School districts across the country were largely unprepared for the onset of the COVID-19 pandemic, and school administrators were scrambling to first, create policies to mitigate the spread of disease, and second, keep students on track with their curriculum.
Orange County, Calif. is home to nearly 30 school districts, over 600 schools, and close to 475,000 students. Margaret Schneider, PhD, a researcher in the Department of Population Health and Disease Prevention at UCI Public Health took part in a project to conduct a first-of-its kind evaluation of a “Decision Tree” created in collaboration with school nurses throughout the county and adapted for use in a school setting during an infectious disease outbreak.
The collaborative effort, made up of input from academic scholars, public health practitioners, and educational stakeholders is described in a paper published in the journal Health Behavior and Policy Review.
The paper outlines the Student Symptom Decision Tree, consisting of branching logic based on symptoms, that helped school personnel to determine an appropriate plan to mitigate the spread of COVID-19. The schematic was updated regularly to reflect the evolving federal and state guidelines as well as the availability of vaccines. A committee of county-level public health officials, representatives from the university, and school district administration vetted the decision tree and its updates on a weekly basis during the early stages of the pandemic and transitioned to monthly updates once the guidelines became more static. The Decision Tree was made available online for download and print to the general public, school administrators, school nurses, staff, parents and even students, to access.
The paper includes evaluation from a 17-measure survey among 56 school personnel, and offers new insights into how decision trees may support public health decision-making in schools.
“The overall perception of the Decision Tree was incredibly positive with many of the beneficiaries using it within the first week and then using it over ten times a week,” said Schneider. “This collaboration is a prime example of how powerful a multi-sector approach is to improving our public health interventions.”
Maritza Salazar Campo, PhD, assistant professor, from the UCI Paul Merage School of Business, and Nicole Miovsky, MS, a data research analyst from the UCI Institute for Clinical and Translational Science, were equally contributing authors. Other team members include Pamela Kahn, MPH, RN, NCSN, from the Orange County Department of Education; Michelle DeHaven, RN, BSN, PHN, NCSN, from Placentia Yorba Linda Unified School District; Michael Weiss, DO, FAAP, from Children’s Health of Orange County; and Amanda Woodworth, BS, and Dan Cooper, MD, from University of California, Irvine.
