School and Asthma

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... Videos for Educators Search English Español School and Asthma KidsHealth / For Kids / School and Asthma Print en ... Let's find out. Why Do I Need an Asthma Action Plan? When you're dealing with asthma, ...

The Breathmobile Program: structure, implementation, and evolution of a large-scale, urban, pediatric asthma disease management program.

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Jones, Craig A; Clement, Loran T; Hanley-Lopez, Jean; Morphew, Tricia; Kwong, Kenny Yat Choi; Lifson, Francene; Opas, Lawrence; Guterman, Jeffrey J

2005-08-01

Despite more than a decade of education and research-oriented intervention programs, inner city children with asthma continue to engage in episodic "rescue" patterns of healthcare and experience a disproportionate level of morbidity. The aim of this study was to establish and evaluate a sustainable community-wide pediatric asthma disease management program designed to shift inner city children in Los Angeles from acute episodic care to regular preventive care in accordance with national standards. In 1995 the Southern California Chapter of the Asthma and Allergy Foundation of America (AAFA), the Los Angeles County Department of Health Services (LAC DHS), and the Los Angeles Unified School District (LAUSD) established an agreement to initiate and sustain the Breathmobile Program. This program includes automated case identification, mobile school-based clinics, and highly structured clinical encounters supported by an advanced information technology solution. Interdisciplinary teams of asthma care specialists provide regular and ongoing care to children at school and county clinic sites over a wide geographic area of urban Los Angeles. Each team operates in a specially equipped mobile clinic (Breathmobile), efficiently moving a structured healthcare process to school and county clinic sites with large numbers of children. Demographic, clinical, and participation data is tracked carefully in an electronic medical record system. Program operations, clinical oversight, and patient tracking are centralized at a care coordination center. Clinical operations and methods have been replicated in fixed specialty clinic sites at the Los Angeles County + University of Southern California Medical Center. Clinical and process measures are regularly evaluated to assure quality, plan iterative improvement, and support evidence-based care. Four Breathmobiles deliver ongoing care at more than 90 school sites. The program has engaged over five thousand patients and their families in a

Asthma Management in Educational Settings: Implementing Guideline-Based Care in Washington State Schools.

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Evans-Agnew, Robin A; Klein, Nicole; Lecce, Sally

2015-11-01

Managing asthma in the schools is complex and requires careful planning. This article highlights key steps in implementing guideline-based care for children with asthma in Washington State schools: assessing students, establishing acuity, communicating with parents, and training staff. Advance planning can improve outcomes for students, parents, and school staff in managing this complex and prevalent disease. NASN recently developed asthma management guidelines. Developing state-specific guidelines provides an opportunity to speak specifically to state laws and nurse practice acts while also reinforcing the importance of specialized practice to school nurses, school administrators and teachers, parents, and students. © 2015 The Author(s).

The international school nurse asthma project: barriers related to asthma management in schools.

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Svavarsdottir, Erla Kolbrun; Garwick, Ann W; Anderson, Lori S; Looman, Wendy S; Seppelt, Ann; Orlygsdottir, Brynja

2013-05-01

This article is a report of an international study of barriers to asthma care from the perspectives of school nurses in Reykjavik, Iceland and St. Paul, Minnesota, in the context of their schools, communities and countries. Globally, asthma affects the health and school performance of many adolescents. School nurses play a key role by providing care to adolescents with asthma in school settings. Understanding universal barriers to asthma management in schools is important for developing interventions that are effective in multiple societal contexts. Exploratory, descriptive study. Parallel studies were conducted from September 2008-January 2009, through six focus groups among school nurses (n = 32, in Reykjavik n = 17 and St. Paul n = 15) who were managing asthma in adolescents. Focus groups were audio-recorded and transcribed verbatim in English or Icelandic. The Icelandic transcripts were translated into English. Descriptive content analytic techniques were used to systematically identify and categorize types of barriers to asthma care. School nurses in both countries identified common barriers, such as time constraints, communication challenges and school staff barriers. The primary difference was that St. Paul school nurses identified more socio-economic and health access barriers than school nurses in Reykjavik. Greater cultural and linguistic diversity and socio-economic differences in the student population in St. Paul and lack of universal healthcare coverage in the US contributed to school nurses' need to focus more on asthma management than school nurses in Reykjavik, who were able to focus more on asthma prevention and education. © 2012 Blackwell Publishing Ltd.

Enhancing Asthma Self-Management in Rural School-Aged Children: A Randomized Controlled Trial.

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Horner, Sharon D; Brown, Adama; Brown, Sharon A; Rew, D Lynn

2016-06-01

To test the effects of 2 modes of delivering an asthma educational intervention on health outcomes and asthma self-management in school-aged children who live in rural areas. Longitudinal design with data collected 4 times over 12 months. The target sample was composed of children in grades 2-5 who had a provider diagnosis of asthma. Elementary schools were stratified into high or low socioeconomic status based on student enrollment in the free or reduced-cost lunch program. Schools were then randomly assigned to 1 of 3 treatment arms: in-school asthma class, asthma day camp, or the attention-control group. Sample retention was good (87.7%) and equally distributed by study arm. Improvements in emergency department visits and office visits were related to attending either the asthma class or asthma day camp. Asthma severity significantly decreased in both asthma treatment groups. Other factors such as hospitalizations, parent asthma management, and child asthma management improved for all groups. Both asthma class and asthma day camp yielded significant reductions in asthma severity. There were reductions in the emergency department and office visits for the 2 asthma arms, and hospitalizations declined significantly for all groups. Asthma self-management also improved in all groups, while it was somewhat higher in the asthma arms. This may be due to the attention being drawn to asthma management by study participation and the action of completing questionnaires about asthma management, asthma symptoms, and health outcomes. © 2015 National Rural Health Association.

Does asthma affect school performance in adolescents? Results from the Swedish population-based birth cohort BAMSE.

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Nilsson, Sara; Ödling, Maria; Andersson, Niklas; Bergström, Anna; Kull, Inger

2018-03-01

Asthma is common among schoolchildren and may influence quality of life and school attendance. However, it is unclear if asthma affects school performance. The aim of this study was to examine whether different phenotypes of asthma affect school performance during adolescence. The study population consisted of 1715 adolescents from a population-based birth cohort, followed up to age 16 with questionnaires and clinical examinations. Asthma was defined as at least 4 wheeze episodes or at least 1 wheeze episode in combination with inhaled steroids in the last 12 months. School grades were obtained from Statistics Sweden, and logistic regression analysis was performed to investigate the association between the final overall grade from secondary school and asthma phenotypes. Among the adolescents, 20.8% have had ever asthma; 24.2% early transient, 47.2% school-age onset, and 24.2% persistent asthma. At 16 years, 7.8% had asthma; 71.7% multimorbidity and 73.9% allergic asthma. A statistically significant association for performing less well was seen for ever asthma (OR adj  = 1.43, 95% CI = 1.09-1.88). In analyses of asthma onset, an association was seen for school-age onset (OR adj  = 1.49, CI = 1.02-2.16) and a tendency for persistent asthma (OR adj  = 1.61, CI = 0.98-2.66), although with overlapping confidence intervals. Further, adolescents with uncontrolled asthma tended to perform less well (OR adj  = 2.60, CI = 0.87-7.80) compared to adolescents with partly controlled (OR adj  = 1.12, CI = 0.68-1.83) and fully controlled (OR adj  = 1.29, CI = 0.55-3.01) asthma. Our results indicate that asthma impairs school performance in adolescence. Moreover, some evidence suggests the adolescents with asthma during school age and with poorer asthma control to be more likely to perform less well. © 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Barriers to Asthma Management for School Nurses: An Integrative Review.

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Hanley Nadeau, Ellen; Toronto, Coleen E

2016-04-01

Childhood asthma is a growing health concern. Asthma is the most common chronic illness of childhood and a leading cause of emergency room visits, hospitalizations, and school absenteeism. School nurses play a valuable role in asthma management. The purpose of this integrative review is to examine barriers to asthma management for school nurses in the school setting. Findings revealed multiple barriers school nurses encounter in managing asthma. Six themes emerged that included lack of resources and support, insufficient time, communication challenges, limited knowledge, and lack of awareness of school nurses' expertise. Students, parents, primary care physicians, school administration, staff, and school nurses themselves all play a role in constructing barriers to asthma management. There is a need for school nurses and school nurse leaders to focus efforts to develop strategies to overcome barriers to ensure evidence-based, best practice management of asthma in the school setting. © The Author(s) 2015.

School variation in asthma: compositional or contextual?

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Tracy K Richmond

2009-12-01

Full Text Available Childhood asthma prevalence and morbidity have been shown to vary by neighborhood. Less is known about between-school variation in asthma prevalence and whether it exists beyond what one might expect due to students at higher risk of asthma clustering within different schools. Our objective was to determine whether between-school variation in asthma prevalence exists and if so, if it is related to the differential distribution of individual risk factors for and correlates of asthma or to contextual influences of schools.Cross-sectional analysis of 16,640 teens in grades 7-12 in Wave 1 (data collected in 1994-5 of the National Longitudinal Study of Adolescent Health. Outcome was current diagnosis of asthma as reported by respondents' parents. Two-level random effects models were used to assess the contribution of schools to the variance in asthma prevalence before and after controlling for individual attributes.The highest quartile schools had mean asthma prevalence of 21.9% compared to the lowest quartile schools with mean asthma prevalence of 7.1%. In our null model, the school contributed significantly to the variance in asthma (sigma(u0(2 = 0.27, CI: 0.20, 0.35. Controlling for individual, school and neighborhood attributes reduced the between-school variance modestly (sigma(u0(2 = 0.19 CI: 0.13-0.29.Significant between-school variation in current asthma prevalence exists even after controlling for the individual, school and neighborhood factors. This provides evidence for school level contextual influences on asthma. Further research is needed to determine potential mechanisms through which schools may influence asthma outcomes.

Evaluation of a pilot national online asthma e-learning program for secondary school students.

LENUS (Irish Health Repository)

Hughes, Mary

2014-06-01

Ireland has the fourth highest incidence of asthma in the world, with Irish children losing on average 10 days of school per annum due to their asthma. It is highly probable that a large percentage of students in each class in Irish schools have asthma and are required to manage symptoms during the out-of-home period. Young people with chronic illnesses such as asthma find themselves labelled and marginalized due to a lack of awareness of others about their condition.

[Nursing care of a school-age child with asthma: an ecological system theory approach].

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Tzeng, Yu-Fen; Gau, Bih-Shya

2012-02-01

This research applied the Ecological System Theory of Dr. Bronfenbrenner (1979) to evaluate and analyze the impact of a school-age asthmatic child's ecological environment on the child's development. This project ran from March 16th to April 16th, 2010. A full range of data was collected during clinical care, outpatient follow-up services, telephone interviews, home visits, and school visits and then identified and analyzed. Results indicated that the family, household environment, campus, teachers, classmates, physical education program, and medical staffs comprised the most immediate microsystem and that parents, school nurses, teachers, and classmates formed the child's mesosystem. Researchers found a lack of understanding and appreciation in the mesosystem regarding asthmatic patient care needs. Hidden factors in the environment induced asthma, which eventually caused the child to be unable to obtain necessary medical care assistance. The exosystem reflected adequacy of the family social economy. The father's flexible working hours allowed him to allocate more time to childcare responsibilities. The government Asthma Medical Payment program also facilitated effective care. The macrosystem demonstrated parental cognition related to asthma treatment and caring to be deeply influenced by local customs. Thus, rather than using advanced medical treatments, parents preferred to follow traditional Chinese medicinal practices. Evaluation using the Ecological of Human Development Theory showed the subject's ecology environment relationships as based upon a foundation of family and school. Therefore, active family and school support for an asthma management plan appropriate to the subject's needs was critical. Asthma symptoms were better controlled after the child and his parents invested greater effort in mastering asthma management protocols.

Asthma and school

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... teacher School nurse School office Gym teachers and coaches Alternative Names Asthma action plan - school; Wheezing - school; ... Children Browse the Encyclopedia A.D.A.M., Inc. is accredited by URAC, also known as the ...

The relationship between school absence, academic performance, and asthma status.

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Moonie, Sheniz; Sterling, David A; Figgs, Larry W; Castro, Mario

2008-03-01

Children with asthma experience more absenteeism from school compared with their nonasthma peers. Excessive absenteeism is related to lower student grades, psychological, social, and educational adjustment. Less is known about the relationship between the presence of asthma and the academic achievement in school-aged children. Since students with asthma miss more days from school, this may negatively impact their academic achievement. The goal of this study was to investigate the relationships between absenteeism, presence of asthma, and asthma severity level with standardized test level performance in a predominantly African American urban school district. A cross-sectional analysis was conducted of 3812 students (aged 8-17 years) who took the Missouri Assessment Program (MAP) standardized test during the 2002-2003 academic year. After adjustment for covariates, a significant inverse relationship was found between absenteeism and test level performance on the MAP standardized test in all children (F = 203.9, p achievement between those with and without asthma (p = .12). Though not statistically different, those with persistent asthma showed a modestly increased likelihood of scoring below Nearing Proficient compared with those with mild intermittent asthma (adjusted odds ratio = 1.93, 95% confidence intervals = 0.93-4.01, p = .08). A negative impact of absenteeism on standardized test level achievement was demonstrated in children from an urban African American school district. Children with asthma perform the same academically as their nonasthma peers. However, those with persistent asthma show a trend of performing worse on MAP standardized test scores and have more absence days compared with other students. More research is warranted on the effects of persistent asthma on academic achievement.

Comparative effectiveness of asthma interventions within a practice based research network

Directory of Open Access Journals (Sweden)

Hebert Lisa

2011-08-01

Full Text Available Abstract Background Asthma is a chronic lung disease that affects more than 23 million people in the United States, including 7 million children. Asthma is a difficult to manage chronic condition associated with disparities in health outcomes, poor medical compliance, and high healthcare costs. The research network coordinating this project includes hospitals, urgent care centers, and outpatient clinics within Carolinas Healthcare System that share a common electronic medical record and billing system allowing for rapid collection of clinical and demographic data. This study investigates the impact of three interventions on clinical outcomes for patients with asthma. Interventions are: an integrated approach to care that incorporates asthma management based on the chronic care model; a shared decision making intervention for asthma patients in underserved or disadvantaged populations; and a school based care approach that examines the efficacy of school-based programs to impact asthma outcomes including effectiveness of linkages between schools and the healthcare providers. Methods/Design This study will include 95 Practices, 171 schools, and over 30,000 asthmatic patients. Five groups (A-E will be evaluated to determine the effectiveness of three interventions. Group A is the usual care control group without electronic medical record (EMR. Group B practices are a second control group that has an EMR with decision support, asthma action plans, and population reports at baseline. A time delay design during year one converts practices in Group B to group C after receiving the integrated approach to care intervention. Four practices within Group C will receive the shared decision making intervention (and become group D. Group E will receive a school based care intervention through case management within the schools. A centralized database will be created with the goal of facilitating comparative effectiveness research on asthma outcomes

The Program for the Prevention of Childhood Asthma: a specialized care program for children with wheezing or asthma in Brazil.

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Urrutia-Pereira, Marilyn; Avila, Jennifer; Solé, Dirceu

2016-01-01

To present the Programa Infantil de Prevenção de Asma (PIPA, Program for the Prevention of Childhood Asthma) and the characteristics of the patients followed in this program. Implemented in the city of Uruguaiana, Brazil, PIPA has as its target population children and adolescents ( 3 years of age, respectively. Physician-diagnosed asthma was reported in 26.5% and 82.2%, respectively. In the sample as a whole, the prevalence of passive smoking was high (> 36%), occurring during pregnancy in > 15%; > 40% of the patients had been born by cesarean section; and 30% had a mother who had had < 8 years of schooling. A prevention program for children with asthma is an effective strategy for controlling the disease. Knowledge of local epidemiological and environmental characteristics is essential to reducing the prevalence of the severe forms of asthma, to improving the use of health resources, and to preventing pulmonary changes that could lead to COPD in adulthood.

The Program for the Prevention of Childhood Asthma: a specialized care program for children with wheezing or asthma in Brazil

Directory of Open Access Journals (Sweden)

Marilyn Urrutia-Pereira

2016-02-01

Full Text Available Objective : To present the Programa Infantil de Prevenção de Asma (PIPA, Program for the Prevention of Childhood Asthma and the characteristics of the patients followed in this program. Methods : Implemented in the city of Uruguaiana, Brazil, PIPA has as its target population children and adolescents ( 3 years of age, respectively. Physician-diagnosed asthma was reported in 26.5% and 82.2%, respectively. In the sample as a whole, the prevalence of passive smoking was high (> 36%, occurring during pregnancy in > 15%; > 40% of the patients had been born by cesarean section; and 30% had a mother who had had < 8 years of schooling. Conclusions : A prevention program for children with asthma is an effective strategy for controlling the disease. Knowledge of local epidemiological and environmental characteristics is essential to reducing the prevalence of the severe forms of asthma, to improving the use of health resources, and to preventing pulmonary changes that could lead to COPD in adulthood.

Asthma & Physical Activity in the School

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Asthma & Physical Activity in the School MAKING A DIFFERENCE Asthma & Physical Activity in the School MAKING A DIFFERENCE Min: 5/ ... D. Chair, NAEPP School Subcommittee Working Group on Physical Activity and School American Medical Association Karen Huss, Ph. ...

Evaluation of a Pilot Asthma Care Program for Electronic Communication between School Health and a Healthcare System's Electronic Medical Record.

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Reeves, Kelly W; Taylor, Yhenneko; Tapp, Hazel; Ludden, Thomas; Shade, Lindsay E; Burton, Beth; Courtlandt, Cheryl; Dulin, Michael

2016-10-19

Asthma is a common childhood chronic lung disease affecting greater than 10% of children in the United States. School nurses are in a unique position to close gaps in care. Indeed, effective asthma management is more likely to result when providers, family, and schools work together to optimize the patient's treatment plan. Currently, effective communication between schools and healthcare systems through electronic medical record (EMR) systems remains a challenge. The goal of this feasibility pilot was to link the school-based care team with primary care providers in the healthcare system network via electronic communication through the EMR, on behalf of pediatric asthma patients who had been hospitalized for an asthma exacerbation. The implementation process and the potential impact of the communication with providers on the reoccurrence of asthma exacerbations with the linked patients were evaluated. By engaging stakeholders from the school system and the healthcare system, we were able to collaboratively design a communication process and implement a pilot which demonstrated the feasibility of electronic communication between school nurses and primary care providers. Outcomes data was collected from the electronic medical record to examine the frequency of asthma exacerbations among patients with a message from their school nurse. The percent of exacerbations in the 12 months before and after electronic communication was compared using McNemar's test. The pilot system successfully established communication between the school nurse and primary care provider for 33 students who had been hospitalized for asthma and a decrease in hospital admissions was observed with students whose school nurse communicated through the EMR with the primary care provider. Findings suggest a collaborative model of care that is enhanced through electronic communication via the EMR could positively impact the health of children with asthma or other chronic illnesses.

