Open Airways for Schools (OAS)

A program of the American Lung Association, implemented in Office of School Health, Department of Health Anne Arundel County, Maryland.

Description of Replicated Program

OAS is currently implemented in almost all of the elementary schools in Anne Arundel County, which is the most centrally located county in the state, bordered to the north by Baltimore County, to the east by the Chesapeake Bay, to the south by Calvert County, and to the west by the Patuxent River, Prince George's County and Howard County. It is diverse economically as well as racially and ethnically.

In the academic year 1992-1993, school health officials Gene Saderholm, Deputy Director of Clinic and School Health, and Dr. Harry Curland, Former Director of Clinic and School Health in Anne Arundel County, decided to obtain the OAS program and implement it in their school system on a limited basis. This decision was made in response to the growing awareness that asthma was responsible for a high percentage of missed school days along with the news that there had been a sharp increase in the number of students with asthma who received concurrent home teaching. In Anne Arundel County, students with chronic health conditions can have a certified teacher instruct them in their homes on days they are too ill to attend school. School health officials believed that teaching children with asthma how to properly manage their asthma would produce healthier students and thus reduce the need for concurrent home teaching while decreasing the number of missed school days.

Due to the success of OAS, Anne Arundel County expanded the program and offered it in the majority of its elementary schools in the academic year 1998-1999. OAS is offered as part of the County’s comprehensive Asthma Management Program (AMP). In addition to providing guidelines to schools on how to meet the needs of children with asthma, AMP provides the infrastructure, such as school health nurses and assistants, that is necessary to administer the various educational programs that are offered for students, families, and school personnel.

The following are components of AMP.

• School health nurses
• Intensive case management
• School emergency plan
• Peak flow monitoring
• Flexible medication policy
• Power Breathing in middle & high schools
• Open airways for schools
• Staff asthma education
• Family asthma management education
• Indoor air quality management
• Systematic identification of students with asthma

Goals of the Replicated Program

Similar to the goals of the intervention research, the overarching goals for Anne Arundel County’s OAS program are to improve children’s understanding of asthma and proper medication use and to teach children how to better manage their asthma. The specific objectives of the Anne Arundel County program are as follows.

• Know personal asthma triggers
• Prevent asthma episodes
• Recognize personal asthma symptoms
• Have fewer absences due to asthma related illness
• Conduct asthma management steps
• Have fewer nurse and hospital visits
• Discuss asthma problems with adults
• Have fewer unscheduled medical visits

In fact, the Anne Arundel County goal of reducing the number of nurse, hospital, and emergency room visits extend beyond the goals for the intervention research, which translated OAS to a school setting.

Recruitment and Characteristics of the Target Population

OAS is offered to all students in third through fifth grades identified with asthma by their school nurse. Students are identified as having asthma if they are currently taking asthma medications, they have a physician’s diagnosis on file, or their parents indicate the child has needed a physician visit for asthma in the last year. The school nurse sends a letter home with students, based on the sample letter provided in the kit, that describes the program and requests permission for the student to participate in the program. Similar to children in the intervention research, many of the children in Anne Arundel County do not have regular access to medical care.

Since 1998, 709 students have participated in OAS in Anne Arundel County.