Multi-level collaboration: H1N1 impact on school absenteeism and school health services

Background and Issues: The State of Colorado saw the 2009 H1N1 Influenza Pandemic as an opportunity for improved multi-level public health collaboration between state public health, local public health and schools. Colorado's 2009 plan for H1N1 school health was developed by collaborative multi-level partners with three components: communication, surveillance, and intervention/ prevention measures. Both public health nurses and school nurses assumed leadership roles within this plan.

Description: The logic model for the three components of Colorado's 2009 H1N1 school health plan included the inputs of the multi-level agencies and personnel, federal and state funding streams, and the past experience of effective communication, surveillance, and intervention/prevention components in disease control. The processes include: weekly meetings, effective information streams, a school influenza-like illness (ILI) absenteeism surveillance system, and school site vaccination clinics. Outputs and outcomes include students following respiratory hygiene measures, parents keeping sick students home, state and local public health staff and schools communicating weekly and collaborating on decisions for school closures, weekly school ILI absenteeism surveillance and other surveillance data from state and local levels shared electronically, and increased seasonal and H1N1 influenza vaccine administered to students and community members at school sites.

Lessons Learned: State and local partnerships between public health and schools provided a new avenue of effective collaboration and disease control and highlighted the value of public health and school nurses as resources for disease surveillance in the state. Regional school nurse/public health nurse workshops are currently being conducted throughout the state to further elucidate and evaluate the H1N1 planning and response effort. The results will be part of the presentation.

Recommendations: The continued and increasing collaborative efforts between state and local public health and school staff will be a beneficial asset to preventable disease control. Increased training of public health nurses and school nurses on the collection and analysis of surveillance data will enhance their ability to understand what is happening within their schools, help in their interaction with families and communities, public health, and help to document the effectiveness of school nurses.