American Academy of Allergy, Asthma, and Immunology

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... reasons to celebrate its journals. Learn More about the American Academy Of Allergy, Asthma & Immunology Life Spectrum of Asthma Meeting School-based Asthma Management Program – (SAMPRO TM ) This central resource focuses on ...

Infant wheeze, comorbidities and school age asthma.

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Neuman, Asa; Bergström, Anna; Gustafsson, Per; Thunqvist, Per; Andersson, Niklas; Nordvall, Lennart; Kull, Inger; Wickman, Magnus

2014-06-01

Factors associated with early onset of wheeze have been described, but there is limited knowledge on which of these infant wheezers who will have developed asthma in school age. The aim was to identify clinical risk factors for asthma in the 8-yr-old children that wheezed during infancy in a population-based setting. Three thousand two hundred and fifty-one children from a population-based birth cohort followed prospectively from infancy until age 8 yr were included in the study. Data were analyzed using multivariate logistic regression analysis. Parents reported any wheeze episode before age 2 yr in 823 subjects (25%). Infant wheezers had an almost fourfold risk of asthma at age 8 [adjusted odds ratio (aOR) 3.68, 95% CI 2.74-4.96], equivalent to an asthma prevalence of 14% compared with 4% among non-wheezers (p < 0.001). After adjustments for sex, exposure to tobacco smoke and indoor dampness/mould, allergic heredity (aOR 1.53, 95% CI 1.02-2.30), increased frequency of wheeze (aOR 3.41, 95% CI 2.09-5.56 for children with ≥3 episodes compared with ≤2 episodes during the first 2 yr of life), infant eczema (aOR 2.31, 95% CI 1.52-3.49), and recurrent abdominal pain (aOR 2.33, 95% CI 1.30-4.16) remained risk factors for school age asthma in the infant wheezing group. Among infant wheezers, allergic heredity, increased severity of wheeze, infant eczema, and recurrent abdominal pain were independent risk factors for asthma at age 8 yr. Among children with three or four of these risk factors, 38% had asthma at school age. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A multifaceted community-based asthma intervention in Chicago: effects of trigger reduction and self-management education on asthma morbidity.

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Turyk, Mary; Banda, Elizabeth; Chisum, Gay; Weems, Dolores; Liu, Yangyang; Damitz, Maureen; Williams, Rhonda; Persky, Victoria

2013-09-01

Home-based, multifaceted interventions have been effective in reducing asthma morbidity in children. However, identification of independent components that contribute to outcomes and delineating effectiveness by level of asthma symptoms would help to refine the intervention and target appropriate populations. A community health educator led asthma intervention implemented in a low-income African-American neighborhood included asthma management education, individually tailored low-cost asthma home trigger remediation, and referrals to social and medical agencies, when appropriate. Changes in asthma morbidity measures were assessed in relation to implementation of individual intervention components using multivariable logistic regression. Among the 218 children who completed the year-long program, there were significant reductions in measures of asthma morbidity, including symptoms, urgent care visits, emergency department (ED) visits, hospitalizations, missed school days, and missed work days for caretakers. We also found significant decreases in the prevalence of many home asthma triggers and improvements in asthma management practices. Improvement in caretaker's ability to manage the child's asthma was associated with reduction in ED visits for asthma and uncontrolled asthma. Specific home interventions, such as repair of water leaks and reduced exposure to plants, dust, clutter and stuffed toys, may be related to reduction in asthma morbidity. This program was effective in reducing asthma morbidity in low-income African-American children and identified specific interventions as possible areas to target in future projects. Furthermore, the intervention was useful in children with persistent asthma symptoms as well as those with less frequent asthma exacerbations.

Perceptions about interpersonal relationships and school environment among middle school students with asthma.

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Rhee, Hyekyun; McQuillan, Brenda; Chen, Ding-Geng; Atis, Shannska

2017-11-01

To examine interpersonal relationships involving peers and teachers and perceptions about school environment among middle school students with asthma in comparison to their healthy counterparts. The study also assesses asthma prevalence in a large sample of middle school students representing different geographic locations. Cross-sectional data were collected from 1059 middle school students in grades 6-8 enrolled in schools in a northeastern region of the United States. Students reported their chronic health conditions including asthma and completed questionnaires measuring perceptions about their relationships with peers and teachers as well as school environment. Analyses of covariance (ANCOVAs) were used to compare students with asthma and their healthy counterparts in the study variables. Asthma was reported by 16.5% of the sample (n = 169). The rate was higher among minority students (23%) than their white counterparts (15%). Greater proportion of urban students (28%) reported asthma than rural (18%) and suburban (14%) students. Students with asthma reported significantly poorer relationships with peers (B = -1.74, p asthma prevalence was substantially higher than the national average of adolescent asthma, particularly those residing in the urban area. Poor perceptions of interpersonal relationships with peers and teachers among students with asthma may indicate compromised quality of life. Suboptimal interpersonal relationships and school environment need to be identified and adequately addressed, given their implications for asthma management at the school setting among middle school students.

Longitudinal patterns of predominant asthma disease activity in pediatric patients enrolled in an asthma-specific disease management program.

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Scott, Lyne; Nichols, Breck; Choi Kwong, Kenny Yat; Morphew, Tricia; Jones, Craig A

2008-08-01

To determine if patterns of predominant asthma disease activity are more closely related than baseline asthma severity to measures of morbidity (acute asthma attack, emergency room visit/hospitalization, missed school days, and/or steroid burst). Retrospective analysis was performed for inner-city Los Angeles asthmatic children (3 to 18 years of age) during their first year of enrollment in an asthma-specific disease management program. All measures of morbidity were more closely related to patterns of predominant disease activity than baseline severity. We conclude that patterns of predominant disease activity are a more significant predictor of asthma morbidity than is baseline severity.

Asthma Education and Intervention Program: Partnership for Asthma Trigger-Free Homes (PATH)

National Research Council Canada - National Science Library

Golden, Cheryl

2008-01-01

...) are the co-Principal Investigators for the Partnership for Asthma Trigger-Free Homes. The PATH study's goal is reducing the asthma disease burden on low-income housing residents by means of a peer-based education program...

The case for exploring the usage of employee wellness programs for pediatric asthma control.

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Jassal, Mandeep S; Butz, Arlene

2018-01-18

The multiple socioecological determinants of asthma mandate that pediatricians develop a treatment strategy beyond the practice-based setting. To expand to a more impactful community-based role, pediatricians must look to form partnerships with groups that are capable of promoting social and environmental change. Traditionally, these groups have included schools, governmental agencies, and child care establishments. One group that is not actively being availed of are employers who have shown success in improving adult-based outcomes through wellness programs. Employers are stakeholders in pediatric asthma care through its impact on reduced worker productivity and higher health insurance premiums. An employer's focus on pediatric asthma will be a collective win for the employer and employee. The article herein describes the rationale for the focus of employers on pediatric asthma care and potential incorporation within employer-based wellness strategies.

Students With Asthma and Its Impacts.

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Isik, Elif; Isik, Ismet S

2017-07-01

Asthma is a common chronic disease in children. Uncontrolled asthma is a significant contributor to school absenteeism, emergency room visits, and hospitalization, all of which can lead to low school performance, financial burdens, and emotional problems for children and their parents. Asthma in children restricts the activities of school-aged children, such as participating in before- and after-school activity and extracurricular activities such as sports. Uncontrolled asthma has the potential to impact a student's self-confidence and social interactions. This article reviews the physical, emotional, and social burden of asthma on school-aged children/parents as well as recounting school asthma intervention programs. One of the roles of the school nurse is to be the leader of the intervention programs, manage asthma, and provide education for the students, parents, and school community to promote knowledge about asthma and its management.

[Effectiveness and practicality of an internet-based asthma refresher course for children and adolescents].

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Schmidt, A; Greuter, T; Möller, A; Steiß, J O

2014-04-01

The effectiveness and practicality of the "Luftikids" (www.luftikids.de) structured, internet-based asthma refresher course was evaluated in a pilot study with 53 patients (ages 8 - 14 years). All patients had previously participated in either an inpatient or outpatient asthma education program. This prospective study examined the effect of a 4-week refresher course on parameters such as asthma symptoms (coughing, dyspnea), the number of unscheduled doctor's visits, use of on-demand medications, number of days absent from school, and asthma monitoring using the Asthma Control Questionnaire (ACQ) and lung function tests. The duration of program use and the number of logins was used to investigate acceptance of the game format. Data were collected at the beginning of the study and at 4 - 6 months after the end of the online refresher course. Significant changes were shown with regard to the decrease in intensity of asthma symptoms such as coughing (p = 0.001) and dyspnea (p = 0.007), reduction in the number of unscheduled doctor's visits (p = 0.005), the use of on-demand medications (4.0 ± 6.5 vs. 1.5 ± 4.9, p = children and adolescents derived "much" to "very much" benefit. Only 7.5% reported no effect. Participation in the "Luftikids" internet-based asthma refresher course resulted in fewer asthma symptoms, a decrease in unscheduled doctor's visits, reduction in the use of on-demand medications, decrease in the number of days absent from school, and improved asthma knowledge. No effect in lung function could be demonstrated. The results support the effectiveness and good acceptance of an outpatient, internet-based asthma refresher course. Young asthma patients in particular can succeed with and be motivated by this form of refresher course. © Georg Thieme Verlag KG Stuttgart · New York.

Development of an International School Nurse Asthma Care Coordination Model

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Garwick, Ann W.; Svavarsdóttir, Erla Kolbrun; Seppelt, Ann M.; Looman, Wendy S.; Anderson, Lori S.; Örlygsdóttir, Brynja

2015-01-01

Aim To identify and compare how school nurses in Reykjavik, Iceland and St. Paul, Minnesota coordinated care for youth with asthma (ages 10–18) and to develop an asthma school nurse care coordination model. Background Little is known about how school nurses coordinate care for youth with asthma in different countries. Design A qualitative descriptive study design using focus group data. Methods Six focus groups with 32 school nurses were conducted in Reykjavik (n=17) and St. Paul (n=15) using the same protocol between September 2008 – January 2009. Descriptive content analytic and constant comparison strategies were used to categorize and compare how school nurses coordinated care, which resulted in the development of an International School Nurse Asthma Care Coordination Model. Findings Participants in both countries spontaneously described a similar asthma care coordination process that involved information gathering, assessing risk for asthma episodes, prioritizing health care needs and anticipating and planning for student needs at the individual and school levels. This process informed how they individualized symptom management, case management and/or asthma education. School nurses played a pivotal part in collaborating with families, school and health care professionals to ensure quality care for youth with asthma. Conclusions Results indicate a high level of complexity in school nurses’ approaches to asthma care coordination that were responsive to the diverse and changing needs of students in school settings. The conceptual model derived provides a framework for investigators to use in examining the asthma care coordination process of school nurses in other geographic locations. PMID:25223389

Development of an International School Nurse Asthma Care Coordination Model.

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Garwick, Ann W; Svavarsdóttir, Erla Kolbrun; Seppelt, Ann M; Looman, Wendy S; Anderson, Lori S; Örlygsdóttir, Brynja

2015-03-01

To identify and compare how school nurses in Reykjavik, Iceland and St. Paul, Minnesota coordinated care for youth with asthma (ages 10-18) and to develop an asthma school nurse care coordination model. Little is known about how school nurses coordinate care for youth with asthma in different countries. A qualitative descriptive study design using focus group data. Six focus groups with 32 school nurses were conducted in Reykjavik (n = 17) and St. Paul (n = 15) using the same protocol between September 2008 and January 2009. Descriptive content analytic and constant comparison strategies were used to categorize and compare how school nurses coordinated care, which resulted in the development of an International School Nurse Asthma Care Coordination Model. Participants in both countries spontaneously described a similar asthma care coordination process that involved information gathering, assessing risk for asthma episodes, prioritizing healthcare needs and anticipating and planning for student needs at the individual and school levels. This process informed how they individualized symptom management, case management and/or asthma education. School nurses played a pivotal part in collaborating with families, school and healthcare professionals to ensure quality care for youth with asthma. Results indicate a high level of complexity in school nurses' approaches to asthma care coordination that were responsive to the diverse and changing needs of students in school settings. The conceptual model derived provides a framework for investigators to use in examining the asthma care coordination process of school nurses in other geographic locations. © 2014 John Wiley & Sons Ltd.

Efficacy of the I Can Control Asthma and Nutrition Now (ICAN) Pilot Program on Health Outcomes in High School Students with Asthma

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Kouba, Joanne; Velsor-Friedrich, Barbarba; Militello, Lisa; Harrison, Patrick R.; Becklenberg, Amy; White, Barb; Surya, Shruti; Ahmed, Avais

2013-01-01

Asthma is the most prevalent chronic illness in childhood affecting 7 million youth. Many youth with asthma face another risk factor in obesity. Obesity, in turn, increases disorders such as asthma. Studies have recommended that asthma programs also address weight management in youth. Taking this into consideration, the I Can Control Asthma and…

The virtual asthma guideline e-learning program: learning effectiveness and user satisfaction.

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Kang, Sung-Yoon; Kim, Sae-Hoon; Kwon, Yong-Eun; Kim, Tae-Bum; Park, Hye-Kyung; Park, Heung-Woo; Chang, Yoon-Seok; Jee, Young-Koo; Moon, Hee-Bom; Min, Kyung-Up; Cho, Sang-Heon

2018-05-01

Effective educational tools are important for increasing adherence to asthma guidelines and clinical improvement of asthma patients. We developed a computer-based interactive education program for asthma guideline named the Virtual Learning Center for Asthma Management (VLCAM). We evaluated the usefulness of program in terms of its effects on user awareness of asthma guideline and level of satisfaction. Physicians-in-training at tertiary hospitals in Korea were enrolled in a cross-sectional questionnaire survey. The e-learning program on asthma guideline was conducted over a 2-week period. We investigated changes in the awareness of asthma guideline using 35-item self-administered questionnaire aiming at assessing physicians' knowledge, attitude, and practice. Satisfaction with the program was scored on 4-point Likert scales. A total of 158 physicians-in-training at six tertiary hospitals completed the survey. Compared with baseline, the overall awareness obtained from the scores of knowledge, attitude, and practice was improved significantly. Participants were satisfied with the VLCAM program in the following aspects: helpfulness, convenience, motivation, effectiveness, physicians' confidence, improvement of asthma management, and willingness to recommend. All items in user satisfaction questionnaires received high scores over 3 points. Moreover, the problem-based learning with a virtual patient received the highest user satisfaction among all parts of the program. Our computer-based e-learning program is useful for improving awareness of asthma management. It could improve adherence to asthma guidelines and enhance the quality of asthma care.

Asthma prevalence among high school students in East Jakarta, 2001, based on ISAAC questionnaire

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Faisal Yunus

2003-09-01

Full Text Available The aim of this study was to assess asthma prevalence in children between 13-14 years of age in East Jakarta. This study is a cross sectional study which surveyed 2234 high school students between the ages of 13 and 14 years in East Jakarta in 2001 using the ISAAC questionnaire. Bronchial challenge test was applied by using methacholine substance to 186 students. Reports based on the ISAAC questionnaire indicate that 7.2% of teenage have had wheezing experience, 4.1% have wheezing within the last 12 months, 1.8% have ever suffered severe asthma attack within the last 12 months, 3.3% have suffered wheezing after exercise, and 6.3% have got night cough while they were not suffering from cold. Prevalence of atopy diseases such as rhinitis and eczema were 14.2% and 3.9%, meanwhile rhinitis and eczema prevalence within the last 12 months according to this study were 10.6% and 2.9% respectively. Statistically, there is a significant correlation between wheezing symptom and atopy (p < 0.05. From indepth questionnaire, a significant value of kappa 0.84 related with wheezing within the last 12 months was found. Bronchial challenge test results indicate that sensitivity was 90%, specificity 83.58%, positive predictive value 68.12% and negative predictive value was 95.73%. Asthma prevalence in East Jakarta at 2001 based on ISAAC questionnaire was 8.9%, and cumulative prevalence 11.5%. The ISAAC questionnaire can be used to study asthma prevalence in children at multicenter in Indonesia. (Med J Indones 2003; 12: 178-86Keywords: bronchial challenge, high school student, ISAAC questionnaire, East Jakarta, asthma prevalence

Barriers to Asthma Management for School Nurses: An Integrative Review

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Hanley Nadeau, Ellen; Toronto, Coleen E.

2016-01-01

Childhood asthma is a growing health concern. Asthma is the most common chronic illness of childhood and a leading cause of emergency room visits, hospitalizations, and school absenteeism. School nurses play a valuable role in asthma management. The purpose of this integrative review is to examine barriers to asthma management for school nurses in…

Asthma-Related School Absenteeism, Morbidity, and Modifiable Factors.

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Hsu, Joy; Qin, Xiaoting; Beavers, Suzanne F; Mirabelli, Maria C

2016-07-01

Asthma is a leading cause of chronic disease-related school absenteeism. Few data exist on how information on absenteeism might be used to identify children for interventions to improve asthma control. This study investigated how asthma-related absenteeism was associated with asthma control, exacerbations, and associated modifiable risk factors using a sample of children from 35 states and the District of Columbia. The Behavioral Risk Factor Surveillance System Child Asthma Call-back Survey is a random-digit dial survey designed to assess the health and experiences of children aged 0-17 years with asthma. During 2014-2015, multivariate analyses were conducted using 2006-2010 data to compare children with and without asthma-related absenteeism with respect to clinical, environmental, and financial measures. These analyses controlled for sociodemographic and clinical characteristics. Compared with children without asthma-related absenteeism, children who missed any school because of asthma were more likely to have not well controlled or very poorly controlled asthma (prevalence ratio=1.50; 95% CI=1.34, 1.69) and visit an emergency department or urgent care center for asthma (prevalence ratio=3.27; 95% CI=2.44, 4.38). Mold in the home and cost as a barrier to asthma-related health care were also significantly associated with asthma-related absenteeism. Missing any school because of asthma is associated with suboptimal asthma control, urgent or emergent asthma-related healthcare utilization, mold in the home, and financial barriers to asthma-related health care. Further understanding of asthma-related absenteeism could establish how to most effectively use absenteeism information as a health status indicator. Published by Elsevier Inc.

Using the Health Belief Model to Understand School Nurse Asthma Management

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Quaranta, Judith E.; Spencer, Gale A.

2015-01-01

Ten million children in the United States have asthma. Since children are in school about 6 hr a day, school nurses are positioned to intervene and influence asthma outcomes. A descriptive correlational study was designed to investigate performance of school nurses' asthma management behaviors in relationship to asthma knowledge, asthma attitude,…

Asthma prevalence and school-related hazardous air pollutants in the US-México border area.

