title: Development of a Tool to Evaluate Asthma Preparedness and Management in Child-Care Centers.
abstract: Introduction:Asthma is a common condition affecting many children in child-care centers. 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.Methods:The Preparing for Asthma in Child Care (PACC) Instrument was developed using information from existing recommendations and standards, the peer-reviewed literature, site visits, and expert interviews. The survey questions were pilot-tested at 36 child-care centers throughout San Francisco.Results: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.Discussion:The PACC Instrument is an evidence-based and comprehensive tool designed to identify areas to target to improve asthma care for children in child-care centers.
authors.affiliation: School of Medicine, University of California , San Francisco, San Francisco, California.
authors.forename: Chelsea A
authors.initials: CA
authors.lastname: Young
authors.affiliation: Maternal, Child and Adolescent Health Division, San Francisco Department of Public Health , San Francisco, California.
authors.forename: Curtis
authors.initials: C
authors.lastname: Chan
authors.affiliation: Maternal, Child and Adolescent Health Division, San Francisco Department of Public Health , San Francisco, California.
authors.forename: Jodi
authors.initials: J
authors.lastname: Stookey
authors.affiliation: Department of Pediatrics, University of California , San Francisco, San Francisco, California.
authors.forename: Anisha I
authors.initials: AI
authors.lastname: Patel
authors.affiliation: Maternal, Child and Adolescent Health Division, San Francisco Department of Public Health , San Francisco, California.
authors.forename: Jane
authors.initials: J
authors.lastname: Evans
authors.affiliation: Children's Environmental Health Division, San Francisco Department of Public Health , San Francisco, California.
authors.forename: Karen
authors.initials: K
authors.lastname: Cohn
authors.affiliation: Children's Environmental Health Division, San Francisco Department of Public Health , San Francisco, California.
authors.forename: Luz
authors.initials: L
authors.lastname: Agana
authors.affiliation: School of Medicine, University of California , San Francisco, San Francisco, California.
authors.forename: Irene H
authors.initials: IH
authors.lastname: Yen
authors.affiliation: School of Medicine, University of California , San Francisco, San Francisco, California.
authors.forename: Alicia
authors.initials: A
authors.lastname: Fernandez
authors.affiliation: Department of Pediatrics, University of California , San Francisco, San Francisco, California. ; Philip R. Lee Institute of Health Policy Studies, University of California , San Francisco, San Francisco, California. ; Department of Epidemiology and Biostatistics, University of California , San Francisco, San Francisco, California.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Cabana