Foundations for Excellence

Example 3

puzzle piece iconComprehensive Health Services: Asthma Management to Promote Regular Attendance

It is essential that Head Start programs implement effective health and safety practices to ensure children are safe at all times. You might identify health and safety practices as a stand-alone goal or as an objective for another program goal, such as general health.

This example shows how a Head Start program sets a health services goal aimed at establishing a comprehensive asthma approach to promote regular attendance and maximize all children's learning opportunities.

SCENARIO

The Healthy Beginnings Head Start/Early Head Start Program is preparing their five-year application. The program operates four centers for infants, toddlers, and preschool children whose families live in two urban communities within their service area. In addition to collecting and aggregating attendance data to determine the monthly average daily attendance rate, the program also disaggregates attendance data by site, classroom, and individual children to identify children who are at risk of missing 10 percent of program days.

Community Assessment Report
During the community assessment, the health manager conducted a health assessment of communities in the program's service area to understand the health needs of children and adults, as well as available resources, gaps in services, and barriers to care. She reviewed multiple sources of health data collected at the local and state levels and found that the prevalence of pediatric asthma in their state was one of the highest in the country. She also conducted interviews with members of the Health Services Advisory Committee, local boards of health, and other key informants. During these discussions, she learned that local health care providers were seeing an increase in the number of children with asthma. This was consistent with the health data she had collected, disaggregated, and analyzed on children with special health care needs enrolled in the program during the last four years. The number of children who received medical treatment for asthma was also trending up. In addition, a multi-year comparison of the grantee's Program Information Report (PIR) revealed that the percentage of children with asthma in their program was higher than the national percentage. One challenge she identified was the lack of any local asthma organization that program families could attend; the closest one was an hour and a half away.

During Ongoing Monitoring and Continuous Program Improvement
The health manager disaggregated and analyzed attendance data for children with asthma and other special health care needs. She noted that 90 percent of children with asthma were absent frequently. They were in the group of children identified as being at risk of missing 10 percent of program days.

During the Annual Self-Assessment
The health manager talked with teachers who had children with asthma in their classrooms. Teachers reported feeling comfortable implementing individual healthcare plans, but not confident about identifying triggers in their classrooms that might aggravate a child's asthma.

The health manager also talked with the families of children with asthma. Many families did not fully understand asthma and wanted more information about their child's health condition. Several families with limited English proficiency said they would like information in their home language.

The health manager shared this information with members of the Health Services Advisory Committee. The committee, in turn, suggested several strategies that included connecting the program to a local business that had previously funded community health initiatives.

During Planning
After further discussion with the self-assessment team and members of the Policy Council and governing body, the program developed the following health program goal, outcome, and expected challenge for their five-year project period.

Program Goal
The Healthy Beginnings Head Start Program will develop a comprehensive asthma approach to maximize all children's learning opportunities and promote their regular attendance in program activities.

Expected Outcome
Children with asthma will increase the number of days they participate in program activities.

Expected Challenge
Children with asthma have higher rates of absenteeism.

As shown in Table 4.4, the planning team developed three SMART objectives and corresponding expected outcomes for their goal. They also decided on the data sources the program would use to track progress.


Table 4.4: Example 3 – Healthy Beginnings Objectives, Expected Outcomes, and Data, Tools, and Methods (Asthma Management to Promote Regular Attendance)

Objective Expected Outcomes Data, Tools, or Methods for Tracking Progress
  1. Develop an asthma policy and related procedures that include staff training on asthma, how to implement an Asthma-Friendly Child Care Checklist in all classrooms, and how to complete Child Enrollment/Attendance/Symptom Records for children with asthma.
    • Develop policy within three months.
    • Within six months, train education staff in all four centers on the new policy and how to implement the checklist and recordkeeping procedure.
    • By the end of year two and in each subsequent year, implement the checklist on a biannual basis in 100 percent of classrooms in the centers and complete Enrollment/Attendance/Symptom Records for children with asthma.
  • Teachers will maintain asthma friendly classrooms that minimize children’s exposure to asthma triggers.
  • The program will use Child Enrollment/Attendance/ Symptom Records to track attendance data and the reason for missed days.
  • Education and facility managers will use checklist data to make facility improvements as needed.
  • Program policy and procedures
  • Checklists
  • Training logs
  • Attendance data and Child Enrollment/Attendance/ Symptom Records for children with asthma
  1. Develop a two-year local health initiative with the ABC Healthy Living Company to: 1) implement an individualized asthma education home visiting program for families with children with asthma; and 2) mentor family services staff to sustain the program.
    • Within three months, develop a written agreement and budget for the initiative.
    • Within six months, hire an asthma educator.
    • By the end of year one, offer an educational home visit to all program families.
    • Continue to provide educational home visits in year two, and train and mentor selected staff on how to conduct an educational home visit by the end of year two.
  • Families will receive educational materials, including an Asthma- Friendly Home Checklist for Families, in English and Spanish and other languages as needed.
  • Families will have a better understanding of their child’s health condition and management strategies.
  • Program staff will build their capacity to provide asthma education to families on an ongoing basis.
  • Signed agreement and funding received
  • Case management notes
  • Checklists
  • Staff training logs
  • Attendance data and Child Enrollment/Attendance/ Symptom Records for children with asthma
  1. Work with the local hospital and the regional chapter of the Asthma and Allergy Foundation of America to establish a local support group to offer asthma education and support to program families and other members of the community.
    • Establish the local support group within four months.
    • Hold the first meeting within six months.
    • Hold quarterly meetings in years two–five and invite all program families who have children with asthma to attend.
  • Program families and the community will benefit from a local collaboration to address community health concerns.
  • Program families will have access to educational resources and support to help them manage their child’s asthma.
  • Meeting agendas
  • Family surveys
  • Attendance data and Child Enrollment/Attendance/ Symptom Records for children with asthma

The Healthy Beginnings Head Start Program then wrote a detailed action plan for each of their three SMART objectives. The action plan for Objective 2 is included in Table 4.5.

Objective 2: The Healthy Beginnings Head Start Program will develop a two-year local health initiative with the ABC Healthy Living Company to: 1) implement an individualized asthma education home visiting program for families with children with asthma; and 2) mentor family services staff to sustain the program. 


Table 4.5. Example 3 – Healthy Beginnings Action Plan for Objective 2 (Asthma Management to Promote Regular Attendance)

Program Action Steps/Strategies Person(s) Responsible Timeline Financial Supports
  1. Develop a written agreement with the ABC Healthy Living Company to fund a two-year local health initiative to provide educational support to Head Start program families who have children with asthma.
Head Start director and health manager Within three months Budget for the health initiative
  1. Hire an asthma educator to conduct home visits with program families.
Health manager and Policy Council parents Within six months  
  1. Select educational materials and translate them into the languages spoken by program families as needed.
Health manager and asthma educator Within nine months Budget for materials and translations
  1. Conduct home visits.
Asthma educator By the end of year one  
  1. Train family service staff on educational materials.
Asthma educator, health manager, and family service staff Year two, first quarter  
  1. Conduct joint home visits with family service workers to mentor staff, ensure they know how to use the educational materials appropriately, and coordinate with the health manager.
Asthma educator, health manager, and family service staff Year two, second quarter  
  1. Mentor interested staff to build their capacity to provide asthma education and support.
Asthma educator, health manager, and family service staff Year two, third and fourth quarters  
  1. Continue to offer educational home visits.
Family service staff and health manager Years three to five Budget for materials

Topic:Program Planning

Resource Type: Article

National Centers: Program Management and Fiscal Operations

Last Updated: January 30, 2019