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Carrillo, Genny; Perez Patron, Maria J; Johnson, Natalie; Zhong, Yan; Lucio, Rose; Xu, Xiaohui

2018-04-01

Asthma is the most common chronic disease in children and has been linked to high levels of ambient air pollution and certain hazardous air pollutants (HAPs). Outdoor pollutants such as benzene, released by car emissions, and organic chemicals found in diesel exhaust, as well as particles and irritant gases, including nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), and ozone (O 3 ), contribute to an increased prevalence of respiratory diseases such as asthma. The objectives of this study were to: 1) conduct a screening survey to identify high risk for asthma among school-age children in Hidalgo County, and, 2) study the potential health impact of school-related exposure to HAPs pertaining to asthma risk. We carried out a quantitative cross-sectional study combining a school-based asthma screening survey across 198 schools in Hidalgo County, Texas, with information on school neighborhood environments, including census tract-level information on hazardous air pollutants (HAPs) and socioeconomic status (SES) in the respective school neighborhoods. HAPs levels were assessed based on the EPA 2011 National-Scale Air Toxics Assessment (NATA) while SES information was assessed using data from the 2010-2014 American Community Survey. 2930 students completed the asthma screening survey and results showed an overall asthma prevalence of 9.4%, slightly higher than the national and state prevalence. Participants in the 14-18 years old age group showed a much higher asthma prevalence of 16.7%. When assessing school-neighborhood characteristics, our results revealed no significant differences in asthma prevalence across census tracts with different SES levels. For HAPs, in the single-pollutant model, chlorine levels showed a significant linear trend for prevalence of asthma (p=0.03) while hydrochloric acid had a marginally significant linear trend (p=0.08). The association with chlorine remained significant in the multi-pollutant model. Asthma prevalence among school

Predictors for Asthma Formation in School-Age Children in Ternopil Region

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E.I. Burbela

2016-10-01

Full Text Available Background. Algorithm of screening diagnostics for bronchial asthma (BA to identify asthma susceptibility forces doctors of a first contact to a differentiated approach to the compilation of forecasting, individual treatment and rehabilitation programs. The aim of the study was to investigate the risk of asthma in school-age children. Materials and methods. 121 children with asthma treated at Ternopil region children hospital during 2012–2016 were studied. The control group consisted of 226 adolescents, of which 76.55 % (n  =  173 apparently healthy children at the time of examination were secondary school urban students and 2.45 % (n  =  53 — rural students. The average age of patients investigated was 12.98 ± 2.80 years old and 12.36 ± 2.80 years old in the control group. The study was conducted with regard to the basic principles of the Helsinki Declaration on Biomedical Research and provisions GCH ICH, compliance with ethical principles and guidelines involving people as subjects set out in Belmont Report. Results and discussion. Based on a simple ranking value %AR factors playinbg a major role in causing asthma were considered as a level above 50 %. These predictors were: maintenance of diathesis manifestations after the first year of life, оbstructive bronchitis, passive smoking, burdened heredity for atopy, atopic dermatitis, high personal anxiety, high and medium situational anxiety, general school anxiety, social stress, frustration at needs to succeed, fear expression and fear of knowledge test, fear not to match to the expectations of others, low resistance to physiological stress, the presence of autonomic dysfunction, high (70 cu Robinson index. Seven contributing factors in the formation of BA level above 25 % were determined: atopic manifestations on the skin up to a year, the presence of phlegmatic temperament, and eutonia and vagotony according to the Kerdem index, Robinson index above average (71–75 cu. Conclusions

School Asthma Screening and Case Management: Attendance and Learning Outcomes

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Moricca, Michelle L.; Grasska, Merry A.; BMarthaler, Marcia; Morphew, Tricia; Weismuller, Penny C.; Galant, Stanley P.

2013-01-01

Asthma is related to school absenteeism and underperformance in elementary students. This pilot study assessed whether school nurse case management (CM) in children identified with asthma impacts academic performance and school absenteeism in one school. A validated questionnaire was used to identify children at risk for asthma and CM was provided…

Know How to Use Your Asthma Inhaler

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Full Text Available ... Work-related Asthma NCHS Asthma FastStats Survey Questions Resources for Health Professionals and Schools Healthcare Professionals Public Health Professionals School and Childcare Providers CDC Publications on Asthma National Asthma Control Program ...

Caregiver Asthma in Urban Families: Implications for School Absenteeism

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Everhart, Robin S.; Miller, Sarah; Leibach, Gillian G.; Dahl, Alexandra L.; Koinis-Mitchell, Daphne

2018-01-01

Asthma is a significant contributor to missed school days, especially for children living in urban settings. This preliminary study examined the impact of caregiver asthma on school absenteeism in a sample of 102 urban children with asthma from African American, Latino, and non-Latino White backgrounds. Caregivers and children participated in a…

Overcoming Medicaid Reimbursement Barriers to Funding School Nursing Services for Low-Income Children with Asthma

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Malcarney, Mary-Beth; Horton, Katherine; Seiler, Naomi

2016-01-01

Background: School nurses can provide direct services for children with asthma, educate, and reinforce treatment recommendations to children and their families, and coordinate the school-wide response to students' asthma emergencies. Unfortunately, school-based health services today depend on an unreliable patchwork of funding. Limited state and…

Asthma and Schools | NIH MedlinePlus the Magazine

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... page please turn Javascript on. Feature: Breathing Easier Asthma and Schools Past Issues / Fall 2013 Table of ... of America 800–727–8462 www.aafa.org Asthma and Physical Activity Exercise-induced asthma is triggered ...

High school students with asthma: attitudes about school health, absenteeism, and its impact on academic achievement.

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Krenitsky-Korn, Susan

2011-01-01

Asthma is the most frequent reason for absence from school; it accounts for one-third of all days of missed instruction, placing students at risk for academic failure and social isolation. This study compared high school students with asthma with those without asthma, and examined the relationship of their attitudes toward school health services, absenteeism, academic achievement, and the supposition that school nurse services play an essential part in the academic process. Surveys were completed by all students who participated in the study. Twenty-eight students with asthma reported levels of illness and school nurse support in an additional survey. Data revealed that students with asthma were absent more frequently, scored lower in mathematics, and participated less in school activities than their peers without asthma. Their level of illness did not predict the number of days absent, which was negatively correlated with achievement and positively correlated with students' permissive attitudes toward absenteeism. Findings indicate that school nurse interventions were sources of physical, social, emotional, and academic support.

[Validation of a knowledge-questionnaire about asthma applied to teachers of elementary school of Monterrey, Mexico].

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González Diaz, Sandra Nora; Cruz, Alfredo Arias; González González, Arya Yannel; Félix Berumen, José Alfredo; Weinmann, Alejandra Macías

2010-01-01

asthma is one of the most common chronic childhood diseases; is increasing in prevalence and an important cause of school absenteeism. Previous studies have failed to evaluate knowledge about asthma among elementary school teachers worldwide because of the lack of validated questionnaires. to validate a questionnaire about asthma knowledge for elementary school teachers in Monterrey, Nuevo Leon. an observational, cross sectional, descriptive study, from February to December 2004, by applying a questionnaire to a group of elementary school teachers in Monterrey, Nuevo Leon. The questionnaire is a translation and adaptation to the questionnaire of 13 questions used to assess the knowledge about asthma among parents, according to the National Asthma Education Program of US. a total of 179 questionnaires were applied, in which 6 of the 13 questions were answered correctly by more than 90% of the teachers. The internal consistency reliability was adequate with a Cronbach a coefficient of 0.75. in order to obtain reliable data using questionnaires, these must undergo a validation process. Our questionnaire got validation because of the reliability shown according to the internal consistency analysis.

Rural and urban children with asthma: are school health services meeting their needs?

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Hillemeier, Marianne M; Gusic, Maryellen E; Bai, Yu

2006-09-01

Children with asthma spend a large portion of their day in school, and the extent to which public schools are prepared to meet their health needs is an important issue. The objective of this study was to identify asthma policies and practices in rural and urban school settings and to compare them with current National Heart, Lung, and Blood Institute recommendations. A stratified random sample of school nurses who represented each of the 500 active Pennsylvania school districts were surveyed in 2004 concerning nurse staffing patterns, availability of asthma monitoring and treatment-related equipment, emergency preparedness, availability of asthma-related support and case management services, school-specific procedures including identification of children with asthma and accessibility of inhaler medication during school hours, presence and content of written asthma management plans, and perceived obstacles to asthma management in the school setting. Sampling weights were incorporated into the analyses to take the survey design into account. The overall response rate was 76%, with a total of 757 surveys analyzed. In more than half of secondary schools and three quarters of elementary schools, nurses were present asthma attack were not always available. In 72% of rural schools, children were allowed to self-carry rescue inhalers, as compared with 47% of urban schools. Asthma management plans were on file for only 1 quarter of children with asthma, and important information often was omitted. Approximately half of the schools were equipped with peak flow meters and nebulizers, and spacers were available in 1 third of schools. Improvements are needed to bring schools into compliance with current recommendations, including more consistent availability of knowledgeable staff, improved access to asthma monitoring and treatment-related equipment, more universal use of asthma management plans, and greater access to inhalers while at school, including increasing the

Environmental Determinants of Bronchial Asthma among Saudi School Children in Southwestern Saudi Arabia

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Jobran M. Alqahtani

2016-12-01

Full Text Available The aim here was to study the possible environmental and dietary determinants of asthma among school-aged children in Southwestern Saudi Arabia. In a cross-sectional study on a representative sample in Najran in Southwestern Saudi Arabia using an Arabic version of the modified ISAAC Phase III, parent-administered questionnaire data were collected. Skin prick tests (SPTs were performed. The study included 1700 school children, out of them 468 (27.5% were diagnosed with, cases of bronchial asthma and 20.8% (353 reported a 12-month nocturnal cough (as a proxy of severe asthma. In multivariable analysis, the study identified the following risk factors for having asthma or severe asthma: having dogs in the house, being male, being exposed to dense truck traffic on the street, using wood as a cooking fuel, conducting vigorous exercise, consuming eggs, consuming vegetables, having an allergic sensitization to dog hair, and being exposed to Cladosporium, pigweed, and Bermuda grass. On the other hand, the following food stuffs were found to be protective: seafood, fruit, and dairy products. Comprehensive school educational programs for both children and their parents should be adopted to prevent the use of wood in cooking and heating, to ensure that house pets are properly cared for, and to encourage proper dietary habits. Physicians should be informed of the patterns of allergens in order to improve asthma diagnosis and management.

Nocturnal asthma in school children of south punjab, pakistan

International Nuclear Information System (INIS)

Mustafa, G.; Khan, P.A.; Iqbal, I.

2008-01-01

At the present time, the epidemiology of the childhood asthma is of considerable interest. There is an understandable concern that changes in the geographical area, lifestyle, and environment. This study was conducted to find the prevalence of nocturnal asthma, in school children of south Punjab, Pakistan. It was a cross sectional, questionnaire based, descriptive survey of the children aged 3-18 years, in randomly selected primary and secondary schools, from October 2002 to March 2003. The data was analysed with Statistical Analysis System (SAS). Of 6120 questionnaire sent to the parents/guardians, we received 3180 back (52%). Of the 3180 respondents, 1767 (56%) were for boys and 1413 (44%) were for girls. The median age was 8.25 years. Around 71% of children were between 4 to 11 years of age. The parents reported nocturnal asthma in 177 (6%) of their children with an equal prevalence in boys and girls, i.e., (3% each, rounded off to nearest whole number). Of these 177 children with nocturnal asthma, 99 (56%) were boys and 78 (44%) were girls. Of the 1767 boys and 1413 girls, the nocturnal asthma reported by parents was 6% each (99 and 78 respectively). The nocturnal asthma was not reported in 14-18 years age group of females. The asthma is taken as a stigma in our society and as such is not reported or disclosed rather denied. An extensive educational media campaign is required for awareness of the masses. (author)

Health-care conditions in elementary schools and teachers' knowledge of childhood asthma.

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Canitez, Yakup; Cekic, Sukru; Celik, Ugur; Kocak, Abdulkadir; Sapan, Nihat

2016-02-01

For the adequate control of asthma in school-age children, it is recommended that teachers, school health personnel and administrators should have sufficient knowledge of how to manage asthma during school hours. To investigate asthma health care in elementary schools, and teachers' knowledge of childhood asthma and its management. The extent of knowledge of childhood asthma in 2779 teachers in 141 elementary schools (children aged 6-14, grades 1-8) in Bursa, the fourth largest city in Turkey, was evaluated. Section I comprised questions about asthma health-care in schools, Section II teachers' knowledge of the main characteristics of asthma and Section III (Likert Scale) teachers' detailed knowledge of the signs, triggering factors, treatment and general knowledge of asthma. The findings of Section I demonstrated that the organisation of health-care for asthma in schools was insufficient. Of the teachers questioned, 14·7% were not even aware and only 1% and 9·6% of the teachers had been made aware by school health personnel and school records, respectively, of asthmatic children. Only 27·3% of the teachers stated that they were responsible for the health of an asthmatic child. The majority of teachers (70%) said that asthmatic children could use the medication (e.g. inhalers) themselves. In Section II, there were between 44·1% and 75·5% correct answers, while in Section III this figure ranged from 3·3% to 78·4%. The correct answer rate was 60·4% for Sections II and III combined. The results of Sections II and III showed that the teachers' knowledge of asthma was poor in many respects. Teachers who stated that they had asthma or had first-degree relatives with asthma, or those with 10 or more years' experience provided significantly more correct answers in Sections II and III combined than did those without these characteristics (Phealth care for asthma (asthma management policies) in schools. The implementation of asthma education programmes for teachers

Internet-based self-management in asthma

NARCIS (Netherlands)

Meer, Victor van der

2010-01-01

This thesis describes the role of internet-based support in the delivery of an asthma self management program. First, the compliance and reliability of home lung function monitoring, one of the key features of asthma self-management, was studied and appeared to be high over a 4-week period. Second,

Disease management programs for patients with asthma in Germany: a longitudinal population-based study.

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Mehring, Michael; Donnachie, Ewan; Mutschler, Robert; Hofmann, Frank; Keller, Manfred; Schneider, Antonius

2013-07-01

The primary aim of the disease management program (DMP) for patients with asthma is to improve health outcomes and to reduce costs. Five years after its introduction in Germany, no consensus has yet been reached as to whether DMP has been effective in reaching these goals. To evaluate the DMP for asthma in Bavaria using routinely collected subject medical records. A longitudinal population-based study encompassing over 100,000 DMP participants between 2006 (when the program began) and 2010. The prescription rate of oral corticosteroids dropped from 15.7% in 2006 to 13.6% in 2007, and again from 7.5% in 2008 to 5.9% in 2010 (P management education increased from 4.4% to 23.4% (P management. The proportion of subjects requiring hospitalization decreased. Our results suggest that the German DMP for asthma has been effective in enhancing the quality of care in regard to an improved symptom frequency, adherence to guidelines, pharmacotherapy, and hospitalization.

Smoking patterns among adolescents with asthma attending upper secondary schools: a community-based study

DEFF Research Database (Denmark)

Precht, Dorthe Hansen; Keiding, Lis; Madsen, Mette

2003-01-01

adjusted for age, gender, parents' job and smoking, family type, body mass index, and exercise habits. RESULTS: In total, 37.7% smoked currently and 16.5% smoked daily; more girls than boys smoked. More pupils with asthma than without smoked daily (adjusted odds ratio [OR]: 1.15; 95% confidence interval......OBJECTIVE: Smoking among people who have asthma may be a serious health problem. We studied the prevalence of smoking and the relations between smoking and asthma, symptoms, medicine, and gender differences among adolescents with asthma. METHODS: A national cross-sectional study on health...... and lifestyles was performed in 1996-1997 using a computerized questionnaire in upper secondary schools in Denmark. We included 1887 pupils with asthma (defined as self-reported asthma diagnosed by a physician) and 20 688 controls. Smoking was categorized as daily, occasional, ex-smokers, and never smoked. We...

Prevalence of Asthma in School Children on the Arizona-Sonora Border.

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Carr, Tara F; Beamer, Paloma I; Rothers, Janet; Stern, Debra A; Gerald, Lynn B; Rosales, Cecilia B; Van Horne, Yoshira Ornelas; Pivniouk, Oksana N; Vercelli, Donata; Halonen, Marilyn; Gameros, Mercedes; Martinez, Fernando D; Wright, Anne L

Mexican-born children living in the United States have a lower prevalence of asthma than other US children. Although children of Mexican descent near the Arizona (AZ)-Sonora border are genetically similar, differences in environmental exposures might result in differences in asthma prevalence across this region. The objective of this study was to determine if the prevalence of asthma and wheeze in these children varies across the AZ-Sonora border. The International Study of Asthma and Allergy in Children written and video questionnaires were administered to 1753 adolescents from 5 middle schools: Tucson (school A), Nogales, AZ (schools B, C), and Nogales, Sonora, Mexico (schools D, E). The prevalence of asthma and symptoms was compared, with analyses in the AZ schools limited to self-identified Mexican American students. Compared with the Sonoran reference school E, the adjusted odds ratio (OR) for asthma was significantly higher in US schools A (OR 4.89, 95% confidence interval [CI] 2.72-8.80), B (OR 3.47, 95% CI 1.88-6.42), and C (OR 4.12, 95% CI 1.78-9.60). The adjusted OR for wheeze in the past year was significantly higher in schools A (OR 2.19, 95% CI 1.20-4.01) and B (OR 2.67, 95% CI 1.42-5.01) on the written questionnaire and significantly higher in A (OR 2.13, 95% CI 1.22-3.75), B (OR 1.95, 95% CI 1.07-3.53), and Sonoran school D (OR 2.34, 95% CI 1.28-4.30) on the video questionnaire compared with school E. Asthma and wheeze prevalence differed significantly between schools and was higher in the United States. Environmental factors that may account for these differences could provide insight into mechanisms of protection from asthma. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Psychosocial functioning and stress-processing of children with asthma in the school context: differences and similarities with children without asthma.

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Röder, Irma; Kroonenberg, Pieter M; Boekaerts, Monique

2003-01-01

To characterize children with asthma by their stress processing at school and their psychosocial functioning. To establish similarities and differences between children with and without asthma. Participants were 79 children with asthma and 359 children without asthma (ages 8-12). Children completed questionnaires on stress processing and their well-being at school. Parents filled in a questionnaire on behavior problems, and teachers provided data on school performance and absence rate. Children with asthma had higher scores on absence rates, teacher-rated well-being, internalizing behavior problems, occurrence of "rejection by peers," and use of aggression when coping with "problems with school work." However, using discriminant analyses, the groups could not reliably be distinguished from one another by these variables. Children with asthma are similar to other children with regard to their stress processing at school and their psychosocial functioning. The value of conducting multivariate analysis over several univariate tests is underscored.

