Instruments The instruments created to document and track changes at both the community and individual levels were developed using tools in use by grantees as well as validated tools in the field of asthma and through a process with multiple rounds of feedback and pilot-testing by CALM grantees. One of these instruments was created to track the systems and policy changes brought about by the grantees that
changed the way stakeholders interacted and operated and aimed to help ensure sustainability of their work
past the CALM funding period. For data collection and reporting purposes, a ‘‘systems change’’ was defined
as a change in a system—such as a school—related to the work of the CALM program that will help sustain the work over time and contribute to positive changes in the lives of children with asthma. ‘‘Policy changes’’
were defined as policies that have been enacted or enforced that supported the work of the CALM project
and improved the lives of children with asthma; these changes should be documented in written policies,
procedural manuals, organizational handbooks, job descriptions, etc. Systems and policy changes were
reported annually. For this article, analyses focus on the data reported by the grantees regarding
these changes that support the sustainability of their work, while highlighting the asthma-related health
outcomes as a demonstration of the effectiveness of the programs. Asthma-related health outcomes were
reported through a survey of caregivers of CALM program participants, administered at baseline and after 1 year of participation. De-identified and coded surveys were reported to the evaluation team online
via the Qualtrics (Provo, UT) reporting system.