Besculides et al. (2005) detail in their recent paper many of the limitations of absenteeism data. Absenteeism data has greater periodicity than many other sources and is sometimes completely unavailable. Time periods prior to holidays often have higher absenteeism. In analyses, the authors had to retrospectively remove certain days from analysis (e.g., Halloween). Signals are absent during holiday periods and weekends. Holiday periods can be prolonged in schools. Issues with absenteeism data arise largely from lack of specificity. Health-related absenteeism is often difficult to distinguish from other causes.
Gilliland et al. (2001) point the way toward approaches to improve the specificity of absenteeism data. If data are collected on the symptoms that led to absences, absenteeism becomes a sensitive and precise signal of health problems. How might we achieve this? Weedn et al. (2004) have suggested developing self-administered questionnaires for web or interactive voice response systems on telephones to help members of the public determine if they have symptoms consistent with an ongoing outbreak. If self-report measurements could be integrated with work processes for collecting absenteeism data, the result might be low-cost timely data on symptoms experienced in a population.
Figure 24.4 illustrates how self-report systems might be integrated within a school absenteeism system. Parents would either call a dedicated telephone number or access a website to report children will be absent. During this call, they would
confidentially report the cause of the absence and the symptoms their child was experiencing. Children absent without an excuse would be detected by the system using current workflow processes. An outbound call to the home would not only inform parents of the absence (as is currently a common practice) but would also attempt to elicit associated symptoms. To complete the picture of school health, districts might add voluntary reporting systems for types of symptoms experienced in children with health problems during school hours, using a system similar to project share.
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