Asthma and food allergy management in Chicago Public Schools.

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Gupta, Ruchi S; Rivkina, Victoria; DeSantiago-Cardenas, Lilliana; Smith, Bridget; Harvey-Gintoft, Blair; Whyte, Stephanie A

2014-10-01

This study aimed to characterize asthma and food allergy reporting and management in Chicago Public Schools. Demographic and health data for students who have asthma and food allergy were extracted from the Chicago Public Schools database. Demographic and geographic variability and the existence of school health management plans were analyzed, and multiple logistic regression models were computed. Home addresses were geocoded to create maps of case counts per community area. Approximately 18,000 asthmatic and 4000 food allergic students were identified. Of asthmatic students, 9.3% had a food allergy; of food allergic students, 40.1% had asthma. Asthma odds were significantly higher among black and Hispanic students (odds ratio [OR] = 2.3 and 1.3, respectively), whereas food allergy odds were significantly higher among black students (OR = 1.1; 95% confidence interval [CI], 1.0-1.3) and significantly lower among Hispanic students (OR = 0.8; 95% CI, 0.7-0.9). Only 24.3% of students who had asthma and 50.9% of students who had food allergy had a school health management plan on file. Odds of having a school health management plan were significantly higher among students with both conditions, but the likelihood of having a plan on file was significantly lower among racial/ethnic minority and low-income students, regardless of medical condition. Only 1 in 4 students who have asthma and half of food allergic students have health management plans in schools, with lower numbers among minority and low-income students. Improving chronic disease reporting and access to school health management plans is critical. Copyright © 2014 by the American Academy of Pediatrics.

The Regional Asthma Disease Management Program (RADMP) for low income underserved children in rural western North Carolina: a National Asthma Control Initiative Demonstration Project.

Science.gov (United States)

Shuler, Melinda S; Yeatts, Karin B; Russell, Donald W; Trees, Amy S; Sutherland, Susan E

2015-01-01

A substantial proportion of low-income children with asthma living in rural western North Carolina have suboptimal asthma management. To address the needs of these underserved children, we developed and implemented the Regional Asthma Disease Management Program (RADMP); RADMP was selected as one of 13 demonstration projects for the National Asthma Control Initiative (NACI). This observational intervention was conducted from 2009 to 2011 in 20 rural counties and the Eastern Band Cherokee Indian Reservation in western North Carolina. Community and individual intervention components included asthma education in-services and environmental assessments/remediation. The individual intervention also included clinical assessment and management. Environmental remediation was conducted in 13 childcare facilities and 50 homes; over 259 administrative staff received asthma education. Fifty children with mild to severe persistent asthma were followed for up to 2 years; 76% were enrolled in Medicaid. From 12-month pre-intervention to 12-month post-intervention, the total number of asthma-related emergency department (ED) visits decreased from 158 to 4 and hospital admissions from 62 to 1 (p < 0.0001). From baseline to intervention completion, lung function FVC, FEV1, FEF 25-75 increased by 7.2%, 13.2% and 21.1%, respectively (all p < 0.001), and average school absences dropped from 17 to 8.8 days. Healthcare cost avoided 12 months post-intervention were approximately $882,021. The RADMP program resulted in decreased ED visits, hospitalizations, school absences and improved lung function and eNO. This was the first NACI demonstration project to show substantial improvements in healthcare utilization and clinical outcomes among rural asthmatic children.

Advantages of video questionnaire in estimating asthma prevalence and risk factors for school children: findings from an asthma survey in American Indian youth.

Science.gov (United States)

Yeh, Fawn; Rhoades, Everett R; Tarpay, Martha; Eichner, June E

2010-09-01

The aims of the present study were to estimate the prevalence and risk factors of asthma among a sample of American Indian youth and to evaluate survey instruments used in determining asthma prevalence and risk factors. Three hundred and fifty-two adolescents aged 9 to 21 years enrolled in an Indian boarding school completed an asthma screening. The survey instruments were a written questionnaire and a video-illustrated questionnaire prepared from the International Study of Asthma and Allergies in Childhood (ISAAC), school health records, and a health questionnaire. Participants also underwent spirometry testing. The prevalence of self-reported asthma varied from 12.7% to 13.4% depending upon the instrument used and the questions asked. A history of hay fever, respiratory infections, and family history of asthma were found to be risk factors for asthma by all instruments. Female gender and living on a reservation were significantly associated with asthma by some, but not all, instruments. Airway obstruction was highly associated with one asthma symptom (wheeze) shown in the video questionnaire. Associations for most risk factors with asthma were strongest for the video questionnaire. The prevalence of self-reported asthma among these American Indian youth was similar to rates reported for other ethnic groups. The video-based questionnaire may be the most sensitive tool for identifying individuals at risk for asthma.

Results from a community-based program evaluating the effect of changing smoking status on asthma symptom control

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To Teresa

2012-04-01

Full Text Available Abstract Background Cigarette smoking has been associated with accelerated decline in lung function, increased health services use and asthma severity in patients with asthma. Previous studies have provided insight into how smoking cessation improves lung function among asthma patients, however, fail to provide measurable asthma symptom-specific outcomes after smoking cessation. The objective of this study was to measure the effect of changing smoking status on asthma symptom control and health services use in adults with asthma. Methods The study was conducted in eight primary care practices across Ontario, Canada participating in a community-based, participatory, and evidence-based Asthma Care Program. Patients aged 18 to 55 identified with physician-diagnosed mild to moderate asthma were recruited. In addition to receiving clinical asthma care, participants were administered a questionnaire at baseline and 12-month follow-up visits to collect information on demographics, smoking status, asthma symptoms and routine health services use. The effect of changing smoking status on asthma symptom control was compared between smoking groups using Chi-square and Fisher’s exact tests where appropriate. Mixed effect models were used to measure the impact of the change in smoking status on asthma symptom and health services use while adjusting for covariates. Results This study included 519 patients with asthma; 11% of baseline smokers quit smoking while 4% of baseline non-smokers started smoking by follow-up. Individuals who quit smoking had 80% lower odds of having tightness in the chest (Odds ratio (OR = 0.21, 95% CI: 0.06, 0.82 and 76% lower odds of night-time symptoms (OR = 0.24, 95% CI: 0.07, 0.85 compared to smokers who continued to smoke. Compared to those who remained non-smokers, those who had not been smoking at baseline but self-reported as current smoker at follow-up had significantly higher odds of chest tightness (OR = 1

Enhancing School Asthma Action Plans: Qualitative Results from Southeast Minnesota Beacon Stakeholder Groups

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Egginton, Jason S.; Textor, Lauren; Knoebel, Erin; McWilliams, Deborah; Aleman, Marty; Yawn, Barbara

2013-01-01

Background: This study explores ways southeast Minnesota schools currently address asthma problems, identifies areas for improvement, and assesses the potential value of asthma action plans (AAPs) in schools. Methods: Focus groups were used to query stakeholder groups on asthma care in schools. Groups were held separately for elementary school…

Asthma and Environment Fact Sheet for Parents and Schools. Revised

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Healthy Schools Network, Inc., 2012

2012-01-01

Important facts about asthma and the environment include: (1) Asthma has reached epidemic proportions in the United States, affecting about 25 million people of all ages and races, including about 7 million children; (2) Nearly one in 10 school-aged children has asthma, and the percentage of children with asthma is rising more rapidly in…

Allergy sensitization and asthma among 13-14 year old school ...

African Journals Online (AJOL)

EB

Allergy sensitization and asthma among 13-14 year old school children in Nigeria. Oluwole O1 ... Identified asthma cases were matched to controls. Allergy skin tests ..... lower risk of asthma than those with low birth order because exposure to ...

Interventions to Improve Asthma Management of the School-Age Child.

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Friend, Mary; Morrison, Amber

2015-06-01

Improvement of medication adherence in the school-age child can lead to improvement in quality of life, decreased morbidity, and a potential decreased risk of deferred academic, social, and emotional development. The objective of this article is to review barriers to asthma medication adherence and identify evidence-based techniques that improve medication management of the asthmatic child 5 to 12 years of age. A literature review was performed and articles were obtained through database searches within Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and PubMed. Research indicates that barriers to the adherence of medication regimens required for asthmatic children include poor understanding of the medication regimen, substandard education on symptom recognition and environmental triggers, rejection of the diagnosis, and a lack of support or understanding within the community. Researched techniques aimed to improve medication management in 5- to 12-year-olds include: computer-based education; workshops for parents, teachers, and children; incorporation of asthma education into classroom lessons; use of case managers; the introduction of a nurse practitioner in the school to provide care, including medication prescriptions for the asthmatic child; and assessment and evaluation of environmental and emotional triggers in the home and school. Collaboration of current data may help lead to a successful interventional model that can improve asthma management in this population. © The Author(s) 2014.

A NATIONAL POLICY ON ASTHMA MANAGEMENT FOR SCHOOLS

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MELLIS, CM; BOWES, G; HENRY, RL; MITCHELL, CA; PHELAN, PD; SHAH, S; SHAROTA, L; STAUGAS, R; SLY, PD; YOUNG, L

Since asthma is the most common chronic illness in childhood, many of the problems associated with this condition will impact on the child's education. Because of widespread concerns regarding the management of asthma in schools, a subcommittee of the Thoracic Society of Australia and New Zealand,

Epidemiology of bronchial asthma in school children (10–16 years in Srinagar

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Uruj Altaf Qureshi

2016-01-01

Full Text Available Objectives: To assess the epidemiological profile of asthma in school going children in Srinagar, Kashmir. Study design: Cross-sectional study. Setting: Thirty-one schools with proportionate representation from both government and private schools as well as from primary, middle, and high schools. Participants: School children aged 10–16 years with equal representation of sex and all ages. Main Outcome Measure: Prevalence of current and past asthma. Methods and Results: After administering a modified pretested questionnaire, peak expiratory flow measurement was carried. Children who had asthma-like symptoms or positive family history of asthma or physician-labeled asthma were subjected to spirometry and bronchodilator reversibility. Out of 806 children, bronchial asthma was seen in 60 (prevalence of 7.4% which included 34 boys and 26 girls. Majority of asthmatic children (78.3% [n = 47] had probable asthma; 6.7% (n = 4 had definite asthma; and 15% (n = 9 had physician-diagnosed asthma. Majority of children had intermittent asthma (78.3% [n = 47]. Mild persistent asthma was seen in 12.7% (n = 7 and 10% (n = 6 had moderate persistent asthma. None of the children had severe persistent asthma. The prevalence of current asthma was 3.2% (n = 26. On univariate analysis, the factors found to be statistically significant were family history of asthma (odds ratio [OR] =8.174; confidence interval [CI] =4.403–15.178, seasonal cough (OR = 4.266; CI = 2.336–7.791, allergic rhinitis (OR = 2.877; CI = 1.414–5.852, atopic dermatitis (OR = 6.597; CI = 2.72–16.004, and obesity (OR = 6.074; CI = 2.308–18.034. On multivariate analysis, family history, seasonal cough, allergic rhinitis, atopic dermatitis, and obesity were found to be significant independent risk factors. Conclusions: Srinagar qualifies as a low prevalence area for bronchial asthma in the age group of 10–16 years. Majority of children had mild intermittent asthma resulting in under

Allergy sensitization and asthma among 13-14 year old school ...

African Journals Online (AJOL)

Background: The prevalence of asthma and role of atopy in asthma among children has not been clearly defined in Nigeria. Objective: To determine the prevalence of asthma and investigate risk factors related to allergy sensitization among urban and rural school children in southwest Nigeria. Methods: Validated ISAAC ...

The Importance of Asthma and Health Programs in Improving Academic Performance

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School air quality has a major impact on asthma and other respiratory illnesses. Airborne allergens or irritants frequently trigger asthma attacks, yet environmental assessments demonstrate that schools often harbor allergen levels at or close to the th

Knowledge of asthma in school teachers in nine Spanish cities.

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Varela, Angel López-Silvarrey; Esteban, Santiago Rueda; Díaz, Sonia Pértega; Murúa, Javier Korta; Fernández-Oliva, Carmen Rosa Rodríguez; Jiménez, Jose Sánchez; Sansano, María Isabel Ubeda; Bernabé, Juan José Morell; López, Bárbara Iglesias; Gómez, Máximo Martínez; Piñana, Juana María Román

2016-07-01

To analyze the knowledge of asthma and its management in Spanish school teachers using the Newcastle Asthma Questionnaire (NAKQ). Descriptive, observational prevalence study, using a self-report questionnaire on knowledge about childhood asthma and its management by teachers in pre-school, primary, and secondary schools in nine Spanish cities. Age, sex, academic training, teaching experience, courses in which they taught, and personal and family history of asthma, were collected from each teacher. For knowledge determination, the validated Spanish version of the NAKQ was used. A total of 208 centers participated, including 7,494 teachers. The questionnaire was completed by 4,679 teachers (62.4%). The mean score of correct responses was 16.0 ± 4.8 points out of 31 (median = 17, range: 0-30). Only 6.8% of teachers were capable of pointing out the three main symptoms of the disease; 1.5% knew the triggering factors of an asthma attack; 8.6% knew two medicines useful during an asthma attack; 32.7% knew that inhaled medications had less side effects than pills, and only 3.8% knew of ways to prevent asthma attacks during exercise. In the multivariate analysis, variables significantly associated with a higher questionnaire score were a "lower age" (Beta coefficient = -0.09), "male gender" (Beta = 0.77), "being asthmatic" (Beta = 2.10), or "having close relatives with asthma" (Beta = 1.36) and "teaching in a private school" (Beta = 0.66) or in "compulsory secondary education" (Beta = 0.59). Teachers have a low level of knowledge about asthma, with an important limitation in some aspects of the disease. They should be trained to recognize the main symptoms of the disease, on how to act in the event of symptoms, and the early identification of situations in which the pupils require health care assistance. Pediatr Pulmonol. 2016;51:678-687. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Association between high school students’ cigarette smoking, asthma and related beliefs: a population-based study

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Resa M. Jones

2016-09-01

Full Text Available Abstract Background Smoking has a detrimental effect on the symptoms and severity of asthma, a common chronic disease among adolescents. The purpose of this study was to examine the association between asthma and smoking among high school students and assess provider-patient communication with asthmatic adolescents regarding smoking and adolescents’ beliefs about the harms of smoking. Methods In fall 2014, data from high school students, ages 14–18 years, completing the 2009-2010 Virginia Youth Tobacco Survey (N = 1796 were used in descriptive analyses and multivariable logistic regression models adjusting for model-specific confounders as appropriate. Results Overall, an estimated 19 % of high school students in Virginia smoked and 16 % had asthma. Odds of smoking did not differ by asthma status; however, asthmatics had 1.5 times higher odds of being asked if they smoke (95 % CI 1.06–2.13 and being advised not to smoke by a health professional (95 % CI 1.10–2.14 compared to non-asthmatics. Asthmatics who believed second-hand smoke or smoking 1–5 cigarettes/day was not harmful had respectively 4.2 and 2.8 times higher odds of smoking than those who thought each was harmful. Further, asthmatics who thought smoking 1−2 years is safe had 3.4 times higher odds of smoking than those who did not (95 % CI 1.57–10.1. Conclusions While asthmatic adolescents are just as likely to smoke as non-asthmatics, less healthy beliefs about the risks of smoking increase the odds of smoking among asthmatics. Thus, targeted asthma-specific smoking prevention and education to change attitudes and beliefs could be an effective tool for adolescents.

Introducing an environmental assessment and intervention program in inner-city schools.

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Huffaker, Michelle; Phipatanakul, Wanda

2014-12-01

Home-based environmental interventions have demonstrated clinical benefit for children with asthma. Although much is known about school-based exposures, few studies have comprehensively examined the role the school environment plays in asthma and how effectively changing the environment might reduce morbidity when adjusting for exposures in the home. This review summarizes the importance and common challenges of school-based environmental assessment and intervention studies linked to health effects. We focus on the key components of study development and the challenges and benefits to implementation. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Relaxation and Guided Imagery: A School-Based Intervention for Children with Asthma.

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Peck, Heather L.; Bray, Melissa A.; Kehle, Thomas J.

2003-01-01

This investigation analyzed the effect of relaxation and guided imagery on lung function and anxiety by employing a multiple baseline design across four middle school students with asthma. With the introduction of the intervention, it was found that lung function improved and anxiety decreased in all students. (Contains 63 references, 1 table, and…

Reducing School Violence: School-Based Curricular Programs and School Climate

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Greene, Michael B.

2008-01-01

This article examines two different, but interrelated approaches to reduce school violence: school-based curricular programs and efforts to change school climate. The state of the research for each is reviewed and the relationship between them is explored.

LEAP: A randomized-controlled trial of a lay-educator inpatient asthma education program.

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Rice, Jessica L; Matlack, Kristen M; Simmons, Marsha D; Steinfeld, Jonathan; Laws, Margaret A; Dovey, Mark E; Cohen, Robyn T

2015-06-29

To evaluate the impact of LEAP, a volunteer-based, inpatient asthma education program for families of inner-city children with asthma. 711 children ages 2-17 years admitted with status asthmaticus were randomized to receive usual care or usual care plus a supplemental education intervention. Both groups completed a baseline interview. Trained volunteer lay educators conducted individualized bedside education with the intervention group. Primary outcome was attendance at a post-hospitalization follow-up visit 7-10 days after discharge. Secondary outcomes included parent-reported asthma management behaviors, symptoms, and self-efficacy scores from a one month follow-up interview. Post-hospitalization asthma clinic attendance was poor (38%), with no difference between groups. Families randomized to the intervention group were more likely to report use of a controller (OR 2.4, 95% CI 1.3-4.2, peducation by trained lay volunteers was associated with improved asthma management behaviors. This novel volunteer-based program could have widespread implications as a sustainable model for asthma education. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Adaptation of an asthma management program to a small clinic.

