Impact of the Air Quality Flag Program on elementary school policy and environmental health curriculum

Asthma is a major public health concern in the United States and California. Nearly 2.9 million Californians with asthma experienced asthma symptoms in the past 12 months, including 667,000 school-aged children. The purpose of this study was to evaluate the impact of the Air Quality Flag Program (AQFP) within the school environment through policy and curriculum implementation. Procedures: A total of 57 elementary/middle school administrators (i.e., principals or their designees) were interviewed across six counties in California's central valley, 29 with the Flag Program and 28 without. The structured questionnaire addressed knowledge of the AQFP; program impact on school policies and curriculum; outdoor activities for students, school personnel, and parents; barriers/challenges with associated policies and curriculum; and, compliance with air quality monitoring data. A qualitative theme analysis was conducted. Results: Overall, 28% of non-Flag participants reported they could not identify a poor air quality day compared to 6% of Flag participants. Furthermore, 72% of the Flag participants reported to have an asthma policy as compared to 46% of the non-Flag participants. Flag participants were more likely to have teachers' and administrators' curriculum (24% and 20%, respectively) as compared to non-participants (14% and 10%, respectively). Over half of the Flag participants reported there were no problems implementing the Flag Program. Identified barriers included: lack of a set policy or curriculum for running the Flag Program, mobility of administrators, reluctance for schools to cancel sporting events/practices, and teachers' need to have a break from their students. Findings and recommendations will be discussed.