Public Health in the Rockies 2026

Background

Asthma affects 8-10% of school aged children in the United States and is a leading cause of both healthcare utilization and school absenteeism in this age group. Enhancing school-based asthma care is a key strategy to meet children and families where they are and improve asthma outcomes. To this end, Colorado Asthma Friendly Schools initiative was created to both recognize schools and school nurses providing appropriate asthma care in schools, as well as encourage ongoing improvements in holistic school-based asthma care.

Methods:

We adapted the American Lung Associations’ Asthma Friendly Schools Framework to address local contexts and created a self-assessment tool to evaluate schools’ performance in 4 key areas: maximizing delivery of school health services, building asthma education, providing a healthy school environment, and managing physical education and activity. Nurses indicated which strategies they were implementing in a few key areas. After a small first year pilot involving 13 schools, invitations to apply for recognition were distributed across a statewide listserv.

Results:

Nurses (n=137) providing care at 221 schools and 24 districts were recognized. Schools covered 126,043 students, which is approximately 14% of all students in Colorado. Two large school districts received special recognition due to their districtwide asthma-friendly efforts. Highly implemented strategies included protocols and training to manage asthma symptoms and emergencies, following care plans, and infrastructure such as integrated pest management plans, and HVAC improvements. Minimal implementation areas included targeted coordination for high-risk students, WSCC model integrations, EPA walkthroughs and idling policies, and integration with physical education (PE) teachers and activities

Implications:

There was high statewide interest in an initiative to recognize high quality asthma care in schools. While treatment of emergencies in schools was a priority, improving integration with physical education teachers and implementing more evidence based environmental mitigation strategies remain areas of opportunity.