Division II Program Archives

Clearing the Air: A Model for Investigating Indoor Air Quality in Texas Schools

Funding: University of Texas School of Public Health, Austin; Southwest Center for Occupational and Environmental Health; National Institute for Occupational Safety & Health; COEP Bench Tutorials Program

This pilot project focused on indoor air quality assessment at Ball High School in Galveston, Texas, utilizing methods based upon a similar study conducted in a series of California schools, and guidelines from the U.S. EPA's Indoor Air Quality Tools for Schools program. We developed an indoor air quality program using this approach, in conjunction with an air-sampling program, to determine if use of Tools for Schools is sufficient to identify conditions causing potential adverse health effects. This program led to the development of MANIAQS: Management of Indoor Air Quality in Schools.

   APPLE: Air Pollution PoLiciEs for Texas Schools

   Funding: COEP Bench Tutorials Program

The purpose of this study is to identify and evaluate exposure to and effects of air pollutants on human health. Until recently, the Houston/Galveston area surpassed even Los Angeles in the number of days during which ozone concentrations exceeded permissible levels; therefore the need to determine associated health effects has increased. This is particularly true for the Texas public school districts, which must determine reasonable policy to protect students from adverse health effects on days when ozone levels are high. To enable the GISD to make an evidenced-based decision regarding ozone policy, a simple study was devised to assess lung function among athletes exercising outdoors under conditions of low ozone pollution vs. high ozone pollution. This, in turn, led to the development of SASS: School-based Asthma Screening, in which all children enrolling in any GISD athletic program are screened for asthma as a part of their comprehensive physical examination.

   SASS: School-based Asthma Screening

   Funding: NIEHS Center and Sealy Center for Environmental Health and Medicine, UTMB

This project is led by NIEHS Center Members but is conducted as a collaborative effort with the GISD Athletic Department, the Galveston Teen Health Clinic, and UTMB Department of Pediatrics. Yearly, students are offered medical exams to fulfill University Interscholastic League (UIL) enrollment requirements for participation in interscholastic athletics. Junior high and high school students participate in a full physical athletic exam, including cardiac, musculoskeletal, and pulmonary assessments. Center members provide lung function assessments of all students capable of performing a spirometric forced expiratory maneuver. Screening interpretations were scored based on the FEV1/FVC ratios. Thus, the screening exams were primarily sensitive to obstructive disease. Physicians scoring the tests also noted a number of abnormal spirometric patterns associated with restrictive defects and upper airway obstruction, such as vocal cord dysfunction. Scores with FEV1/FVC ratios less than 0.8, but greater than 0.75 were considered marginal, and letters were sent home to suggest consultation with the family health care provider. Students scoring below 0.75 would require clearance from a physician. The head athletic trainer from the high school in GISD has been trained in spirometry and was provided with a spirometer in his office in the Fall of 2003. Two players since that time have received appropriate therapy to manage undiagnosed and undertreated asthma. Long-term outcomes, using trainer logs of respiratory complaints, will be tracked to assess impact.

   Camp-in-a-Box: A Specialty Camp for Children with Asthma

   Funding: NIEHS Center, Fraternal Order of Eagles

This program is shared with the proviso that essential core components of the program remain intact. For example, the camper curriculum has been professionally designed to reflect important asthma management concepts in a developmentally appropriate manner. This curriculum cannot be changed. Evaluation of camp outcomes is also an essential component of the program. These components may also not be altered. On the other hand, it is intended that some parts of the program will be altered to meet the unique needs of the community. For example, camp policies are included as blueprints to be modified to suit the unique needs of each camp setting. Camp activities will need to be altered based on resources available in each community.

   Radical Randy: A 3-D Anatomical Asthma Teaching Model

Funding: School of Nursing; seeking long-term funding
Collaborators: The Camp RAD planning committee and Legacy, Inc.

Radical Randy is a teaching innovation developed in response to the need for improved 3-dimensional, interactive teaching methods for UTMB's asthma camp, Camp RAD. The model is designed to illustrate the differences between healthy and inflamed airways. The pathological processes of swelling, bronchoconstriction and excessive mucus production can be demonstrated for school age children, who learn best through concrete teaching strategies. This understanding should result in increased adherence with daily controller medication use.

In addition to field tests, Radical Randy has also been used in asthma specialty clinics and in asthma camps. Anecdotal data from these experiences indicate that the model is extremely useful in a small group setting. The strong visual imagery of the model replaced much of the didactic content of the class, and allowed the teacher to illustrate concepts in a time frame that was compatible with the children’s limited attention span. When used in a group setting, it is important to limit group size to 6 to 8 children and to assure that each child be given an opportunity to touch and feel.

In the clinic setting, Radical Randy is usually used individually. Teaching is targeted toward the child – however, parents also benefit as observers. Parents have sometimes requested to see the model when the practitioner attempts to explain airway changes verbally. Their feedback indicates that the model facilitates their understanding of the inflammatory process. Of greatest concern in the clinic setting is finding the time to teach. It is expected that reimbursement for asthma education will be available in the near future, particularly for practitioners who obtain certification as asthma educators. With reimbursement, there will be an increased impetus for patient education. Interactive models will help fill a teaching resource gap. Strong visual models that promote interaction can cut teaching time significantly.

   ARCH Program: Asthma OutReach for Children's Health

   Funding: Ronald McDonald House Charities

The ARCH program will deliver health-related education through the use of computer-based games, stories and presentations with educational value that make learning fun. This project will develop prototype ARCH modules concerning respiratory and environmental health, with emphasis on elimination or reduction of risk factors for asthma exacerbation. The prototype will be adaptable to a number of media including kiosks, interactive CDROM or DVD, and the Internet. The first prototype will be a computer-based interactive kiosk.