Toolkit provides guidelines and resources for sharing influenza-like illness data between health agencies and schools

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In Brief

Public health agencies can vary greatly in the degree to which they partner with schools to track influenza-related illness (ILI) and its effects on the health of children and the community. In response to this need, a Texas public health agency developed a toolkit that walks agencies through the steps of creating, using, and evaluating a system for tracking ILI-related absences in public schools as well as in childcare facilities. After 3 years of testing the program, planners distributed the toolkit as a means to strengthening relationships between schools and health agencies and to encourage more widespread use of Web-based child health surveillance systems.


As experienced during the 2009 H1N1 pandemic, health agencies and schools must work closely together when infectious disease outbreaks occur in their communities. Pre-school and school-aged children may often be important vectors for disease transmission and spread, and decisions regarding school closures can significantly affect the surrounding community.

Prior to the emergence of H1N1 in spring 2009, Tarrant County Public Health (TCPH) and the Southwest Center for Advanced Public Health Practice (APC), a grant-funded unit of TCPH in Fort Worth, TX, developed a communications and surveillance portal to enhance relationships between schools and health agencies. In 2009, Public Health Practices published a practice describing this program and its use within Tarrant County. The information below details the center's subsequent approaches to making the program available to other health departments.

Specific issues
  • Inconsistent exchange of information between health agencies and schools. The toolkit gives health agencies detailed insight on how to develop an affordable, effective means of conducting surveillance in schools and childcare facilities so they can measure how many students are absent due specifically to ILI.
  • Difficulties with early community detection of ILI. Schools often see significant rates of seasonal influenza among children. Monitoring spread of illness in schools may help health agencies identify an outbreak in its early stages and efficiently focus public health resources to where they are most needed.
The practice

The APC developed a toolkit describing how to integrate influenza surveillance into public schools via a Web-based absenteeism monitoring tool that schools can use to submit health data to public health daily, just as they do with TCPH in Tarrant County.

"Pre-School and School Health Surveillance: A Guidance Kit" represents training developed after 3 years of practiced influenza surveillance with more than 200 schools and several childcare facilities in Tarrant County. The purpose of the toolkit is to provide a comprehensive set of resources all health agencies can use to develop surveillance relationships with their local public schools and childcare facilities. The toolkit focuses on these training components:

  • Background information on the agency's system and the need for child health surveillance in schools
  • A timeline for the first year of project development, with accompanying training resources for health agencies to use as they build and revise systems with data providers
  • Resources for identifying user needs
  • Project development steps related to assembling the project team, developing a plan, and implementing and closing the project
  • Establishment of an online system and beneficial technical choices
  • Administration and usability of the online portal by school and health agency staff
  • Guidelines to data management, analysis, interpretation, and presentation
  • The process of evaluation, including methods, lessons learned, and proposed modifications
  • An overview of scientific literature that supports school health surveillance
  • Case studies from health agencies that adapted systems based on TCPH’s surveillance portal.

A variety of resources and tools accompany process descriptions in the following areas:

  • Administrative resources, including data analysis procedures, articles and publicity materials, and a system evaluation
  • Technical resources, such as a child health surveillance system report form and user instructions
  • Health-related resources, featuring information about influenza, universal precautions, vaccination, and Methicillin-Resistant Staphylococcus Aureus (MRSA) for parents, schools, and childcare facilities

Need validation and system recruiting resources, including checklists for childcare facilities and K-12 schools, information about the benefits of immunization, certificates of appreciation, newsletters and presentations, and a recruitment brochure.

What made this practice possible?

Three years of testing and evaluation within the local school system generated the data and fodder for the APC to showcase what worked for TCPH and data providers in its jurisdiction and how other health agencies can partner with school districts and childcare facilities to achieve similar results.

  • Health agency planners developed and evaluated strong relationships with school systems based on the consistent sharing of absentee data
  • Providing an array of tools led to a comprehensive child health surveillance program encompassing the pre-school community and public school system

Find Practices

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