? ? On any given weekday, more than one-fifth of the U.S. population is in schools. While we all want schools to be safe places-havens for learning-schoolchildren today face serious health threats including bioterrorism. In the proper project, we will develop and evaluate a system called ASIAN (Absenteeism-causing Symptom-Level Assessment Network), designed to monitor the health of children in schools. Our system focuses on monitoring children's school attendance, because most experts agree that absenteeism from school is an early sign of an outbreak in a community. However, school absenteeism is not a precise sign of an outbreak or epidemic. Absenteeism is often not even related to illness, reflecting, instead, problems in the child's home environment, important social or cultural obligations, and even opportunities for family recreation. But what if a system could identify absences due to illnesses and collect data on the symptoms causing the illness-related absences? Such a system might well offer an early, highly specific signal of an illness in a population, allowing public and school health officials to detect outbreaks in schools very early in their course. We propose to develop a VoiceXML speech processing system that can accurately capture during a brief telephone interview the symptoms a person is experiencing that are causing an absence. We propose to modify the """"""""work processes"""""""" school districts use to have parents or guardians report that their children will be absent from school. Parents will use the interactive voice response questionnaire (or a web site, if they prefer) to report (on a voluntary basis) the symptoms that are causing the child's absence. We believe that monitoring of reports of such symptoms could both protect the health of children from bioterrorist attacks and from toxins in the environment. It could also improve their health on a daily basis by helping school nurses identify children with poorly managed chronic illnesses, and recognize and manage the routine outbreaks of infectious diseases that occur each year. The study plan focuses on creation of a computer telephone interviewing system and a formative evaluation that will include both qualitative and quantitative components and will assess the feasibility, validity, and potential usefulness of the system. ? ? ? ?
