Thirty (30) school districts were awarded grants to receive training and implement the program.

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A cooperative agreement between Centers for Disease Control and American Academy of Pediatrics was established to develop a program to assist school districts in making improvements to their school health services. Thirty (30) school districts were awarded grants to receive training and implement the program.

o Establish a unique leadership team consisting of a school nurse, a public health agency Cooperative Agreement between CDC and AAP to develop a program to assist school districts in making improvements person, to their and school a local health services. medical provider or Assess their current school health services policies, practices, and infrastructure; pediatrician Identify and prioritize key areas for improvement and develop a strategic action plan; and Implement o Assess and evaluate current changes. school health services, Unique was that the leadership team was to be a school nurse, a public health agency person and a local pediatrician policies, or medical practices, provider. and infrastructure o Identify and prioritize key areas for improvement and develop a strategic action plan o Implement and evaluate changes

E n g a g e S t a k e h o l d e r s Form team Identify issues Develop plan Implement plan and monitor Evaluate Sustain Strategy Phase Implementation Phase Adapted from: -Uncommon Solutions -Issel, L. M. (2004). Health Program Planning and Evaluation. Sudbury: Jones and Bartlett. -New Zealand Health Promoting Schools Inquiry Cycle -Strive Site Level Theory of Change

Through Platte County R-111 School s participation in TEAMS, we learned that TEAMS: o o o Emphasizes partnerships and the development of school health services policy and protocol to drive long-term, sustainable change Provides worksheets, templates, and examples to help the team apply the program content, with the ultimate goal of improving the health of children Is self-paced, self-directed, action-oriented and designed to guide in planning and implementing health services improvements In addition, TEAMS is now offered FREE OF CHARGE and includes the Health services Assessment Tool for Schools (HATS)

Aligns with National Asthma Control Program s school-based priorities Whole School, Whole Community, Whole Child Model Coordinate school, family, and community efforts to better manage asthma symptoms and reduce school absences among students with asthma Linking students to medical care https://www.cdc.gov/health yyouth/wscc/ https://www.cdc.gov/asthma/pdfs/strategies_for_addressing_asthma_in_scho ols_508.pdf

Number of students Source: Missouri Department of Elementary & Secondary Education https://mcds.dese.mo.gov/pages/-and-schoololocation odiversity oinfrastructure Number of Students in TEAM School s by Race and Ethnicity, Missouri, 2017 20000 18000 16000 Other 14000 12000 Multiracial 10000 Asian 8000 6000 African American 4000 2000 White 0 Parkway School Fergerson Florissant School Poplar Bluff R-I School Sedalia School Grandview C4 School University City School Mexico Public School Kennet Public School Hancock Place School

Contacted AAP to request training and cost involved to use materials (Fall 2015) Chose candidates to be trained as facilitators and held training with Rocky Mountain Training Institute (May 2016) Sought funding for implementation of Teams (Fall 2016- Winter 2016) Identified and contracted with nine (9) pilot schools for implementation Implemented Teams 2017 Received reports Fall 2017

o Provided the school district with minimal funding to implement the program o Met with all TEAMS districts to explain the process o If the district did not have a Physician Champion, we assisted in identifying one o Facilitated public health engagement, when needed o Provided technical assistance when needed o Offered a timeline and check-ins to assist with moving forward o Validation

o School nurses not aware of resources local public health agencies provide o Local public health agencies not aware of the shared interests and opportunities working with the same population o Willingness of TEAM members to participate and collaborate when the right information is available o Aggregate data school nurses have and the story it tells o Physicians not aware of the resources/programs schools have that could benefit their patients o Many A-ha!! moments

Expected and Validated 1. Need to implement protocols and policy for management of chronic health conditions/special health care needs 2. Need for preventative oral/dental health services on-site 3. Need to address mental health issues (suicide, bullying) 4. Need to address immunizations

Unexpected 5. Need to track health insurance status of students on health inventory forms 6. Need to provide comprehensive outreach to assist families in obtaining health insurance 7. Need for disaster preparedness planning 8. Need to develop strategies to address health office visits associated with complaints of headache and stomachache

o Recruit schools in the winter with start dates in the summer- have a plan ready for the beginning of the school year o All schools are unique- need to be flexible- meet the districts where they are o Many of our schools needed the perspective of the state school nurse consultant o Include the state and school health services data o Engage our state partners ( AAP, school board association). o Provide a forum at the state level for shared communication among our TEAM schools z

Marjorie Cole, MSN, RN, MO State School Nurse Consultant Missouri School Health Program Marjorie.Cole@health.mo.gov Peggy Gaddy, RRT, MBA, Coordinator Missouri Asthma Prevention and Control Program Peggy.Gaddy@health.mo.gov