Programs For Schools & Daycares

Program Goals

The overall goal of the program is to reduce the frequency and severity of asthmatic episodes. Additional goals are to:

• Increase the children’s and parent’s knowledge of symptoms, causes, and treatment regimens
• Explore their attitudes and feelings about asthma and its treatment
• Improve their decision-making skills in preventing asthma episodes
• Encourage parents to permit and reinforce their children’s self-care behaviors

Program Outline

Session One: Warning Signals

• What asthma is and how it affects the body
• Recognizing and gauging the severity of symptoms
• Use of peak flow meters
• Decision-making about asthma-related issues

Session Two: Roadblocks

• Why asthma develops and what triggers it
• Asthma facts and fallacies
• Identifying personal asthma triggers and what to do to avoid them
• Peak flow practice

Session Three: Tune-Ups

• Medications
• Breathing exercises and relaxation techniques
• Program review

Program Materials

The ACT program kit includes:

• Three instructor manuals (one for the children’s instructor, one for the parent’s instructor and one for the physician/pharmacist to discuss asthma medications)
• Two instructor kits (reusable trigger and environmental picture panels, relaxation tape, etc.)
• Master copy of reproducible handouts for the parents and children
• One set of supplementary items for educating 10 families
• Telephone training on how to use the kit (for purchasers in the U.S.)

Preparation of Instructors

Instructors for this program should be health professionals such as nurses, respiratory therapists, physicians and pharmacists familiar with pediatric asthma management. A team of 2 – 3 instructors is needed to implement ACT (1 child instructor, 1 parent instructor, and 1 medication concepts instructor). Training of the ACT team of instructors is required and included in the purchase price of the program for U.S. purchasers. The 2-hour session is conducted by an AAFA trainer via a telephone conference call.

Program Development

ACT was developed by a group of physicians, nurses, and educators at UCLA School of Nursing in 1983 and is cited as a validated patient education resource in the 1997 National Asthma Education and Prevention Program (NAEPP) 1997 Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma. The program was updated in 1994 and 1997 to adhere to NAEPP Guidelines for the Diagnosis and Management of Asthma. In 2003 the medication section of the program materials was updated to conform to the NAEPP Update on Selected Topics 2002.

Program Validation

For more details on the research validating the ACT program, reference the following two articles:

Lewis CD, Rachelefsky G, Lewis MA, de la Sota A, Kaplan M. A randomized trial of ACT (asthma care training) for kids. Pediatrics. 1984 Oct;74(4):478-86.

Rachelefsky GS, Lewis CE, de la Sota A, Lewis MA. ACT (asthma care training) for kids. A childhood asthma self-management program. Chest. 1985 Jan;87(1Suppl):98S-100S.

In addition, visit the following CDC website http://www.cdc.gov/asthma/interventions/children.htm#ACT Kids for a case study on how one site successfully replicated the program.

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These low-literacy, culturally appropriate booklets, available in English and Spanish, can be used alone or with the Implementation Guide in a formal educational program. The illustrations, messages, vocabulary and layout of the booklets have been extensively tested with children and adults who have reading limitations.

Program Goals

The purpose of this initiative is to educate children with asthma, ages 6 to 12, and their parents/guardians about managing asthma, coping with the challenges associated with asthma, and providing a healthy home environment.

Program Outline

The Implementation Guide includes lesson plans for 5 parent and 5 child modules covering the following topics:

• Module I Asthma and Asthma Attacks
• Module II Asthma Triggers
• Module III Peak Flow Meters
• Module IV Medicines
• Module V Decisions, School and Feelings

Instructor Preparation

The Implementation Guide provides information to prepare instructors. Instructors of the education sessions should be trained health professionals such as nurses, respiratory therapists, health educators, or social workers.

Program Development

The books for children and families were developed by a team of physicians, nurses, and health educators which included Georgetown University’s Division of Children’s Health Promotion in the Department of Family Medicine. The Implementation Guide was created by AAFA by compiling the experiences of many organizations that have been using the books to educate children and parents in clinical, community, and school settings.

Program Validation

The You Can Control Asthma program was validated in 1991 and updated in 1997 to adhere to the National Asthma Education and Prevention Program’s (NAEPP) Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma. Program materials were updated again in 2004 to adhere to the NAEPP Update on Selected Topics 2002.

For more information on the research validating the effectiveness of this program see the following articles:

Taggart V.S., Zuckerman A. E., Sly M. R., Steinmueller C., et al. You Can Control Asthma: Evaluation of an Asthma Education Program for Hospitalized Inner-City Children. Patient Education and Counseling. 1991; 17: 35-47.

Taggart VS, Zuckerman AE, Lucas S, Acty-Lindsey A, Bellanti JA. Adapting a self-management education program for asthma for use in an outpatient clinic. Annals of Allergy. 1987 March, 58: 173-178.

Also visit the following CDC website http://www.cdc.gov/asthma/interventions/children.htm#control for a case study on how one site successfully implemented the program.

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The program is presented in three 90-minute sessions or alternately six 45-minute sessions suitable for school settings. An additional fourth session is designed for older teens leaving home or entering the workforce. Each session includes hands-on instruction; discussion and strategic thinking; video animation; and Class Dismissed!—a board game to test asthma knowledge.

