In most cases the second trainer had participated in the HLAI in Minneapolis schools or its replication in St Paul schools.
Procedures, tools, and materials from the HLAI can be useful without using the entire program.
Enhanced asthma management, as defined in HLAI procedures and Core Components, was provided in intervention schools while control schools continued usual asthma care.
It was determined that 16 schools would be needed to provide a large enough sample of students to detect a significant impact of the HLAI on school absences due to asthma and to represent the range of school types in the district.
To determine if implementation of the HLAI was associated with differences in the number of asthma visits to the health office and asthma care provided by health personnel, health office records (daily visit log, student medication, and health records) were audited.
To evaluate the effect of the HLAI on school attendance, comparisons were made between students with and without asthma in control and intervention schools over 2 school years.
To determine if the HLAI and Core Components are being sustained across elementary, middle, and high schools, indicators of asthma management activities are monitored each October, February, and April in all MPS schools.
Observations by asthma staff and the external evaluator indicate institutionalization of most HLAI asthma management components and verify the importance of the asthma resource nurse for mentoring staff and providing consultation regarding asthma management issues.