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Kwong, Kenny Yat-Choi; Redjal, Nasser; Scott, Lyne; Li, Marilyn; Thobani, Salima; Yang, Brian

2017-07-01

Asthma management programs, such as the Breathmobile program, have been extremely effective in reducing asthma morbidity and increasing disease control; however, their high start-up costs may preclude their implementation in smaller health systems. In this study, we extended validated asthma disease management principles from the Breathmobile program to a smaller clinic system utilizing existing resources and compared clinical outcomes. Cox-regression analyses were conducted to determine the cumulative probability that a new patient entering the program would achieve improved clinical control of asthma with each subsequent visit to the program. A weekly asthma disease management clinic was initiated in an existing multi-specialty pediatric clinic in collaboration with the Breathmobile program. Existing nursing staff was utilized in conjunction with an asthma specialist provider. Patients were referred from a regional healthcare maintenance organization and patients were evaluated and treated every 2 months. Reduction in emergency department (ED) visits and hospitalizations, and improvements in asthma control were assessed at the end of 1 year. A total of 116 patients were enrolled over a period of 1 year. Mean patient age was 6.4 years at the time of their first visit. Patient ethnicity was self-described predominantly as Hispanic or African American. Initial asthma severity for most patients, classified in accordance with national guidelines, was "moderate persistent." After 1 year of enrollment, there was a 69% and 92% reduction in ED/urgent care visits and hospitalizations, respectively, compared with the year before enrollment. Up to 70% of patients achieved asthma control by the third visit. Thirty-six different patients were seen during 1 year for a total of $15,938.70 in contracted reimbursements. A large-scale successful asthma management program can be adapted to a stationary clinic system and achieve comparable results.

Prevalence of asthma among school children in Gaborone, Botswana

African Journals Online (AJOL)

Background: Asthma prevalence is high (>10%) in developed countries and although data is still missing for most of Africa, rates are increasing in developing regions as they become more westernized. We investigated the prevalence of asthma in school children in Gaborone, Botswana. Methods: This was a cross sectional ...

School nurses' role in asthma management, school absenteeism, and cost savings: a demonstration project.

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Rodriguez, Eunice; Rivera, Diana Austria; Perlroth, Daniella; Becker, Edmund; Wang, Nancy Ewen; Landau, Melinda

2013-12-01

With increasing budget cuts to education and social services, rigorous evaluation needs to document school nurses' impact on student health, academic outcomes, and district funding. Utilizing a quasi-experimental design, we evaluated outcomes in 4 schools with added full-time nurses and 5 matched schools with part-time nurses in the San Jose Unified School District. Student data and logistic regression models were used to examine predictors of illness-related absenteeism for 2006-2007 and 2008-2009. We calculated average daily attendance (ADA) funding and parent wages associated with an improvement in illness-related absenteeism. Utilizing parent surveys, we also estimated the cost of services for asthma-related visits to the emergency room (ER; N = 2489). Children with asthma were more likely to be absent due to illness; however, mean absenteeism due to illness decreased when full-time nurses were added to demonstration schools but increased in comparison schools during 2008-2009, resulting in a potential savings of $48,518.62 in ADA funding (N = 6081). Parents in demonstration schools reported fewer ER visits, and the estimated savings in ER services and parent wages were significant. Full-time school nurses play an important role in improving asthma management among students in underserved schools, which can impact school absenteeism and attendance-related economic costs. © 2013, American School Health Association.

Regional variations in risk factors for asthma in school children.

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Lawson, Joshua A; Rennie, Donna C; Senthilselvan, Ambikaipakan; Cockcroft, Donald W; McDuffie, Helen H

2005-09-01

The authors have previously reported an increased prevalence of asthma in Estevan, Saskatchewan (21.4%) compared with Swift Current, Saskatchewan (16.2%). To determine the association between asthma and personal and indoor environmental risk factors in these communities. A population-based cross-sectional study was conducted in January 2000. A questionnaire was distributed to school children in grades 1 to 6 for completion by a parent. Multivariate logistic regression was used to examine associations between various risk factors and physician-diagnosed asthma. Asthma was associated with respiratory allergy (adjusted OR [adjOR]=8.85, 95% CI 6.79 to 11.54), early respiratory illness (adjOR=2.81, 95% CI 1.96 to 4.03) and family history of asthma (adjOR=2.37, 95% CI 1.67 to 3.36). Several environmental factors varied with asthma by town. In Estevan, asthma was associated with home mould or dampness (adjOR=1.82, 95% CI 1.23 to 2.69) and was inversely associated with air conditioning (adjOR=0.56, 95% CI 0.37 to 0.85). The risk of asthma was increased if the child had previous exposure to environmental tobacco smoke from the mother in both communities (Swift Current: OR=1.87, 95% CI 1.06 to 3.30; Estevan: OR=2.00, 95% CI 1.17 to 3.43), and there was an inverse association with current exposure to environmental tobacco smoke from the mother in Estevan (OR=0.64, 95% CI 0.40 to 1.00). When multivariate analyses were stratified by sex, the relationship between home mould or dampness and asthma was most prominent in girls in Estevan. Despite a similar regional location, different risk factors for asthma were identified in each community. Local environmental factors are important to consider when interpreting findings and planning asthma care.

A Biobehavioral Approach to Managing Childhood Asthma.

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Kohen, Daniel P.

1987-01-01

Describes childhood asthma and a program which teaches relaxation and mental imagery (RMI) exercises to children and adolescents as an adjunct in the management of asthma. Clinical experience indicates children who learn RMI rate their asthma as significantly reduced in severity, miss fewer days of school, and make fewer visits to emergency rooms.…

Allergic rhinitis, atopic dermatitis, and asthma are associated with differences in school performance among Korean adolescents.

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Kim, So Young; Kim, Min-Su; Park, Bumjung; Kim, Jin-Hwan; Choi, Hyo Geun

2017-01-01

Several studies have reported negative relations between allergic diseases and school performance but have not simultaneously considered various allergic diseases, including allergic rhinitis, asthma, and atopic dermatitis, and only examined a limited number of participants. The present study investigated the associations of allergic rhinitis, asthma, and atopic dermatitis with school performance in a large, representative Korean adolescent population. A total of 299,695 7th through 12th grade students participated in the Korea Youth Risk Behaviour Web-based Survey (KYRBWS) from 2009 to 2013. The subjects' history of allergic rhinitis, asthma, and atopic dermatitis and number of school absences due to these diseases in the previous 12 months were examined and compared. School performance was classified into 5 levels. The relations between allergic disorders and school performance were analyzed using multiple logistic regressions with complex sampling and adjusted for the subjects' durations of sleep, days of physical activity, body mass indexes (BMIs), regions of residence, economic levels, parents' education levels, stress levels, smoking status, and alcohol use. A subgroup analysis of the economic groups was performed. Allergic rhinitis was positively correlated with better school performance in a dose-dependent manner (adjusted odds ratios, AOR, [95% confidence interval, CI] = 1.50 [1.43-1.56 > 1.33 [1.28-1.38] > 1.17 [1.13-1.22] > 1.09 [1.05-1.14] for grades A > B > C > D; P school performance (AOR [95% CI] = 0.74 [0.66-0.83], 0.87 [0.79-0.96], 0.83 [0.75-0.91], 0.93 [0.85-1.02] for performance A, B, C, and D, respectively; P school performance. The subgroup analysis of the students' economic levels revealed associations between allergic diseases and school performance. Compared to other allergic disorders, the asthma group had more school absences due to their symptoms (P School performance was positively correlated with allergic rhinitis and negatively

Managing Asthma in the School Environment: Indoor Air Quality Tools for Schools. EPA 402-K-10-004

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US Environmental Protection Agency, 2010

2010-01-01

Asthma has reached epidemic proportions in the United States, affecting millions of people of all ages and races. An average of one out of every 10 school-age children now has asthma, and the percentage of children with asthma is rising more rapidly in preschool-age children than in any other age group. Asthma is a leading cause of school…

Perinatal Programming of Asthma: The Role of Gut Microbiota

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Meghan B. Azad

2012-01-01

Full Text Available Perinatal programming, a dominant theory for the origins of cardiovascular disease, proposes that environmental stimuli influence developmental pathways during critical periods of prenatal and postnatal development, inducing permanent changes in metabolism. In this paper, we present evidence for the perinatal programming of asthma via the intestinal microbiome. While epigenetic mechanisms continue to provide new explanations for the programming hypothesis of asthma development, it is increasingly apparent that the intestinal microbiota plays an independent and potentially interactive role. Commensal gut bacteria are essential to immune system development, and exposures disrupting the infant gut microbiota have been linked to asthma. This paper summarizes the recent findings that implicate caesarean delivery, breastfeeding, perinatal stress, probiotics, and antibiotics as modifiers of infant gut microbiota in the development of asthma.

Validation of a questionnaire for asthma case identification in pre-schools in Latin America.

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Busi, Luciano E; Sly, Peter D; Llancaman, Lidia

2015-08-01

We recently developed and validated a screening questionnaire for determining which school-aged children may need further investigation to diagnose and manage asthma. In the present study we sought to extend this to pre-school aged children. Questions from the school-aged questionnaire and literature on pre-school asthma were used to inform a focus group of parents with pre-school-aged children with asthma to develop a screening questionnaire. Parents of children attending 6 randomly selected kindergartens in Trelew, Argentina (n = 639) were invited to respond to the questionnaire. A reliability test-retest was undertaken in 187 randomly selected parents who completed the same questionnaire twice within 2-5 weeks. Clinical assessment included a standardized history and physical examination, spirometry before and after a β-agonist inhaler, and chest X-ray. Asthma was diagnosed by the pulmonologist. Completed surveys were returned for 620 children, 607 of whom underwent clinical evaluation. The mean age was 4.21 years (range of 3.01-5.50) and included 82.5% white and 49.4% male children. Asthma was diagnosed in 103 (17.0%) children); 72 (69.9%) of these children did not have a previous diagnosis of asthma. The specificity, sensitivity, positive predictive value and negative predictive value of the questionnaire were 93.2%, 86.1%, 57.8% and 98.4%, respectively. We have demonstrated the utility of a screening questionnaire for identifying pre-school-aged children who may benefit from further assessment for asthma. © 2015 Asian Pacific Society of Respirology.

Medication education program for Indian children with asthma: A ...

African Journals Online (AJOL)

Medication education program for Indian children with asthma: A feasibility study. C Grover, N Goel, C Armour, PP Van Asperen, SN Gaur, RJ Moles, B Saini. Abstract. Objective: It is postulated that children with asthma who receive an interactive, comprehensive, culturally relevant education program would improve their ...

78 FR 42788 - School-Based Health Center Program

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2013-07-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration School-Based... Gadsden County. SUMMARY: HRSA will be transferring a School-Based Health Center Capital (SBHCC) Program... support the expansion of services at school-based health centers will continue. SUPPLEMENTARY INFORMATION...

The Presence of Asthma, the Use of Inhaled Steroids, and Parental Education Level Affect School Performance in Children

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A. Tsakiris

2013-01-01

Full Text Available Objective. Childhood asthma is a frequent cause of absenteeism that affects school performance. We aimed to investigate the impact of asthma on absenteeism and school performance level of elementary and high school students. Methods. Data about sociodemographics, absenteeism, and academic achievement were obtained from 1539 students attending 98 schools in Greece. School performance was assessed for the last two years of school attendance using parents’ and teachers’ reports and grade point average promotion. Results. The mean of the days of absence of students with asthma was higher compared to the healthy students (6.2 ± 11.7 versus 0.3 ± 3.1, resp., P<0.001. Students with reduced healthcare use presented less absenteeism than those with increased healthcare use for asthma (4.3 ± 8.6 versus 12.4 ± 17.0 days, resp., P<0.001. Asthma and healthcare use for asthma accounted for an overall estimated variability in absence days of 13.8% and 9%, respectively. Absenteeism was associated with poor school performance for the last two years of school (P=0.002 and with lower grade point promotion in elementary school students (P=0.001 but not in high school students (P=0.316. Higher level of parental education was associated with better school performance (P<0.001. Asthma was associated with a decreased possibility for excellent performance (OR = 0.64, P=0.049, 95%CI = 0.41–1.00 in elementary students. Students with asthma using inhalers were four times more likely to perform excellently in elementary school (OR = 4.3, P=0.028, 95%CI = 1.17–15.95 than their asthmatic peers with alternative asthma treatments. Conclusions. Asthma and increased healthcare use enhance school absenteeism. Inhaled steroid use and the higher parental education level were the most important predicting factors for good school performance in elementary school asthmatic children.

Suitability of asthma education materials for school-age children: Implications for health literacy.

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Tzeng, Yu-Fen; Gau, Bih-Shya

2018-03-01

To investigate the suitability of asthma education materials for school-age children with asthma and elucidate how these children used their health-literacy abilities to identify whether the materials can be accepted, comprehended and applied. Effective asthma self-management education is influenced by the suitability of materials and an individual's health literacy. A mixed-method research design was developed using quantitative and qualitative surveys. The suitability of the materials was assessed on the basis of the Chinese version of the Suitability Assessment of Materials by five experts. In addition, five school-age children (age: 8-12 years) were recruited and interviewed. In total, 25 pieces of asthma education material for children were collected. On the basis of their type, the materials were categorised as nine brochures, 11 leaflets and five videos. Of the 25 materials, 17 were rated as superior materials, whereas eight were rated as adequate materials. The suitability scores of the video-based materials were significantly higher than those of the brochures and leaflets (p = .006). One print material was considered to have a reading level suitable for fifth-grade or younger children, whereas the remaining materials were considered suitable for sixth-grade or older children. The following six health-literacy domains were identified: recognising asthma through body knowledge, posing reflective questions, identifying self-care difficulties, receiving adult guidance, learning with enjoyment and addressing learning requirements. The video-based materials had integrated content and were appealing to children. Cartoon animations, interactive computer games, and skill demonstrations may enhance learning stimulation and motivation and increase learning effects in children. The present results may help healthcare providers to understand children's capacities to manage their disease, effectively address children's requirements and function as a key resource for

A Cost-Benefit Analysis of a State-Funded Healthy Homes Program for Residents With Asthma: Findings From the New York State Healthy Neighborhoods Program.

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Gomez, Marta; Reddy, Amanda L; Dixon, Sherry L; Wilson, Jonathan; Jacobs, David E

Despite considerable evidence that the economic and other benefits of asthma home visits far exceed their cost, few health care payers reimburse or provide coverage for these services. To evaluate the cost and savings of the asthma intervention of a state-funded healthy homes program. Pre- versus postintervention comparisons of asthma outcomes for visits conducted during 2008-2012. The New York State Healthy Neighborhoods Program operates in select communities with a higher burden of housing-related illness and associated risk factors. One thousand households with 550 children and 731 adults with active asthma; 791 households with 448 children and 551 adults with asthma events in the previous year. The program provides home environmental assessments and low-cost interventions to address asthma trigger-promoting conditions and asthma self-management. Conditions are reassessed 3 to 6 months after the initial visit. Program costs and estimated benefits from changes in asthma medication use, visits to the doctor for asthma, emergency department visits, and hospitalizations over a 12-month follow-up period. For the asthma event group, the per person savings for all medical encounters and medications filled was $1083 per in-home asthma visit, and the average cost of the visit was $302, for a benefit to program cost ratio of 3.58 and net benefit of $781 per asthma visit. For the active asthma group, per person savings was $613 per asthma visit, with a benefit to program cost ratio of 2.03 and net benefit of $311. Low-intensity, home-based, environmental interventions for people with asthma decrease the cost of health care utilization. Greater reductions are realized when services are targeted toward people with more poorly controlled asthma. While low-intensity approaches may produce more modest benefits, they may also be more feasible to implement on a large scale. Health care payers, and public payers in particular, should consider expanding coverage, at least for

Evaluating the implementation of a multicomponent asthma education program for Head Start staff.

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Ruvalcaba, Elizabeth; Chung, Shang-En; Rand, Cynthia; Riekert, Kristin A; Eakin, Michelle

2018-03-15

Asthma disproportionately affects minority groups, low income populations, and young children under 5. Head Start (HS) programs predominantly serve this high-risk population, yet staff are not trained on asthma management. The objective of this study was to assess a 5-year, multicomponent HS staff asthma education program in Baltimore City HS programs. All HS programs were offered annual staff asthma education by a medical research team that included didactic lectures and hands-on training. Attendees received continuing education credits. HS staff were anonymously surveyed on asthma knowledge and skills and asthma medication management practices in Year 1 (preimplementation) and Year 5. There was an estimated response rate of 94% for Year 1 and 82% for Year 5. Compared to staff in Year 1, Year 5 staff were significantly more likely to report they had very good knowledge and skills related to asthma [odds ratio (OR) 1.63; p staff reported higher self-assessed knowledge and skills, self-reports of asthma medication management practices, and self-reports of asthma activities compared to Year 1 staff. HS serves high-risk children with asthma, and a multicomponent program can adequately prepare staff to manage asthma in the child care setting. Our results indicate the feasibility of providing efficacious health skill education into child care provider training to reduce asthma knowledge gaps.

Building Rural Communities through School-Based Agriculture Programs

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Martin, Michael J.; Henry, Anna

2012-01-01

The purpose of this study was to develop a substantive theory for community development by school-based agriculture programs through grounded theory methodology. Data for the study included in-depth interviews and field observations from three school-based agriculture programs in three non-metropolitan counties across a Midwestern state. The…

Signs of an asthma attack

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... resources Asthma - children Patient Instructions Asthma and school Asthma - child - discharge Asthma - control drugs Asthma - quick-relief drugs Asthma - what to ask the doctor - adult Asthma - what to ask your doctor - child Exercise-induced asthma Exercising and asthma at school ...

Development, implementation, and evaluation of a community pharmacy-based asthma care model.

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Saini, Bandana; Krass, Ines; Armour, Carol

2004-11-01

Pharmacists are uniquely placed in the healthcare system to address critical issues in asthma management in the community. Various programs have shown the benefits of a pharmacist-led asthma care program; however, no such programs have previously been evaluated in Australia. To measure the impact of a specialized asthma service provided through community pharmacies in terms of objective patient clinical, humanistic, and economic outcomes. A parallel controlled design, where 52 intervention patients and 50 control patients with asthma were recruited in 2 distinct locations, was used. In the intervention area, pharmacists were trained and delivered an asthma care model, with 3 follow-up visits over 6 months. This model was evaluated based on clinical, humanistic, and economic outcomes compared between and within groups. There was a significant reduction in asthma severity in the intervention group, 2.6 +/- 0.5 to 1.6 +/- 0.7 (mean +/- SD; p < 0.001) versus the control group, 2.3 +/- 0.7 to 2.4 +/- 0.5. In the intervention group, peak flow indices improved from 82.7% +/- 8.2% at baseline to 87.4% +/- 8.9% (p < 0.001) at the final visit, and there was a significant reduction in the defined daily dose of albuterol used by patients, from 374.8 +/- 314.8 microg at baseline to 198.4 +/- 196.9 microg at the final visit (p < 0.015). There was also a statistically significant improvement in perceived control of asthma and asthma-related knowledge scores in the intervention group compared with the control group between baseline and the final visit. Annual savings of $132.84(AU) in medication costs per patient and $100,801.20 for the whole group, based on overall severity reduction, were demonstrated. Based on the results of this study, it appears that a specialized asthma care model offers community pharmacists an opportunity to contribute toward improving asthma management in the Australian community.

Prevalence of childhood asthma in Korea: international study of asthma and allergies in childhood.

