Transporting Kids to Lung Health

The Breathe Better Bus engages sound, sight, and touch in interactive stations that teach kids and adults about lung health and elements that affect it.

 The Breathe Better Bus traveled to 76 schools in its first year, reaching 10,000 students. It also visits community and corporate centers.

When the 40-foot Breathe Better Bus pulls into a school parking lot, its brightly colored exterior makes it clear that it is focused on fun. Over the past year, more than 10,000 Colorado schoolchildren not only have had fun on the bus, but also have learned a thing or two about lung health. “I think this bus has been successful because it’s different, it’s not something offered by many other groups in our community. It’s fun, it’s bright, it’s colorful, and it’s so open to children,” says Cindy Liverance, vice president of community relations for the American Lung Association Colorado (ALAC).

Developed by the nonprofit Breathe Better Foundation, Denver, the Breathe Better Bus has traveled throughout Colorado, stopping at schools, community and corporate health fairs, and community clinics to teach children and adults about lung health and identify those, particularly in underserved communities, with asthma or other respiratory problems.

What lies inside the vibrantly colored bus, powered by natural gas, are six interactive learning stations designed to teach students about healthy lungs, asthma, lung measurement, air quality, indoor air triggers, and smoking prevention. Education is the primary goal of the bus, so 76 of its 96 stops during its first year of operation were at schools, where it reached 10,000 students grades 3 to 8. Visits, which are free to the schools, are highly regulated, with the Breathe Better Foundation requiring two parents or teachers to accompany groups of 12 to 14 children paired off in twos. On average, the bus spends at least 2 days at a school with 125 to 150 children passing through it each day.

Before the student groups are turned loose, there is a 3-minute presentation about the bus; the remainder of the 35-minute visit is spent at learning stations that have two to three activities per stop.

The first thing students see when they walk into the bus is a set of real, healthy, pink lungs. The students can make the lungs breathe, take apart and reassemble a lung model, read about the respiratory system, and listen to lung sounds—including those of a wheezing 16-year-old boy, a wheezing baby, and a normal breather. The second station includes an interactive CD-ROM that shows students what happens during an asthma attack and demonstrates how to correctly use a metered dose inhaler. The third station allows students to experience what it is like to be asthmatic. “At the peak flow station—we actually call it the blowing station—you get to blow into tubes that send these Ping Pong balls up. They turn it to the yellow zone and it gets a little harder, and you turn it to the red zone and it’s very difficult,” says Robin Wilson, MS, executive director of the Breathe Better Foundation. “And that’s where we tell the kids that’s what it can feel like for somebody with asthma. It’s not just about trying to breathe in, it’s hard to breathe out as well.”

The fourth station is a tour of a miniature model house that highlights potential household allergens that can trigger asthma attacks. A computer screen displays questions about each room, which the students must answer. A correct answer elicits applause, an incorrect one, a cough. The fifth station takes the students from the home to the outside world with a diorama of the common causes of outdoor pollution including cars, trucks, homes, snowmobiles, and lawnmowers. The exhaust fumes put off by each source light up when the students answer questions about pollution and ozone layor damage. The display also explains the difference between good and bad ozone.

The final station takes the students full circle, showing them a real set of smoke-damaged lungs. The station also includes one of the most popular items, particularly for the girls: a mirror that shows students what they might look like after 20 years of smoking. The station also includes a video on smoking facts and a tactile element.

The success of the bus was not assured from the beginning. The Breathe Better Foundation, which has an annual operating budget of between $250,000 and $500,000, had to raise $200,000 to purchase and outfit the bus. The majority of this money was raised by Breathe Better Foundation president and founder Sanford Avner, MD, CEO of the Colorado Allergy and Asthma Centers, PC (CAAC). To offset some of these costs, Wilson turned to the community they hoped to educate. Community resources included student engineers at the University of Colorado at Boulder who helped design the six stations.

Helping to shepherd the project was ALAC, which saw the bus as part of its long-term relationship with the Breathe Better Foundation. “We found that they had the concept [for the bus] but they didn’t have a plan yet on how to do the interactive stations, so we helped them with that,” says Liverance. In addition to supporting the Breathe Better Bus with printed materials, ALAC has also provided funds—$95,000 over the past 4 years—and supports the bus with staff and volunteers.

The Breathe Better Bus is not the only activity being carried out by the Breathe Better Foundation. Other programs include a school-based asthma screening program in the underserved Adams County district #50 and the sponsorship of Run for Your Life—a run/walk that showcases the bus and the outreach efforts of the ALAC—serving the Colorado Asthma Coalition in several capacities.

But education and screening are only the beginning of the story. The Breathe Better Bus and the foundation as a whole are a gateway to asthma and respiratory treatment. As part of its screening program, the Breathe Better Foundation also helps students find treatment by providing local heath care options, including the school-based health center. At community and corporate health fairs, the bus not only has educational materials, but information about care options offered by the Breathe Better Foundation’s founding sponsor, the CAAC, and listings of its offices.

No matter how it is evaluated, the Breathe Better Bus was an almost instant success, with bookings filled through February 2003. But this success has brought challenges as well. “We need another bus out there actually—it’s very popular,” says Wilson. “We need community volunteers. We would love to have respiratory therapists and parent volunteers and nursing students. We would love to have those people come out and volunteer for an hour or for the day.” Volunteers can contact Wilson at either the foundation’s Web site ( or via CAAC at (720) 858-7600 ext 7412. Wilson is also looking for additional sponsors.

The next step for the Breathe Better Foundation is to continue running the bus for at least 5 years, continue the asthma screening program, increase its involvement with the Colorado Asthma Coalition, and expand its service area.

C.A. Wolski is associate editor of RT Magazine.