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Example #1: American Lung Association of Kansas

In the U.S., asthma is the leading cause of missed school days due to a chronic illness.

With a program called "Open Airways," the American Lung Association of Kansas takes asthma education to children where they are--in public and private schools--to help them gain better control of their illness. This outreach program also expands the knowledge of adults who care for them.

The program provides training to school nurses and community volunteers, who then conduct sessions for children ages 8-12 on how to manage their asthma. The children learn how to take their medicines, what their medicines are, and how to use a peak flow meter to monitor their breathing capacity.

"We're reinforcing the work of their doctors," says Lynne Crabtree, Outreach Program Director. "Many families hear the diagnosis of asthma, but everything that follows doesn't quite sink in."

Open Airways is a national program that is implemented statewide. It was created at Columbia University, so workers at the state level begin with a well-researched program. The Kansas Lung Association is able to offer the program free to schools through funding from grants and individuals.

Implementing the program begins with recruiting the educators. Usually the partner in this outreach effort is a school nurse, but in Kansas many schools are phasing out or reducing the position of school nurse in response to tight budgets. If a nurse isn't available, Crabtree contacts other medical folks in the community--respiratory therapists from local hospitals or people in emergency medical services, such as ambulance workers and firefighters.

Through eight weekly sessions held during the school day, the children become a support group for each other, and the older kids also teach the younger ones. Each school decides what time of day to hold the sessions, so they need not infringe on academic work or recess.

Parents are involved, too. Handouts are sent home to encourage child-parent interaction about asthma management and to inform parents how to avoid asthma activators, such as smoke, dust and mold.

"Like diabetes, it is so important for people to understand and manage this disease. No amount of prescribed medicine will help if a child sleeps in a moldy, damp basement," Crabtree notes.

How does the Kansas Lung Association let people know this program is available? "We usually start at the interest level. It could be the school nurse, parents, families, the PTA, or the district office," says Crabtree.

And how do they evaluate the success of the program? "School nurses, who serve as volunteer Open Airways facilitators for the American Lung Association of Kansas, evaluate the program by the number of children with asthma who are better able to manage their disease after completing the classes," Crabtree explains. Success is measured by the facts that children are attending school more consistently, actively participating in sports, and spending less time in the nurse's office for asthma-related symptoms.

In addition, parents report to school nurses that they have a better understanding of their child's disease after reading the handouts and they appreciate the active role their children take in monitoring their asthma symptoms.

Along with Open Airways, the Lung Association markets an EPA-approved program to check the school building itself for activators of asthma and headaches. Any improvements made as a result of the check help the school's staff as well as the students.

The "Tools for Schools" outreach effort teaches school representatives to see with new eyes by walking them through the building to inspect for mold, poor circulation, dirty vents, and radon. Take, for example, that hamster cage in the kindergarten classroom, right next to the return air vent. This could adversely affect someone with allergies, while a simple move of the cage could prevent problems.

Or what about the wonderful school remodeling that was just completed? Yes, it offered more room--but did it also stir up mold and mildew? Did the architects' moving of walls also allow for proper movement of air?

Tools for Schools is marketed to people responsible for the building. In a large school district, that might be the district's risk manager, while in small schools or districts, the contact could be the maintenance person. "This program doesn't put any requirements on the school, but it does help them identify triggers," Crabtree says.

Both programs seek to improve health by bringing education to the people who will benefit. In order to accomplish successful outreach, Crabtree offers the following tips from her experience:

"Our outreach is only as effective as our networking with contacts. Therefore, follow up on all leads and welcome volunteers from all walks of life, including parents, interested individuals, healthcare professionals and community leaders. Often a contact will be a resource for more than one program. For example, someone calling for information about asthma will probably also be interested in second-hand smoke as an irritant and may want to participate in more than one project."

And on a larger scale: "Share information freely with other organizations and welcome coalition building to help strengthen your mission."


Example #2: Breaking the Prison Pipeline

An ex-convict, Susan Burton, furnished her house with bunk beds to accommodate ten women and within a few weeks, all ten beds were occupied. Her guests slept in the bedrooms and she slept in the dining room. With no fixed rent, the women chipped in to the best of their abilities with welfare money – if their benefits hadn’t been eliminated because of drug convictions – to help pay the mortgage. They shared their food stamps to stock the refrigerator. Most importantly, they stayed as long as they needed. Burton helped these women transition back into regular life by providing services and opportunities to get a driver’s license, addiction treatment, a job, and a sense of self-worth. Before long, she noticed a change. Women who would have gone without assistance in their old neighborhoods or maybe even be in trouble with the law again were beginning to thrive. Burton claims, she saw the re-emergence of life, right there in front of her. Astonishingly, that was eighteen years ago and since then, Burton has expanded her efforts to five houses in South Central Los Angeles and provided more than 1,000 women a chance to rebuild their lives after prison. In California, about sixty-five percent of former prisoners are re-incarcerated within three years, according to a 2012 report by the state’s department of corrections. Strikingly, last year, the recidivism rate of the women Burton took in was just thirteen percent.

Read more about Breaking the Prison Pipeline.

Contributed by Lia Thompson, University of Kansas, Community Tool Box Intern.



Val Renault