to functional morbidity and


psychological factors. J Am Acad Child Adolesc Psychiatry 1996;35(8):1033–41.


26. Clark NM, Partridge MR. Strengthening asthma education to enhance disease control. Chest 2002;121(5):1661–9.


27.	 Evans D, Clark M, Feldman C, Rips J, Kaplan D, Levison M. A school health education program for children with asthma aged 8–11


years. Health Educ Q 1987; 14:267–79.


28. Evans D, Clark N, Levison M, Levin B, Mellins R. Can children teach their parents about asthma? Health Educ Behav 2001; 28:500–11.


29.	 Spencer G, Atav S, Johnston Y, Harrigan J. Managing childhood asthma: the effectiveness of the Open Airways for Schools program.


Fam Community Health 2000;23:20–30.


30.	 Gregory EK. Empowering students on medication for asthma to be active participants in their care: an exploratory study. J Sch Nursing


2000; 16(1):20–7.


31. Fillmore EJ, Jones N, Blankson JM. Achieving treatment goals for schoolchildren with asthma. Arch Dis Child 1997;77:420–2.


32. Atchison JM, Cuskelly M. Educating teachers about asthma. J Asthma 1994;31(4):269–76.


33.	 Henry RL, Hazell J, Halliday JA. Two hour seminar improves knowledge about childhood asthma in school staff. J Paediatr Child


Health 1994;30:403–5.


34.	 Hay GH, Harper TB, Courson FH. Preparing school personnel to assist students with life-threatening food allergies. J Sch Health


1994;64(3):119–21.


35. Eisenberg JD, Moe EL, Stillger CF. Educating school personnel about asthma. J Asthma 1993;30(5):351–8.


36.	 Lurie N, Straub MJ, Goodman N, Bauer EJ. Incorporating asthma education into a traditional school curriculum. Am J Pub Health


1998;88(5):822.


37.	 Centers for Disease Control and Prevention. Guidelines for school health programs to prevent tobacco use and addiction. MMWR


1994;43(RR-2):1–18.


38.	 Centers for Disease Control and Prevention. Preventing tobacco use among young people: a report of the Surgeon General. MMWR


1994;43(RR-4):1–10.


39.	 Clark NM, Brown RW, Parker E, Robins TG, Remick DG, Philbert MA. Childhood asthma. Environ Health Perspect


1999;107(3):421–9.


8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


18 
Strategies for Addressing Asthma Within a Coordinated School Health Program 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


40.	 Epps RP, Manley MW, Glynn TJ. Tobacco use among adolescents: strategies for prevention. Pediatr Clin North Am 1995;42(2): 

389–402. 

41.	 Morkjaroenpong V, Rand CS, Butz AM, Huss K, Eggleston P, Malveaux FJ. Environmental tobacco smoke exposure and nocturnal 

symptoms among inner-city children with asthma. J Allergy Clin Immunol 2002;110(1):147–54. 

42. Eggleston PA, Bush RK. Environmental allergen avoidance: an overview. J Allergy Clin Immunol 2001;107(3):S403–5. 

43.	 U.S. Department of Housing and Urban Development. Healthy home issues: asthma. Washington DC: U.S. Department of Housing and 

Urban Development, October 2001. Available at www.hud.gov/offices/lead/hhi/Asthma_v2_12-5-01.pdf 

44.	 Dautel PJ, Whitehead L, Tortolero S, Abramson S, Sockrider MM. Asthma triggers in the elementary school environment: a pilot 

study. J Asthma 1999;36(8):691–702. 

45.	 Tortolero SR, Bartholomew LK, Tyrrell S, Abramson SL, Sockrider MM, Markham CM. Environmental allergens and irritants in 

schools: a focus on asthma. J Sch Health 2002;72(1):33–8. 

46.	 Campbell ME, Dwyer JJ, Goettler F, Ruf F, Vittiglo M. A program to reduce pesticide spraying in the indoor environment: evaluation 

of the “Roach Coach” Project. Can J Public Health 1999;90(4):277–81. 

47. Greene A, Breisch NL. Measuring integrated pest management programs for public buildings. J Econ Entom 2002;95(1):1013. 

48. Herfurt D. Exercise and EIA. J Respir Care Practitioners 1997;10(3):42–8. 

49.	 Block ME, Garcia C, eds. Including students with disabilities in regular physical education. Reston, Virginia: National Association for Sport 

and Physical Education, American Association for Active Lifestyles and Fitness, 1995. 

50. Gean J, Schroth MK, Lemanske RF. Childhood asthma: older children and adolescents. Clin Chest Med 1995;16(4):657–70. 

51. Howenstine MS, Eigen H. Medical care of the adolescent with asthma. Adolesc Med 2000;11(3):501–19. 

52. Kumar A, Busse WW. Recognizing and controlling exercise-induced asthma. J Respir Dis 1995;16(12):1087–96. 

53. Majer LS. Managing patients who have asthma: the pediatrician and the school. Pediatr Rev 1993;14(10):391–4. 

54. Einhorn E, DiMaio M. An interdisciplinary program to control pediatric asthma. Continuum May-June 2000;8–13. 

For More Information 

If you would like to know more about CDC’s asthma activities, please contact: 

Division of Adolescent and School Health 

National Center for Chronic Disease Prevention 

and Health Promotion 

Centers for Disease Control and Prevention 

4770 Buford Highway, NE 

Mail Stop K-12 

Atlanta, Georgia 30341-3717 

888-231-6405 

E-mail: HealthyYouth@cdc.gov 

Web site: www.cdc.gov/healthyyouth 

Division of Environmental Hazards and Health Effects


National Center for Environmental Health


Centers for Disease Control and Prevention


1600 Clifton Road, NE


Mail Stop E-19


Atlanta, Georgia 30333


888-232-6789


E-mail: EHHEinq@cdc.gov


Web site: www.cdc.gov/asthma