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Lee, Sang-Il

2010-04-01

Childhood asthma is a major concern because it leads to more hospital visits and a heavy economic burden. Proper management and prevention strategies for childhood asthma must be based on correct evaluation of prevalence and risk factors for its development. In Korea, nationwide studies were conducted in 1995 and 2000 on students from 68 elementary schools (age, 6-12 years) and junior high schools (age, 12-15 years) by the Korean Academy of Pediatric Allergy and Respiratory Diseases. We used the Korean version of the International Study of Asthma and Allergies in Childhood (ISAAC) written and video questionnaires at the same schools during the same period (October-November). The prevalence of asthma in junior high school children seemed to increase over 5 years. However, in elementary school children, the prevalence of asthma symptoms decreased, although the prevalence of 'diagnosis of asthma, ever' and 'treatment of asthma, last 12 months' increased. In addition, it was found that various factors, such as obesity, passive smoking, dietary habits, raising pets at home, and fever/antibiotic use during infancy were associated with childhood asthma. When prevalence of asthma in Korea was compared with that in different regions, the prevalence changes in the 6-7 years age group did not seem to be consistent between regions, whereas similar trends were observed among children aged 13-14 years. To conduct another epidemiological study to evaluate the time trend over time, a third nationwide survey is planned in 2010, and we anticipate ISAAC Phase 3 will explore recent changes in the prevalence of childhood asthma and assess its risk factors in Korean children. On the basis of accurate data on the current status of childhood asthma in 2010, we will be able to establish proper management strategies.

Predicting asthma in preschool children with asthma symptoms: study rationale and design

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Hafkamp-de Groen Esther

2012-10-01

Full Text Available Abstract Background In well-child care it is difficult to determine whether preschool children with asthma symptoms actually have or will develop asthma at school age. The PIAMA (Prevention and Incidence of Asthma and Mite Allergy Risk Score has been proposed as an instrument that predicts asthma at school age, using eight easy obtainable parameters, assessed at the time of first asthma symptoms at preschool age. The aim of this study is to present the rationale and design of a study 1 to externally validate and update the PIAMA Risk Score, 2 to develop an Asthma Risk Appraisal Tool to predict asthma at school age in (specific subgroups of preschool children with asthma symptoms and 3 to test implementation of the Asthma Risk Appraisal Tool in well-child care. Methods and design The study will be performed within the framework of Generation R, a prospective multi-ethnic cohort study. In total, consent for postnatal follow-up was obtained from 7893 children, born between 2002 and 2006. At preschool age the PIAMA Risk Score will be assessed and used to predict asthma at school age. Discrimination (C-index and calibration will be assessed for the external validation. We will study whether the predictive ability of the PIAMA Risk Score can be improved by removing or adding predictors (e.g. preterm birth. The (updated PIAMA Risk Score will be converted to the Asthma Risk Appraisal Tool- to predict asthma at school age in preschool children with asthma symptoms. Additionally, we will conduct a pilot study to test implementation of the Asthma Risk Appraisal Tool in well-child care. Discussion Application of the Asthma Risk Appraisal Tool in well-child care will help to distinguish preschool children at high- and low-risk of developing asthma at school age when asthma symptoms appear. This study will increase knowledge about the validity of the PIAMA risk score and might improve risk assessment of developing asthma at school age in (specific subgroups

The presence of asthma, the use of inhaled steroids, and parental education level affect school performance in children.

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Tsakiris, A; Iordanidou, M; Paraskakis, E; Tsalkidis, A; Rigas, A; Zimeras, S; Katsardis, C; Chatzimichael, A

2013-01-01

Childhood asthma is a frequent cause of absenteeism that affects school performance. We aimed to investigate the impact of asthma on absenteeism and school performance level of elementary and high school students. Data about sociodemographics, absenteeism, and academic achievement were obtained from 1539 students attending 98 schools in Greece. School performance was assessed for the last two years of school attendance using parents' and teachers' reports and grade point average promotion. The mean of the days of absence of students with asthma was higher compared to the healthy students (6.2 ± 11.7 versus 0.3 ± 3.1, resp., P absenteeism than those with increased healthcare use for asthma (4.3 ± 8.6 versus 12.4 ± 17.0 days, resp., P Absenteeism was associated with poor school performance for the last two years of school (P = 0.002) and with lower grade point promotion in elementary school students (P = 0.001) but not in high school students (P = 0.316). Higher level of parental education was associated with better school performance (P performance (OR = 0.64, P = 0.049, 95%CI = 0.41-1.00) in elementary students. Students with asthma using inhalers were four times more likely to perform excellently in elementary school (OR = 4.3, P = 0.028, 95%CI = 1.17-15.95) than their asthmatic peers with alternative asthma treatments. Conclusions. Asthma and increased healthcare use enhance school absenteeism. Inhaled steroid use and the higher parental education level were the most important predicting factors for good school performance in elementary school asthmatic children.

How much do school teachers know about childhood asthma in ...

African Journals Online (AJOL)

2017-03-10

Mar 10, 2017 ... pating in school sports and recreational activities can make the child .... AKQ and length of time in teaching service were sum- marized using ..... childhood asthma than knowledge about management of .... school-age youth.

Grade retention risk among children with asthma and other chronic health conditions in a large urban school district.

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Moonie, Sheniz; Cross, Chad L; Guillermo, Chrisalbeth J; Gupta, Tina

2010-09-01

Asthma accounts for 12.8 million missed school days for children nationwide. Whether this excess absenteeism contributes to poor outcomes such as grade retention is of interest. The Clark County School District in Las Vegas, NV has incorporated the Federal "No Child Left Behind Act," which states that absences per individual in excess of 10 per school year are considered unapproved and may put a child at risk for repeating a grade. The purpose of this study was to determine if children with asthma are at increased risk for absenteeism associated with grade retention. Secondary data were obtained for students in attendance for the 2006-2007 school year. Days absent were weighted for enrollment time. Frequencies were obtained using descriptive statistics, and multivariate logistic regression was used to model the odds of absenteeism > 10 days per year. Of 300 881 students, 27 299 (9.1%) reported having asthma, as determined by school health records. The population was 52% male, 37% white, and 39% Hispanic. Significant predictors of missing > 10 days per school year included ethnicity, gender, grade, and health status (P 10 school days per year compared with healthy students or those with a medical condition other than asthma (P grade point average by race, gender, and asthma status. Children with asthma have a greater risk of absenteeism associated with grade retention. Therefore, improved asthma management and tailored education is necessary to identify and eliminate asthma triggers in the home and school setting for school-aged children.

Increasing Availability to and Ascertaining Value of Asthma Action Plans in Schools through Use of Technology and Community Collaboration

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Hanson, Tabitha K.; Aleman, Martha; Hart, Lacey; Yawn, Barbara

2013-01-01

Background: Approximately 9% of school-aged children in the United States have asthma. Since 1997, the Asthma Action Plan (AAP) has been recommended as an asthma self-management tool for individuals with asthma. In the school setting, the use of the AAP has been primarily dependent on communication between the family and the school through a paper…

Childhood Asthma and Student Performance at School

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Taras, Howard; Potts-Datema, William

2005-01-01

To better understand what is known about the association between childhood asthma, school attendance, and academic outcomes, the authors reviewed published studies investigating this topic. Tables with brief descriptions of each study's research methodology and outcomes are included. Research reveals evidence that rates of absenteeism are higher…

Environmental and Personal Factors Related to Asthma Severity among Children: Hospital Based Study, Egypt

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Omaima Ibrahim AboElkheir

2016-09-01

Full Text Available Background: Childhood asthma is a complex disorder in which many environmental and personal factors play a role. However, the contribution of these factors to asthma severity is poorly understood. This study aims to determine the relationship between environmental exposures, personal factors and asthma severity among asthmatic children. Methods: This cross-sectional hospital based study was conducted on 180 asthmatic children; they were divided into mild, moderate and severe asthma according to forced expiratory volume in first second. Environmental factors (indoor and outdoor, food allergy, history of other allergic diseases, family history of allergic disorders, time trend of attacks as well as asthma outcome were reported. Results: Children with severe asthma were younger than those with mild or moderate asthma. Severe asthma was significantly linked to family history of allergy, presence of co-morbid allergic diseases, fish, egg and milk allergy, as well as exposure to passive smoking (73.7% and poor housing conditions. Also, it was significantly linked to presence of unauthorized factories in residential area (31.6 %, p=0.001. As well as, contact with pets (42.1%. Children with severe asthma had more limitations of physical activities (73.7%, missed school days (81.5%, with poor school performance (p=0.04 than those with mild moderate or asthma. Conclusion: Severe asthma was linked to female gender and younger age, co-morbid allergic diseases, family history of atopy and food allergy. It was higher among children residing in places with unauthorized factories and living in substandard housing condition. Children with severe asthma had poor asthma outcome.

Comparison of asthma prevalence among African American teenage youth attending public high schools in rural Georgia and urban Detroit.

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Ownby, Dennis R; Tingen, Martha S; Havstad, Suzanne; Waller, Jennifer L; Johnson, Christine C; Joseph, Christine L M

2015-09-01

The high prevalence of asthma among urban African American (AA) populations has attracted research attention, whereas the prevalence among rural AA populations is poorly documented. We sought to compare the prevalence of asthma among AA youth in rural Georgia and urban Detroit, Michigan. The prevalence of asthma was compared in population-based samples of 7297 youth attending Detroit public high schools and in 2523 youth attending public high schools in rural Georgia. Current asthma was defined as a physician diagnosis and symptoms in the previous 12 months. Undiagnosed asthma was defined as multiple respiratory symptoms in the previous 12 months without a physician diagnosis. In Detroit, 6994 (95.8%) youth were AA compared with 1514 (60.0%) in Georgia. Average population density in high school postal codes was 5628 people/mile(2) in Detroit and 45.1 people/mile(2) in Georgia. The percentages of poverty and of students qualifying for free or reduced lunches were similar in both areas. The prevalence of current diagnosed asthma among AA youth in Detroit and Georgia was similar: 15.0% (95% CI, 14.1-15.8) and 13.7% (95% CI, 12.0-17.1) (P = .22), respectively. The prevalence of undiagnosed asthma in AA youth was 8.0% in Detroit and 7.5% in Georgia (P = .56). Asthma symptoms were reported more frequently among those with diagnosed asthma in Detroit, whereas those with undiagnosed asthma in Georgia reported more symptoms. Among AA youth living in similar socioeconomic circumstances, asthma prevalence is as high in rural Georgia as it is in urban Detroit, suggesting that urban residence is not an asthma risk factor. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Parent Interest in a School-Based, School Nurse-Led Weight Management Program

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Kubik, Martha Y.; Lee, Jiwoo

2014-01-01

Because one in three children is already overweight or obese, school-based interventions targeting secondary obesity prevention merit consideration. This study assessed parent interest in participating in a school-based, school nurse-led weight management program for young school-aged children. A random sample of parents ("n" = 122) of…

School-Based Drug Abuse Prevention Programs in High School Students

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Sharma, Manoj; Branscum, Paul

2013-01-01

Drug abuse, or substance abuse, is a substantial public health problem in the United States, particularly among high school students. The purpose of this article was to review school-based programs implemented in high schools for substance abuse prevention and to suggest recommendations for future interventions. Included were English language…

Increasing availability to and ascertaining value of asthma action plans in schools through use of technology and community collaboration.

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Hanson, Tabitha K; Aleman, Martha; Hart, Lacey; Yawn, Barbara

2013-12-01

Approximately 9% of school-aged children in the United States have asthma. Since 1997, the Asthma Action Plan (AAP) has been recommended as an asthma self-management tool for individuals with asthma. In the school setting, the use of the AAP has been primarily dependent on communication between the family and the school through a paper process. To address the limited availability of AAPs, the Southeast Minnesota Beacon Project developed and implemented a secure portal designed for the electronic exchange of the AAP between providers and schools. This project was designed to assess school nurses' responses to the portal and the perceived value of AAPs, efficiency, self-efficacy, and project impact. School nurses perceive that the AAP enables more efficient management of the care of students with asthma and increases school nurse self-efficacy in regard to asthma management. Overall, school nurses felt the AAP portal was useful and they reported satisfaction with its function as a school health office resource. Electronic sharing of the AAP has the potential to increase efficiency and enhance effective communication among health care providers, families, and schools. © 2013, American School Health Association.

PREVALENCE OF ASTHMA IN ISFAHAN JUNIOR HIGH SCHOOL CHILDREN (1998-1999

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M GOLSHAN

2000-06-01

Full Text Available Introduction. Asthma is the most common chronic disease in children. Unfortunately there are not exact epidemiologic data concerning the prevalence of this disorder in Iranian children. The purpose of this study was to estimate the prevalence of asthma or respiratory symptoms in Isfahan Junior high school children. Methods. From 1998 Oct. to 1999 May. 3986 children from urban junior high schools children were selected by a proportional random cluster sampling. A self administered questionnaire prepared by International Study of Asthma and Allergies in Childhood (ISSAC modified by several supplementary questions was distributed among the selected children. The response rate was 98.5 percent (N=3924. Of these children, 2588 pupils who had at least one positive answer referring to respiratory symptoms were invited to AL-Zahra medical center for further evaluation, but 1710 pupils (66 percent of the invited attended the clinic and underwent complete medical interview, physical examination and post-exercise pulmonary function testing. Those children who failed to attend the clinic were examined at their schools (774 cases and 104 absent pupils were not examined. Our criterion for the diagnosis of asthma was the positive history of wheezing and dyspnea. Results. The overall prevalence of asthma was 19.6 percent with a male to female ratio of 1.7:1 (P<0.0001. The frequencies of wheezing ever in life and sleep disturbed by wheeze were 31.7 percent and 9.5 percent, respectively. Wheeze and rhoncus on chest auscultation while the children were examined in clinic or school was recorded in 4.2 percent and 3.5 percent of the population, respectively. Pulmonary function tests revealed FEV1:5,80 percent of predicted value (prd in 5.9 percent, FEF 25-75£70 Percent prd in 9.6 percent and FEF75£70 percent prd in 20.5 percent of tested children. The three later findings correlated to history of wheezing and dyspnea (P < 0.0001. Discussion. The prevalence of

School-Based Child Abuse Prevention Programs

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Brassard, Marla R.; Fiorvanti, Christina M.

2015-01-01

Child abuse is a leading cause of emotional, behavioral, and health problems across the lifespan. It is also preventable. School-based abuse prevention programs for early childhood and elementary school children have been found to be effective in increasing student knowledge and protective behaviors. The purpose of this article is to help school…

Physical exercise program for children with bronchial asthma.

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Szentágothai, K; Gyene, I; Szócska, M; Osváth, P

1987-01-01

A long-term physical exercise program was established for a large number of children with bronchial asthma. Asthmatic children were first taught to swim on their backs to prevent breathing problems customary for beginners using other strokes. They concurrently participated in gymnasium exercises, and the program was later completed with outdoor running. Program effectiveness was evaluated by monitoring asthmatic symptoms, changes in medication, and changes in the activity and physical fitness of the children. Data collected from 121 children showed that during the first year in the program the number of days with asthmatic symptoms decreased in a large majority of the patients while medication was decreased. School absenteeism and hospitalization dropped markedly. Parental evaluation of the children indicated much improvement in 51.2%, improvement in 40.5%, unchanged condition in 7.4%, and deterioration of general health was only reported in one child (0.8%). The same extent of improvement continued during the second year. The Cooper test was applied for the first time to such an exercise program and indicated that the participating asthmatic children performed as well as a control group of nonasthmatic children, and the cardiovascular efficiency of the asthmatics was actually better.

The Principal and Nurse Perspective on Gaps in Asthma Care and Barriers to Physical Activity in New York City Schools: A Qualitative Study.

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Cain, Agnieszka; Reznik, Marina

2017-10-01

School officials and nurses play an important role in facilitating asthma management in schools. Little is known about their perspectives on in-school asthma management and barriers to physical activity (PA) at school. The goal of this study is to explore school officials' and nurses' perspectives on asthma care and barriers to PA in children with asthma attending New York City schools. We conducted qualitative, semistructured interviews with 10 principals, 3 assistant principals, and 9 nurses in 10 Bronx, New York elementary schools. Sampling continued until thematic saturation was reached. Interviews were recorded, transcribed, and coded for common themes. The thematic and content review was subsequently used to analyze interview data. Emerging themes were discussed and agreed on by both investigators. Three main categories arose from the analysis: (1) procedures and policies around asthma management in school, (2) barriers to effective medication administration in school, and (3) barriers to PA in children with asthma. Participants identified gaps to in-school asthma management and barriers to PA participation: ineffective ways of identifying students with asthma; lack of written procedures for asthma management; difficulty in meeting the administrative requirements to administer asthma medication; lack of knowledge and training on asthma management for the parents, students, and school staff; parental limitation of children's PA; and schools not meeting the state physical education requirement. Our findings suggest the need for policy reform on asthma management and PA in urban schools and should be considered in the design of future interventions.

Prevalence of bronchial asthma among school-going children in Mangalore, South India

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Sowmini P Kamath

2017-03-01

Full Text Available Background: Asthma in childhood is a major public health issue. Objective: To estimate prevalence and associated housing environment factors of asthma among school children. Material & Methods: We conducted a cross sectional study among school children aged six to fifteen years. Standard ISAAC (International Study of Asthma and Allergies in Children Core Questionnaire for Asthma was used for determining the prevalence of wheezing and asthma. Demographic, housing and indoor pollution factors were collected. Data were analyzed by SPSS version 15. Results: Prevalence of ‘wheeze ever’ and ‘current wheezers’ was 10% and 9% respectively.  Physician diagnosed asthma was seen in 6.3 %. Severe asthma was noted in 28.6% of current wheezerswith 84.6% and 8.8% having one to two and four to 12 wheezing attacks per year respectively. Wheezing was present post exercise in 5.4%, nocturnal cough in 6.1%, sleep disturbance less than one night/week (40.7%, one or more nights/week (3.3% and wheezing limiting speech to few words between breaths (20.9%. Prevalence was greater among boys (9.8% than girls (7.5% and maximal in age group eight to nine years. On multiple logistic regression presence of overcrowding and absence of smoke outlet were significantly associated with current wheeze. Socio-economic status, beedi rolling practices and absence of separate kitchen was statistically significant with severe asthma. Conclusions: Current wheezer prevalence was9% and more in boys. Adoption of improved housing conditions and avoiding environmental tobacco exposure may aid in reducing childhood asthma attacks in this developing city.

Evaluation of the Environmental Scoring System in Multiple Child Asthma Intervention Programs in Boston, Massachusetts.

