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Development of a Tool to Evaluate Asthma Preparedness and Management in Child-Care Centers

was featured in the June 2015 quarterly edition of Pediatric Allergy, Immunology, and Pulmonology. This article is the result of a collaborative relationship between the MCAH Child Care Health Program, DPH Children's Environmental Health Promotion Program and the UCSF School of Medicine, Department of Pediatrics to study asthma preparedness in a targeted group of SF child care centers serving a high risk population. Asthma is a common condition affecting many children in child-care centers. With more children spending increasing time in child-care settings, a method to assess a center's ability to care for children with asthma is crucial for public health practitioners, child-care administrators, and parents. The National Asthma Education and Prevention Program offers recommendations about creating an asthma-friendly child-care setting. However, no studies have investigated the extent to which child-care centers adhere to these recommendations. This study describes the development of a novel instrument to determine the ability of child-care centers to meet national recommendations for asthma. The Preparing for Asthma in Child Care (PACC) Instrument is an evidence-based and comprehensive tool. The instrument is composed of 43 items across seven domains: smoking exposure, presence of a medical consultant and policies, management of ventilation and triggers, access to medication, presence of asthma action plans, staff training, and encouragement of physical activity. The instrument was developed and pilot tested at 36 child care centers, for use by a health worker or nurse and identifies specific domains in need of improvement.