Through the Power Breathing™ Program, teens learn that “they have the power” to control their asthma and not allow asthma to control them!

Program Goals

The Power Breathing™ Program is designed for teens to achieve each of the following goals:

• Describe the basic pathophysiology of asthma and the role of inflammation.
• State three triggers and irritants and measures to reduce or avoid them.
• Express personal wishes and hopes with the expectation that these life goals can be achieved in spite of their asthma.
• Develop constructive coping strategies to address concerns, fears, and barriers in asthma management.
• Use new communication skills in working with their asthma management team.
• Introduce peak flow monitoring into their asthma management plan.
• Identify classes of medications, how they work, and when they should be taken.

Program Outline

Session One: Basic Asthma Education

• How the body is affected.
• The role of inflammation.
• Triggers and irritants.

Session Two: Social and Emotional Issues of Asthma

• Fitting in without jeopardizing health.
• Family dynamics.
• Realistic and reassuring coping mechanisms.

Session Three: Asthma Treatment

• Myths and falsehoods.
• Medication overview.
• Peak flow monitoring.

Session Four:Transitions and Healthy Choices

• Leaving home.
• Entering the workforce.
• Changing health care providers.
• Dealing with peer pressure.

Program Materials

The Power Breathing™ Program kit includes:

• “You’ve Got the Power” video (shown at the beginning of each session)
• Facilitator Handbook
• Implementation Guide
• Masters of reproducible handouts for teens and parents
• Two new videos: “A Message to Parents” and “Facilitator Orientation” (contains sessions 1-7 for facilitators’ self-study and for teens who miss a class)
• “Class Dismissed!” board game

Preparation of Facilitator

The Power Breathing™ Program Facilitator Handbook and Implementation Guide are designed for the preparation of new facilitators. These materials provide information on the characteristics, educational needs, and compliance issues unique to adolescents with asthma; strategies for communicating with adolescents; the goals and content of the Power Breathing™ Program; recruiting strategies; conducting a session; and follow-up activities.

Program Development

A diverse team of physicians, health educators, and teens worked with AAFA during the development phase to ensure the effectiveness of the Power Breathing™ Program. All sessions and materials adhere to the 1997 National Asthma Education and Prevention Program’s (NAEPP) Expert Panel Report 2:Guidelines for the Diagnosis and Management of Asthma. In addition, the medication section was updated in 2004 to conform to the NAEPP Update on Selected Topics 2002.

Program Validation

Preliminary reports from the Research Triangle Institute indicate significant improvement on multiple measures including asthma knowledge, attitudes about asthma, asthma management behaviors, and quality of life. A full report on their recent research study validating the Power Breathing™ Program will be available soon. Moreover, the program has been referenced in the following article:

Berg J, Tichacek MJ, Theodorakis R. Evaluation of an educational program for adolescents with asthma. J Sch Nurs. 2004 Feb;20(1):29-35.

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Program Goals

The program helps parents gain the knowledge, skills and motivation necessary to recognize, prevent, and/or appropriately manage asthma symptoms; to use medical, educational, and interpersonal resources for information and support; communicate effectively with other adult caretakers and physicians; and promote general well-being of the family unit. The program helps children learn basic asthma management skills.

Program Content

Parents

• Basic Concepts of Asthma
• Coping in Crisis
• Action Plan for Asthma Management
• Symptoms of an Acute Episode
• Feelings/Concerns
• Symptoms Prevention
• Communication about Asthma

Children

• Asthma physiology
• Early warning signs and triggers
• Belly breathing
• Asthma self-management
• Use of peak flow meters
• Use of metered dose inhalers
• Use of asthma medications

Program Materials

The Wee Wheezers program kit includes the following materials packaged in a convenient box with carrying handle for easy transport to your program site:

• Instructor Manual (includes a Program Implementation and Training Guide, Evaluation Guide, and Curriculum)
• Instructor Videotape (for classroom viewing)
• Companion Videotape (for at-home viewing)
• Masters of handouts for reproduction
• CD with handouts, visuals, and evaluation forms (PowerPoint and PDF formats)

Preparation of Instructors

Instructors for this program should be health professionals (i.e. nurses, respiratory therapists, nurse practitioners, etc.) or others who have:

• Interpersonal skills with both parents and young children;
• Pediatric asthma management knowledge and experience; and
• Group facilitation skills.

A Program Implementation and Training Guide is included with the program materials to prepare instructors for teaching the program.

Program Developer

Wee Wheezers was developed by a team of pediatric and pulmonary medicine specialists, psychologists, public health educators, and educational video specialists led by Dr. Sandra Wilson, Ph.D.

Program Validation

The results of the original research validating the effectiveness of this program indicate improvement on five outcome measures with statistically significant improvement in symptom-free days and sleep interruption. There were also significant gains in parental knowledge about asthma and asthma management.

For more details on the research validating the Wee Wheezers program, reference the following article:

Wilson SR, Latini D, Starr NJ, Fish L, Loes LM, Page A, Kubic P. Education of parents and infants and very young children with asthma: a developmental evaluation of the Wee Wheezers program. J Asthma. 1996;33(4):239-54

In addition, visit the following CDC website http://www.cdc.gov/asthma/interventions/children.htm#wee for a case study on how one site successfully replicated the program.

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