1. Asthma, Indoor Air Quality and Tribal Schools in Montana A rural state’s perspective

2. Asthma is a common disease among Montana children affecting over 17,000 children aged 0-17. 6.3% of children aged 0-18 and 10.4% of high school students in MT report current asthma Asthma affects school attendance and performance. With planning, asthma can be controlled in the school setting. Asthma in Montana Youth

3. Asthma among American Indian Youth MT has 7 American Indian reservations and 12 Tribal Nations represented in the state 11.4 % of students in Montana public schools are American Indian (Source: OPI) 10.3% of American Indians aged 0-17 in Montana report current asthma (2008-2009 BRFSS) Smoking and Environmental Tobacco Smoke exposure are of greater concern in tribal populations

4. What is asthma? Chronic disease No Cure Can be CONTROLLED Underlying Inflammation (Silent component) Muscle tightening (During attack)

5. How is asthma controlled? Medical management Proper medication Self-management education

6. How is asthma controlled? ENVIRONMENTAL CONTROL: Reduce exposure to things that trigger attacks

7. Asthma in Montana: Carlene’s Story

8. Special challenges related to working in Montana schools Difficulty with working across 429 separate school districts Many MT schools are very small (69% have <500 students) Importance of local control Unique perspective and needs of tribal schools Need for interventions to be low/no costs and for man power required to be minimal

9. Organizations working on asthma in MT schools Montana Association of School Nurses Montana Team Asthma

10. Key activities “Creating Asthma Friendly Schools” resource guide School administrator’s surveys- 2008 and 2011 In-person training to school office staff on using the resource guide (600+ school staff trained) School nurse mini-grants New AsthmaMontana website with free online training www.asthmamontana.com

11. 7 Steps to creating an asthma friendly school Identify students with asthma Allow students easy access to their inhalers Enable students with asthma to participate in activities Educate staff parents and students about asthma Collaborate with families, students, staff and health providers Identify and reduce common asthma triggers 1 Create a school wide protocol for handling worsening asthma 23 4 5 6 7

12. Results of School Administrator Survey, 2008 and 2011

14. Results of School Administrator Survey 2011

15. Step 1: Identify students with asthma

16. Step 4: Identify and reduce common asthma triggers

17. Goal #6: Provide education to personnel, parents and students

18. Step 4: Identify and reduce common asthma triggers Resource guide recommendations: First and foremost, know your school and your students (eg peanut allergy) Focus on the triggers most important in Montana and in your school settings

19. Step 4: Identify and reduce common asthma triggers Resource guide recommendations: Reduce school bus idling Enact a comprehensive tobacco free school policy Consider pet free policies if necessary Utilize Integrated Pest Management Reduce strong odors and sprays Accommodate weather changes Respond to allergens Utilize your janitorial staff and keep HVAC/building inspections up to date Control respirator y infections

20. School nurse mini-grant projects Assessing asthma friendly policies and practices:

21. Reduce asthma triggers Request free resources and training: www.asthmamontana.com

22. Conclusion: Making your school more asthma friendly Utilize the resources provided free of charge by the Montana Asthma Control Program Do an assessment (potentially through the school nurse mini- grant program) of what simple steps could be taken to improve your school environment Know your setting and students-every school is unique Utilize comprehensive resources like Tools for Schools if feasible Contact Montana Team Asthma Katie Loveland, MPH, MSW kloveland@mt.gov 406-444-7304

23. Questions?