The objective of this Fast Track Small Business Innovation Research (SBIR) application, submitted by KDH Research and Communication (KDHRC), is to develop and evaluate the School TIME Toolkit (Toolkit) to support parents and teachers of elementary school-aged children who have a chronic illness and intermittent school attendance (CICISA). Children with chronic illnesses, such as asthma, cancer, diabetes and other illnesses with physical and medical effects lasting longer than three months are at risk of intermittent school absences which can negatively impact their academic and psychosocial outcomes. The burden of navigating and securing school services and easing transitions into and out of school because of absences falls heavily on the parents and teachers of CICISA and can result in their increased stress, depression, and anxiety. The Toolkit aims to reduce this burden by increasing parents'and teachers'knowledge, attitudes, and self-efficacy toward managing the educational needs of CICISA, providing parents and teachers with practical skills to understand, navigate, and advocate for school services for CICISA, and also decrease their stress and increase their coping abilities. Armed with these improved skills and lower stress, teachers and parents will then contribute to a more supportive school environment for CICISA characterized by greater access to school. The Toolkit will be a comprehensive, evidence-based, integrated set of print and multimedia materials, hosted on an interactive website. The need for the Toolkit is significant. Approximately 4.4 million children with a chronic illness in te United States experience disruption to school because of their illness. Parents and teachers are key players in helping CICISA access school services, navigating transitions into and out of school because of absences, and establishing support to help CICISA succeed. However, parents and teachers face multiple challenges in providing CICISA with the support they need, and the resulting burden can lead to increased risk for stress and depression. With proper support, however, such as that offered by the Toolkit, parents and teachers can help CICISA spend more time in school and avoid the negative academic consequences often associated with chronic illness and intermittent absence. In Phase I of the Toolkit, we will conduct formative research with a panel of experts in the field, an online needs assessment with parents and teachers, and a parent/teacher/administrator grassroots program development team. We will then develop the Toolkit prototype, which will consist of the print parent and teacher guides and a website architecture plan. Finally, we will conduct a feasibility evaluation of the prototype using a quasi-experimental, pretest/post-test group design to examine the extent to which the Toolkit prototype changes parents'and teachers'knowledge, attitudes, and self-efficacy. The Toolkit will be considered feasible if parents and teachers show statistically significant gains in knowledge, attitudes, or self-efficacy from pretest to post test. In Phase II, we will finalize th Toolkit by filming footage of streaming video and programming an interactive website. We will then conduct an outcome evaluation that will include three studies. The first two studies will examine changes in knowledge, attitudes, self-efficacy, skills, and stress/coping from pretest to post test in parents and teachers. The third evaluation will be a case study examination and will explore how use of the Toolkit by parents and teachers can impact the creation of a more supportive school environment for CICISA. Together, the three evaluations will provide information on the evidence-base of the Toolkit as a foundation for dissemination, as well as a wealth of data for academic publishing. In summary, the Toolkit will meet a documented need for greater support for parents and teachers of CICISA. The Toolkit will provide this support and increase parents'and teachers'ability to create a supportive school environment for CICISA, while simultaneously contributing to the scientific literature on the needs of these populations.
The School TIME Toolkit (Toolkit) will significantly impact the field of public health and education in two ways. First, the Toolkit will fill a documented need by providing a widely-available, comprehensive, scientifically- based resource to support parents and teachers of chronically ill children with intermittent school attendance (CICISA). The potential societal impact of the Toolkit is significant. By increasing parents'and teachers'knowledge, attitudes, self-efficacy, and skills and decreasing their stress, the Toolkit will provie parents and teachers with the tools to increase access to education for children with chronic illnesses and reduce disruption caused by frequent absences. Reducing school absenteeism is documented to increase high school graduation rates, which in turn reduces health disparities. In fact, increasing high school graduation rates may be more cost-effective in reducing health disparities than medical interventions. Public health professionals have called for greater support for parents and teachers of CICISA to ameliorate negative outcomes both for them and the CICISA they support, and the Toolkit will respond to this call to action. Second, by analyzing and disseminating our research results from the extensive formative, feasibility, and outcome evaluations, we will contribute to the scientific literature on the needs of parents and teachers o CICISA and how to best address them. The public health impact of the Toolkit lies in its promise to meet the documented need for evidence- based, comprehensive support for these populations.