Comprehensive 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)

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)

Last Updated: August 8, 2023