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Dong, Zhao; Nath, Anjali; Guo, Jing; Bhaumik, Urmi; Chin, May Y; Dong, Sherry; Marshall, Erica; Murphy, Johnna S; Sandel, Megan T; Sommer, Susan J; Ursprung, W W Sanouri; Woods, Elizabeth R; Reid, Margaret; Adamkiewicz, Gary

2018-01-01

To test the applicability of the Environmental Scoring System, a quick and simple approach for quantitatively measuring environmental triggers collected during home visits, and to evaluate its contribution to improving asthma outcomes among various child asthma programs. We pooled and analyzed data from multiple child asthma programs in the Greater Boston Area, Massachusetts, collected in 2011 to 2016, to examine the association of environmental scores (ES) with measures of asthma outcomes and compare the results across programs. Our analysis showed that demographics were important contributors to variability in asthma outcomes and total ES, and largely explained the differences among programs at baseline. Among all programs in general, we found that asthma outcomes were significantly improved and total ES significantly reduced over visits, with the total Asthma Control Test score negatively associated with total ES. Our study demonstrated that the Environmental Scoring System is a useful tool for measuring home asthma triggers and can be applied regardless of program and survey designs, and that demographics of the target population may influence the improvement in asthma outcomes.

Impact of a quality improvement program on care and outcomes for children with asthma.

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Homer, Charles J; Forbes, Peter; Horvitz, Lisa; Peterson, Laura E; Wypij, David; Heinrich, Patricia

2005-05-01

To test a quality improvement intervention, a learning collaborative based on the Institute for Healthcare Improvement's Breakthrough Series methodology, specifically intended to improve care and outcomes for patients with childhood asthma. Randomized trial in primary care practices. Practices in greater Boston, Mass, and greater Detroit, Mich. Forty-three practices, with 13 878 pediatric patients with asthma, randomized to intervention and control groups. Intervention Participation in a learning collaborative project based on the Breakthrough Series methodology of continuous quality improvement. Change from baseline in the proportion of children with persistent asthma who received appropriate medication therapy for asthma, and in the proportion of children whose parent received a written management plan for their child's asthma, as determined by telephone interviews with parents of 631 children. After adjusting for state, practice size, child age, sex, and within-practice clustering, no overall effect of the intervention was found. This methodologically rigorous assessment of a widely used quality improvement technique did not demonstrate a significant effect on processes or outcomes of care for children with asthma. Potential deficiencies in program implementation, project duration, sample selection, and data sources preclude making the general inference that this type of improvement program is ineffective. Additional rigorous studies should be undertaken under more optimal settings to assess the efficacy of this method for improving care.

The effect of the training program on the quality of life in patients with asthma based on the Precede model in Ahvaz, Iran.

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Nejad, Mina Motaghi; Nejad, Ghodratollah Shakeri; Tavakol, Heshmatollah; Cheraghi, Maria

2017-06-01

The aim of the study was to determine the effect of the training program based on the Precede model and its main components on improving the quality of life in patients with asthma. It was a randomized quasi-experimental study done on 120 patients with asthma who were referred to the Imam Khomeini hospital in Ahvaz who were selected using the convenience sampling method and were randomly divided into intervention and control groups. The data collection tool consisted of two questionnaires. The first questionnaire evaluated the quality of life in patients with asthma and the other one was developed by the researcher based on the structures of the Precede model. Training intervention was conducted during four sessions twice a week and each session was carried out for an hour based on the structures of the Precede model. In order to achieve the results, SPSS software, even t -test, and χ 2 were used. The results showed that after the training intervention in the experimental group, the mean scores of predisposing factors ( p quality of life in two groups after the intervention ( p quality of life of patients in the experimental group was improved after the training intervention. The design and implementation of the training program based on the Precede model can have a positive effect on the improvement of quality of life in patients with asthma.

The Impacts of Educational Asthma Interventions in Schools: A Systematic Review of the Literature

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Barretto Cardoso, Laís Souza; de Souza-Machado, Carolina; Souza-Machado, Adelmir

2016-01-01

Objective. To review the literature on the impact of educational asthma interventions in schools regarding the knowledge and morbidity of the disease among children and adolescents. Methods. A systematic review was conducted for controlled clinical trials investigating the effectiveness of educational asthma interventions for students, asthmatic or nonasthmatic, families, and school staff. Databases were CENTRAL, PubMed, LILACS, MEDLINE, and SciELO. Articles published in any language were considered, in the period from 2005 to 2014, according to the PRISMA guidelines. Results. Seventeen articles were selected (N = 5,879 subjects). 94% of the interventions (16 of 17 studies) were applied in developed countries that were led by health professionals and most of them targeted asthmatics. Asthma education promotes the improvement of knowledge about the disease in at least one of the evaluated areas. 29% of the interventions (5 of 17 studies) showed a reduction of the asthma symptoms, 35% (6 of 17 studies) reduction of the hospitalization instances and emergency visits, 29% (5 of 17 studies) reduction of school absenteeism, and 41% (7 of 17 studies) increase in the quality of life of the individuals. Conclusions. Educational interventions in schools raise the awareness of asthma and weaken the impact of morbidity indicators. PMID:27656097

The Impacts of Educational Asthma Interventions in Schools: A Systematic Review of the Literature

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Ana Carla Carvalho Coelho

2016-01-01

Full Text Available Objective. To review the literature on the impact of educational asthma interventions in schools regarding the knowledge and morbidity of the disease among children and adolescents. Methods. A systematic review was conducted for controlled clinical trials investigating the effectiveness of educational asthma interventions for students, asthmatic or nonasthmatic, families, and school staff. Databases were CENTRAL, PubMed, LILACS, MEDLINE, and SciELO. Articles published in any language were considered, in the period from 2005 to 2014, according to the PRISMA guidelines. Results. Seventeen articles were selected (N=5,879 subjects. 94% of the interventions (16 of 17 studies were applied in developed countries that were led by health professionals and most of them targeted asthmatics. Asthma education promotes the improvement of knowledge about the disease in at least one of the evaluated areas. 29% of the interventions (5 of 17 studies showed a reduction of the asthma symptoms, 35% (6 of 17 studies reduction of the hospitalization instances and emergency visits, 29% (5 of 17 studies reduction of school absenteeism, and 41% (7 of 17 studies increase in the quality of life of the individuals. Conclusions. Educational interventions in schools raise the awareness of asthma and weaken the impact of morbidity indicators.

Self-management program in treatment of asthma

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Milenković Branislava

2007-01-01

Full Text Available Introduction. Recently published national and international guidelines stress the importance of self-management in asthma. They have recommended that self-management plans should be an essential part of the long-term management of asthmatic patients. These plans essentially focus on the early recognition of unstable or deteoriorating asthma, by monitoring peak flow or symptoms. Objective. The aim of our one-year study was to compare the efficacy of peak-flow based self-management of asthma with traditional treatment. Method. Sixty clinically stable adult patients with mild and moderate persistent asthma were randomly allocated to peakflow based self-management (Group A, n=30 or to conventional treatment (Group B, n=30, with no significant difference between groups in terms of age, sex distribution and initial lung function. The recorded measurements were: lung function, asthma exacerbations, unscheduled ambulatory care facilities (hospital-based emergency department, consultations with general practitioner or pulmonologist, courses of oral prednisolone, courses of antibiotics, days off work. Results. There was a significant difference between groups in number of asthma exacerbations (p<0.05, unscheduled visits to ambulatory care facilities (p<0.005, days off work (p<0.0001, courses of oral prednisolone (p<0.001 and antibiotics (p<0.05. At the final visit, there was a significant improvement in some measurements of asthma severity in group A (reduced unscheduled visits for ambulatory care, reduced treatment requirements for oral corticosteroids and antibiotics, reduced days off work, but a lack of statistical difference in lung function and the maintenance-inhaled corticosteroid dose. There was no significant change in group B. Conclusion. These results suggest that peak-flow based self management is more effective than traditonal treatment in mild and moderate persistent asthma. .

Factors that influence quality of life in rural children with asthma and their parents.

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Walker, Jennifer; Winkelstein, Marilyn; Land, Cassia; Lewis-Boyer, Lapricia; Quartey, Ruth; Pham, Luu; Butz, Arlene

2008-01-01

Among rural children with asthma and their parents, this study examined the relationship between parental and child reports of quality of life and described the relationship of several factors such as asthma severity, missed days of work, and asthma education on their quality of life. Two hundred one rural families with asthma were enrolled in a school-based educational program. Intervention parents and children participated in interactive asthma workshop(s) and received asthma devices and literature. Parent and child quality of life measurements were obtained before and after the intervention using Juniper's Paediatric Caregivers Quality of Life and Juniper's Paediatric Quality of Life Questionnaires. Asthma severity was measured using criteria from the National Asthma Education and Prevention Program guidelines. There was no association between parent and child total quality of life scores, and mean parental total quality of life scores were higher at baseline and follow-up than those of the children. All the parents' quality of life scores were correlated with parental reports of missed days of work. For all children, emotional quality of life (EQOL) was significantly associated with parental reports of school days missed (P = .03) and marginally associated with parental reports of hospitalizations due to asthma (P = .08). Parent's EQOL and activity quality of life (AQOL) were significantly associated with children's asthma severity (EQOL, P = .009; AQOL, P = .03), but not the asthma educational intervention. None of the child quality of life measurements was associated with asthma severity. Asthma interventions for rural families should help families focus on gaining and maintaining low asthma severity levels to enjoy an optimal quality of life. Health care providers should try to assess the child's quality of life at each asthma care visit independently of the parents.

Internet-Based Asthma Education -- A Novel Approach to Compliance: A case Report

Directory of Open Access Journals (Sweden)

Cindy O'hara

2006-01-01

Full Text Available Asthma costs Canadians over $1.2 billion per annum and, despite advances, many asthmatic patients still have poor control. An action plan, symptom diary and measurement of peak expiratory flow have been shown to improve clinical outcomes. Effective educational interventions are an important component of good care. However, many rural sites lack not only access to education but physician care as well. It is reasonable, therefore, that an Internet-based asthma management program may be used as an approach. In the present case report, a novel approach that may increase access in these poorly serviced areas is presented. In an Internet-based asthma management program, patients are reviewed by a physician, receive education and are given a unique password that provides program access. Patients record symptoms and peak expiratory flow rates. The present case report shows that a patient can be assisted through an exacerbation, thus averting emergency intervention and stabilizing control, even when travelling on another continent.

The Effectiveness of a Brief Asthma Education Intervention for Child Care Providers and Primary School Teachers

Science.gov (United States)

Neuharth-Pritchett, Stacey; Getch, Yvette Q.

2016-01-01

Limited information exists about management of asthma in child care settings and primary school classrooms. The goal of this study was to evaluate a brief asthma management intervention for child care providers and primary school teachers. Child care providers and primary school teachers were recruited to participate in two 3-h workshops on asthma…

Risk Assessment and Community Participation Model for Environmental Asthma Management in an Elementary Public School: A Case Study in Puerto Rico

Directory of Open Access Journals (Sweden)

Alberto Rivera-Rentas

2006-03-01

% receive treatment for the disease. The study also showed that most asthmatic children are between 7 and 9 year old, and live in households with an annual income below $10,000. It also showed that 25 % of the student’s parents have the condition, and that 25% of the employees are also affected by this chronic condition. All these numbers are significantly higher than those reported by the CDC for Puerto Rico. The perception component had a response of 83% of school employees, and a 39% response from parents. It showed that people know asthma as a disease but many can’t identify most environmental asthma triggers. Pre and post tests of the workshop protocol showed that before the activity only 21% of participants can identify asthma triggers. At the end of the workshop nearly 80% were able to identify and manage environmental asthma triggers. This work validates the fact that Puerto Rico continues to have a significant number of people with asthma, particularly children asthma, and that schools are an important settings to create community based action plans to manage environmental asthma triggers through outreach and training.

School-based sleep education program improves sleep and academic performance of school-age children.

Science.gov (United States)

Gruber, Reut; Somerville, Gail; Bergmame, Lana; Fontil, Laura; Paquin, Soukaina

2016-05-01

The objective of this study was to develop and evaluate the effectiveness of a school-based sleep education program aimed at improving the sleep and academic performance of school-age children. Using a community-based participatory research approach, we created a school-based sleep education program, "Sleep for Success"™ (SFS), composed of four distinct modules that addressed the children, their family and community, the school staff, and decision makers within the school setting. Implementation was carried out in three elementary schools. Seventy-one students participated in the evaluation of the program. The effectiveness of the SFS program was evaluated using non-randomized controlled before-and-after study groups (intervention and control) assessed over two time points (pre- and post-program implementation). Before (baseline) and after implementation, sleep and academic performance were measured using actigraphy and report card marks, respectively. In the intervention group, true sleep was extended by 18.2 min per night, sleep efficiency improved by 2.3%, and sleep latency was shortened by 2.3 min, and report card grades in mathematics and English improved significantly. No changes were noted in the control group. Participation in the sleep education program was associated with significant improvements in children's sleep and academic performance. Copyright © 2016 Elsevier B.V. All rights reserved.

Children with asthma by school age display aberrant immune responses to pathogenic airway bacteria as infants

DEFF Research Database (Denmark)

Larsen, Jeppe Madura; Pedersen, Susanne Brix; Thysen, Anna Hammerich

2014-01-01

childhood asthma. We hypothesized that children with asthma have an abnormal immune response to pathogenic bacteria in infancy. ObjectiveWe aimed to assess the bacterial immune response in asymptomatic infants and the association with later development of asthma by age 7 years. MethodsThe Copenhagen...... was assessed based on the pattern of cytokines produced and T-cell activation. ResultsThe immune response to pathogenic bacteria was different in infants with asthma by 7 years of age (P = .0007). In particular, prospective asthmatic subjects had aberrant production of IL-5 (P = .008), IL-13 (P = .057), IL-17...... (P = .001), and IL-10 (P = .028), whereas there were no differences in T-cell activation or peripheral T-cell composition. ConclusionsChildren with asthma by school age exhibited an aberrant immune response to pathogenic bacteria in infancy. We propose that an abnormal immune response to pathogenic...

Perinatal programming of childhood asthma: early fetal size, growth trajectory during infancy, and childhood asthma outcomes.

Science.gov (United States)

Turner, Steve

2012-01-01

The "fetal origins hypothesis" or concept of "developmental programming" suggests that faltering fetal growth and subsequent catch-up growth are implicated in the aetiology of cardiovascular disease. Associations between reduced birth weight, rapid postnatal weight gain, and asthma suggest that there are fetal origins to respiratory disease. The present paper first summarises the literature relating birth weight and post natal growth trajectories to asthma outcomes. Second, issues regarding the interpretation of antenatal fetal ultrasound measurements are discussed. Finally, recent reports linking antenatal measurement and growth trajectory to early childhood asthma outcomes are discussed. Understanding the nature and timing of factors which influence antenatal growth may give important insight into the antecedents of early-onset asthma with implications for interventions.

The Effects of School-Based Maum Meditation Program on the Self-Esteem and School Adjustment in Primary School Students

Science.gov (United States)

Yoo, Yang Gyeong; Lee, In Soo

2013-01-01

Self-esteem and school adjustment of children in the lower grades of primary school, the beginning stage of school life, have a close relationship with development of personality, mental health and characters of children. Therefore, the present study aimed to verify the effect of school-based Maum Meditation program on children in the lower grades of primary school, as a personality education program. The result showed that the experimental group with application of Maum Meditation program had significant improvements in self-esteem and school adjustment, compared to the control group without the application. In conclusion, since the study provides significant evidence that the intervention of Maum Meditation program had positive effects on self-esteem and school adjustment of children in the early stage of primary school, it is suggested to actively employ Maum Meditation as a school-based meditation program for mental health promotion of children in the early school ages, the stage of formation of personalities and habits. PMID:23777717

Mode of Delivery and Asthma at School Age in 9 European Birth Cohorts

DEFF Research Database (Denmark)

Rusconi, Franca; Zugna, Daniela; Annesi-Maesano, Isabella

2017-01-01

Evidence on the association between mode of delivery and asthma at school age is inconclusive. We assessed the associations between specific modes of delivery and asthma in children from 9 European birth cohorts that enrolled participants between 1996 and 2006. Cohort-specific crude and adjusted ...

Community-based asthma care: trial of a "credit card" asthma self-management plan.

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D'Souza, W; Crane, J; Burgess, C; Te Karu, H; Fox, C; Harper, M; Robson, B; Howden-Chapman, P; Crossland, L; Woodman, K

1994-07-01

Although asthma self-management plans are widely recommended as essential in the long-term treatment of adult asthma, there have been few studies examining their use. Our objective was to assess the effect of a "credit card" adult asthma self-management plan in a community experiencing major health problems from asthma, by means of a before and after intervention trial of the efficacy of the "credit card" plan, when introduced through community-based asthma clinics. The participants were 69 Maori people with asthma. The "credit card" plan consisted of written guidelines for the self-management of asthma, based on self-assessment of asthma severity, printed on a plastic card. On one side, management guidelines were based on the interpretation of peak expiratory flow rate (PEFR) recordings, whilst the reverse side was based on symptoms. The outcome measures used were before and after comparison of markers of asthma morbidity and requirement for acute medical treatment; and a structured questionnaire assessing the acceptability and use of the credit card plan. Following the introduction of the plan, the mean PEFR increased from 347 to 389 l.min-1, the percentage of nights woken fell from 30.4 to 16.9%, and the number of days "out of action" fell from 3.8 to 1.7%. The requirements for acute medical treatment also fell during the intervention period. Most participants commented favourably on the content and usefulness of the plan. In the situation of worsening asthma, 28% of subjects found the peak flow side of the card most helpful, 7% the symptoms side, and 48% found both sides equally helpful.(ABSTRACT TRUNCATED AT 250 WORDS)

A systematic review of school-based suicide prevention programs.

Science.gov (United States)

Katz, Cara; Bolton, Shay-Lee; Katz, Laurence Y; Isaak, Corinne; Tilston-Jones, Toni; Sareen, Jitender

2013-10-01

Suicide is one of the leading causes of death among youth today. Schools are a cost-effective way to reach youth, yet there is no conclusive evidence regarding the most effective prevention strategy. We conducted a systematic review of the empirical literature on school-based suicide prevention programs. Studies were identified through MEDLINE and Scopus searches, using keywords such as "suicide, education, prevention and program evaluation." Additional studies were identified with a manual search of relevant reference lists. Individual studies were rated for level of evidence, and the programs were given a grade of recommendation. Five reviewers rated all studies independently and disagreements were resolved through discussion. Sixteen programs were identified. Few programs have been evaluated for their effectiveness in reducing suicide attempts. Most studies evaluated the programs' abilities to improve students' and school staffs' knowledge and attitudes toward suicide. Signs of Suicide and the Good Behavior Game were the only programs found to reduce suicide attempts. Several other programs were found to reduce suicidal ideation, improve general life skills, and change gatekeeper behaviors. There are few evidence-based, school-based suicide prevention programs, a combination of which may be effective. It would be useful to evaluate the effectiveness of general mental health promotion programs on the outcome of suicide. The grades assigned in this review are reflective of the available literature, demonstrating a lack of randomized controlled trials. Further evaluation of programs examining suicidal behavior outcomes in randomized controlled trials is warranted. © 2013 Wiley Periodicals, Inc.

