Self-Administration of Asthma medication in Georgia schools: Establishing a policy surveillance system to assess implementation

Introduction: The burden of asthma among children in the state of Georgia (10%) remains higher than the US national average (9%).  Georgia code 20-2-774 was adopted to authorize students to self-administer asthma medication to manage asthma exacerbation in school settings.  To effectively evaluate the public health impact of this policy, a policy surveillance system was established to assess the breadth and depth of implementation of the code across the state.

Methods: The Georgia Asthma Control Program implemented a policy surveillance process to assess implementation of the asthma medication self-administration policy.  Initial surveillance included schools in three health districts and assessed 1) written documentation of the school's asthma policy; 2) school personnel familiarity with the policy; and 3) practices/procedures relating to student self-administration of medication.

Findings: Of the preliminary schools assessed, there was variation regarding familiarity with Georgia code 20-2-774 among school personnel and school nurses.  While written documentation of the asthma policy existed in the majority of schools assessed, practices and procedures of student self-administration varied; policy procedures for student self-administration varied broadly by schools even within the same school district.

Conclusion: The preliminary analysis suggests the need to increase awareness/familiarity of the medication self-administration policy among school personnel, as well as to provide technical assistance to establish appropriate standardized procedures for effective implementation.  Further, the ongoing, systematic collection and surveillance of asthma policy data will help identify the nuances of local level policy implementation, in order to facilitate a comprehensive evaluation of the public health impact of these policies.