Underrecognition and undertreatment of asthma in Cape Town ...

African Journals Online (AJOL)

Background. In view of the high local prevalence of asthma, the extent of recognition and appropriate managementof childhood asthma was studied in a large suburban area of Cape Town. Design. Cross-sectional study based on random community sample of schools. Method. 1955 parents of sub B pupils from 16 schools ...

A cross-sectional questionnaire study of the rules governing pupils' carriage of inhalers for asthma treatment in secondary schools in North East England.

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Funston, Wendy; Howard, Simon J

2016-01-01

Objectives. The primary objective of this study was to assess the rules governing secondary school pupils' carriage of inhalers for emergency treatment of asthma in the North East of England. Design. This study was based upon a postal questionnaire survey. Setting. The setting for this study was mainstream free-to-attend secondary schools which admit 16 year old pupils within the 12 Local Authority areas which make up the North East of England. Participants. All 153 schools meeting the inclusion criteria were invited to participate in the study, of which 106 (69%) took part. Main Outcome Measures. Our three main outcome measures were: whether pupils are permitted to carry inhalers on their person while at school; whether advance permission is required for pupils to carry inhalers, and from whom; and whether the school has an emergency 'standby' salbutamol inhaler for use in asthma emergencies, as permitted since October 2014 under recent amendments to The Human Medicines Regulations 2012. Results. Of 98 schools submitting valid responses to the question, 99% (n = 97) permitted pupils to carry inhalers on their person while at school; the remaining school stored pupils' inhalers in a central location within the school. A total of 22% of included schools (n = 22) required parental permission before pupils were permitted to carry inhalers. Of 102 schools submitting valid responses to the question, 44% (n = 45) had purchased a 'standby' salbutamol inhaler for use in asthma emergencies. Conclusions. Most secondary schools in North East England permit pupils to carry inhalers on their person. The requirement in a minority of schools for parental permission to be given possibly contravenes the standard ethical practices in clinical medicine for children of this age. Only a minority of schools hold a 'standby' salbutamol inhaler for use in asthma emergencies. Wider availability may improve outcomes for asthma emergencies occurring in schools.

Know How to Use Your Asthma Inhaler

Medline Plus

Full Text Available ... Providers CDC Publications on Asthma National Asthma Control Program America Breathing Easier Guide for State Programs Interventions Community Guide—Evidence-based Potentially Effective Interventions ...

Promoting healthy computer use among middle school students: a pilot school-based health promotion program.

Science.gov (United States)

Ciccarelli, Marina; Portsmouth, Linda; Harris, Courtenay; Jacobs, Karen

2012-01-01

Introduction of notebook computers in many schools has become integral to learning. This has increased students' screen-based exposure and the potential risks to physical and visual health. Unhealthy computing behaviours include frequent and long durations of exposure; awkward postures due to inappropriate furniture and workstation layout, and ignoring computer-related discomfort. Describe the framework for a planned school-based health promotion program to encourage healthy computing behaviours among middle school students. This planned program uses a community- based participatory research approach. Students in Year 7 in 2011 at a co-educational middle school, their parents, and teachers have been recruited. Baseline data was collected on students' knowledge of computer ergonomics, current notebook exposure, and attitudes towards healthy computing behaviours; and teachers' and self-perceived competence to promote healthy notebook use among students, and what education they wanted. The health promotion program is being developed by an inter-professional team in collaboration with students, teachers and parents to embed concepts of ergonomics education in relevant school activities and school culture. End of year changes in reported and observed student computing behaviours will be used to determine the effectiveness of the program. Building a body of evidence regarding physical health benefits to students from this school-based ergonomics program can guide policy development on the healthy use of computers within children's educational environments.

Factors associated with medication adherence in school-aged children with asthma

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Amy H.Y. Chan

2016-03-01

Full Text Available Adherence to preventive asthma treatment is poor, particularly in children, yet the factors associated with adherence in this age group are not well understood. Adherence was monitored electronically over 6 months in school-aged children who attended a regional emergency department in New Zealand for an asthma exacerbation and were prescribed twice-daily inhaled corticosteroids. Participants completed questionnaires including assessment of family demographics, asthma responsibility and learning style. Multivariable analysis of factors associated with adherence was conducted. 101 children (mean (range age 8.9 (6–15 years, 51% male participated. Median (interquartile range preventer adherence was 30% (17–48% of prescribed. Four explanatory factors were identified: female sex (+12% adherence, Asian ethnicity (+19% adherence, living in a smaller household (−3.0% adherence per person in the household, and younger age at diagnosis (+2.7% for every younger year of diagnosis (all p<0.02. In school-aged children attending the emergency department for asthma, males and non-Asian ethnic groups were at high risk for poor inhaled corticosteroid adherence and may benefit most from intervention. Four factors explained a small proportion of adherence behaviour indicating the difficulty in identifying adherence barriers. Further research is recommended in other similar populations.

[Effect of school-based peer leader centered smoking prevention program].

Science.gov (United States)

Shin, Sung Rae; Oh, Pok Ja; Youn, Hye Kyung; Shin, Sun Hwa

2014-12-01

The purpose of this study was to develop and evaluate a school-based peer leader centered smoking prevention program. Non-equivalent control group with a pre/post-test design was used. Students (n=174) in two boys' junior high schools located in D city, Korea participated with 85 being selected for the experimental group and 89 for the control group. Five sessions were given to the experimental group and a 50 minute lecture to the control group. Knowledge, attitude, non-smoking intention, and non-smoking efficacy were measured for the both experimental and control group at two weeks before the program and one month after the program was completed. Data were analyzed using χ²-test, Fisher's exact test, independent t-test and paired t-test with the SPSS 21.0 program. The experimental group showed higher overall knowledge, negative attitude toward smoking, and higher non-smoking intention and efficacy. After receiving the school based peer leader centered smoking prevention program scores for attitude toward smoking and non-smoking efficacy increased in the experimental group were higher than in the control group. The school-based peer leader centered smoking prevention program needs longitudinal evaluation, but from this study, there is an indication that this program can be used with junior high school students and effectively change students' attitude toward smoking and promote non-smoking efficacy.

ERICA: prevalence of asthma in Brazilian adolescents

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Fábio Chigres Kuschnir

2016-02-01

Full Text Available ABSTRACT OBJECTIVE To describe the prevalence of asthma and physician-diagnosed asthma in Brazilian adolescents. METHODS Cross-sectional, national, school-based study with adolescents from 12 to 17 years old, participants in the Study of Cardiovascular Risks in Adolescents (ERICA. The study stratified the sample by region and grouped according to schools and classes with representativeness to the set of cities with more than 100,000 inhabitants of the Country, macro-regions, capitals, and Federal District. A questionnaire collected data through a self-filled in method. We calculated the prevalences and their confidence intervals of 95% (95%CI according to sex, age group, type of school and skin color. RESULTS Between 2013 and 2014, 74,589 adolescents were evaluated, 55.3% of the female sex. The total prevalence of active asthma was of 13.1% (95%CI 12.1-13.9, being higher in girls (14.8%; 95%CI 13.7-16.0 when compared to boys (11.2%; 95%CI 10.3-12.2 in all geographical strata examined. It was also higher between students of private schools (15.9%; 95%CI 14.2-17.7 when compared to public ones (12.4%; 95%CI 11.4-13.4. It was higher in the Southeast region (14.5%; 95%CI 12.9-16.1, and in the city of Sao Paulo (16.7%; 95%CI 14.7-18.7. The lowest prevalence was observed in North region (9.7%; 95%CI 9.7-10.5, and in Teresina (6.3%; 95%CI 4.9-7.7. The prevalence of physician-diagnosed asthma was of 8.7% (95%CI 8.2-9.1; higher in the North region (13.5%; 95%CI 12.7-14.2, and in Porto Alegre (19.8%; 95%CI 17.5-22.3. It was lower in the Midwest (6.9%; 95%CI 6.0-7.8, and in Cuiaba (4.8%; 95%CI 3.8-5.9. We found no significant difference in the expression of this rate between the sexes, as well as in other variables evaluated by the study. CONCLUSIONS The prevalence of asthma in Brazilian adolescents is high. Rates of active asthma and physician-diagnosed asthma vary widely in different regions and capitals evaluated by the ERICA. These results may assist in

ERICA: prevalence of asthma in Brazilian adolescents

Science.gov (United States)

Kuschnir, Fábio Chigres; Gurgel, Ricardo Queiroz; Solé, Dirceu; Costa, Eduardo; Felix, Mara Morelo Rocha; de Oliveira, Cecília Lacroix; de Vasconcellos, Maurício Teixeira Leite; Kuschnir, Maria Cristina Caetano

2016-01-01

ABSTRACT OBJECTIVE To describe the prevalence of asthma and physician-diagnosed asthma in Brazilian adolescents. METHODS Cross-sectional, national, school-based study with adolescents from 12 to 17 years old, participants in the Study of Cardiovascular Risks in Adolescents (ERICA). The study stratified the sample by region and grouped according to schools and classes with representativeness to the set of cities with more than 100,000 inhabitants of the Country, macro-regions, capitals, and Federal District. A questionnaire collected data through a self-filled in method. We calculated the prevalences and their confidence intervals of 95% (95%CI) according to sex, age group, type of school and skin color. RESULTS Between 2013 and 2014, 74,589 adolescents were evaluated, 55.3% of the female sex. The total prevalence of active asthma was of 13.1% (95%CI 12.1-13.9), being higher in girls (14.8%; 95%CI 13.7-16.0) when compared to boys (11.2%; 95%CI 10.3-12.2) in all geographical strata examined. It was also higher between students of private schools (15.9%; 95%CI 14.2-17.7) when compared to public ones (12.4%; 95%CI 11.4-13.4). It was higher in the Southeast region (14.5%; 95%CI 12.9-16.1), and in the city of Sao Paulo (16.7%; 95%CI 14.7-18.7). The lowest prevalence was observed in North region (9.7%; 95%CI 9.7-10.5), and in Teresina (6.3%; 95%CI 4.9-7.7). The prevalence of physician-diagnosed asthma was of 8.7% (95%CI 8.2-9.1); higher in the North region (13.5%; 95%CI 12.7-14.2), and in Porto Alegre (19.8%; 95%CI 17.5-22.3). It was lower in the Midwest (6.9%; 95%CI 6.0-7.8), and in Cuiaba (4.8%; 95%CI 3.8-5.9). We found no significant difference in the expression of this rate between the sexes, as well as in other variables evaluated by the study. CONCLUSIONS The prevalence of asthma in Brazilian adolescents is high. Rates of active asthma and physician-diagnosed asthma vary widely in different regions and capitals evaluated by the ERICA. These results may assist in the

Prescription of respiratory medication without an asthma diagnosis in children: a population based study.

NARCIS (Netherlands)

Zuidgeest, M.G.P.; Dijk, L. van; Smit, H.A.; Wouden, J.C. van der; Brunekreef, B.; Leufkens, H.G.M.; Bracke, M.

2008-01-01

BACKGROUND: In pre-school children a diagnosis of asthma is not easily made and only a minority of wheezing children will develop persistent atopic asthma. According to the general consensus a diagnosis of asthma becomes more certain with increasing age. Therefore the congruence between asthma

Evaluation of a standardized patient education program for inpatient asthma rehabilitation: Impact on patient-reported health outcomes up to one year.

Science.gov (United States)

Bäuerle, Kathrin; Feicke, Janine; Scherer, Wolfgang; Spörhase, Ulrike; Bitzer, Eva-Maria

2017-05-01

To modify and evaluate a patient education program for adult asthma patients in consideration of quality criteria for teaching. This was a prospective single-center controlled trial in an inpatient rehabilitation center. The control group (n=215) received the usual lecture-based education program, and the intervention group (n=209) the modified patient education program. Data were assessed at admission, discharge, 6 and 12 months post discharge. The primary outcome was asthma control, the secondary outcomes were asthma knowledge, quality of life, and program acceptance. Analysis of change was performed by ANCOVA for each follow-up, adjusting for baseline values. Statistically significant increases in all health outcomes and in asthma control were maintained in both groups at 12 months: CG: +1.9 (95%-CI 1.3-2.6) IG: +1.6 (95%-CI 0.8-2.3). We observed no significant differences between the programs for asthma control and quality of life. Regarding practical asthma knowledge, after 12 months, a group*time interaction emerged with a small effect size (P=0.06, η2=0.01). The modified program was not superior to traditional patient education concerning asthma control. It permanently increased self-management knowledge. Structured and behavioral patient education fosters patient's disease management ability. Possible ways of improving asthma control need to be explored. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Application of the asthma phenotype algorithm from the Severe Asthma Research Program to an urban population.

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Paru Patrawalla

Full Text Available Identification and characterization of asthma phenotypes are challenging due to disease complexity and heterogeneity. The Severe Asthma Research Program (SARP used unsupervised cluster analysis to define 5 phenotypically distinct asthma clusters that they replicated using 3 variables in a simplified algorithm. We evaluated whether this simplified SARP algorithm could be used in a separate and diverse urban asthma population to recreate these 5 phenotypic clusters.The SARP simplified algorithm was applied to adults with asthma recruited to the New York University/Bellevue Asthma Registry (NYUBAR to classify patients into five groups. The clinical phenotypes were summarized and compared.Asthma subjects in NYUBAR (n = 471 were predominantly women (70% and Hispanic (57%, which were demographically different from the SARP population. The clinical phenotypes of the five groups generated by the simplified SARP algorithm were distinct across groups and distributed similarly to those described for the SARP population. Groups 1 and 2 (6 and 63%, respectively had predominantly childhood onset atopic asthma. Groups 4 and 5 (20% were older, with the longest duration of asthma, increased symptoms and exacerbations. Group 4 subjects were the most atopic and had the highest peripheral eosinophils. Group 3 (10% had the least atopy, but included older obese women with adult-onset asthma, and increased exacerbations.Application of the simplified SARP algorithm to the NYUBAR yielded groups that were phenotypically distinct and useful to characterize disease heterogeneity. Differences across NYUBAR groups support phenotypic variation and support the use of the simplified SARP algorithm for classification of asthma phenotypes in future prospective studies to investigate treatment and outcome differences between these distinct groups.Clinicaltrials.gov NCT00212537.

Risk Factors in Preschool Children for Predicting Asthma During the Preschool Age and the Early School Age: a Systematic Review and Meta-Analysis.

Science.gov (United States)

Bao, Yixia; Chen, Zhimin; Liu, Enmei; Xiang, Li; Zhao, Deyu; Hong, Jianguo

2017-11-18

The aim of this study was to identify risk factors of asthma among children asthma during the preschool age and early school age (≤ 10 years of age). MEDLINE, Cochrane, EMBASE, and Google Scholar databases were searched until June 30, 2017. Prospective or retrospective cohort and case-control studies were included. Studies had to have evaluated risk factors or a predictive model for developing asthma in children ≤ 6 years of age or persistent asthma in early school age. A total of 17 studies were included in the analysis. Factors associated with developing asthma in children ≤ 10 years of age (both pre-school and early school age) included male gender (pooled OR = 1.70, P asthma (pooled OR = 2.20, P asthma in early school age (pooled OR = 1.51, P = 0.030 and pooled OR = 2.59, P asthma predictive models (e.g., API, PIAMA, PAPS) had relatively low sensitivity (range, 21% to 71.4%) but high specificity (range, 69% to 98%). The study found that male gender, exposure to smoke, atopic dermatitis, family history of asthma, history of wheezing, and serum IgE level ≥ 60 kU/l or having specific IgE were significantly associated with developing asthma by either preschool or early school age. Asthma predictive models can be developed by those risk factors.

Adolescents’ Responses to a School-Based Prevention Program Promoting Healthy Eating at School

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Roel C. J. Hermans

2017-11-01

Full Text Available BackgroundTo improve the effectiveness of school-based programs that aim to promote adolescents’ healthy food choices, it is essential to understand the views and behaviors of the target group. This study aimed to get a better understanding of adolescents’ food and health perceptions and their willingness to be involved in a specific school-based prevention program, i.e., the Dutch “Healthy School Canteen Program.”MethodsThis study used a mixed-methods research design. First, seven semi-structured focus groups were conducted using a selective sample of 42 Dutch adolescents (25 girls, 17 boys, aged 13–16 years. Second, an online survey among 133 adolescent respondents (72 girls, 61 boys, aged 12–19 years using snowball sampling was conducted. Content analysis was performed to make inferences about the focus group discussions, whereas statistical analyses were conducted to analyze the survey data.ResultsFindings from the group discussions indicated that healthy eating was only an issue of importance when adolescents perceived negative physical changes (e.g., with regard to looks or physical performance. Adolescents also indicated that they clearly wanted to make their own food and beverage choices at school. The quantitative data indicated that taste, price, and variety were seen as the most important aspects of a healthy food assortment (mean scores 8.1, 7.8, and 7.7 on a 10-point scale, respectively. In general, a majority of the adolescents (64% expressed that students should be involved in the organization of a healthy food environment in schools. At the same time, however, adolescents were not willing to participate themselves. This was mostly because they were skeptical about their ideas being heard and put into action by their schools.ConclusionSchool-based prevention programs, such as the Healthy School Program, should take into account that adolescents have a low risk perception of unhealthy eating and are seeking food

Parental coping, depressive symptoms, and children's asthma control and school attendance in low-income, racially, and ethnically diverse urban families.

Science.gov (United States)

Rodríguez, Erin M; Kumar, Harsha; Alba-Suarez, Juliana; Sánchez-Johnsen, Lisa

2017-10-01

Low-income urban children of color are at elevated risk for poor asthma control. This cross-sectional study examined associations among parents' coping (primary control, secondary control, and disengagement), parental depressive symptoms, and children's asthma outcomes (asthma control and school attendance) in a predominantly low-income, racially/ethnically diverse sample of families. Parents (N = 78; 90% female) of children (33% female; 46% Black; 38% Latino) aged 5-17 years (M = 9.5 years) reported on their own coping and depressive symptoms, their child's asthma control, and full and partial days of school missed due to asthma. Parents' secondary control coping (i.e., coping efforts to accommodate/adapt to asthma-related stressors) was negatively correlated, and disengagement coping (i.e. coping efforts to avoid/detach from stressors) was positively correlated, with their depressive symptoms. Secondary control coping was also correlated with fewer partial days of school missed. Primary control coping (i.e., coping efforts to change stressors) was not associated with depressive symptoms or asthma outcomes. Parents' depressive symptoms were also positively correlated with poorer asthma control and partial days of school missed. Regression models showed direct and indirect effects of secondary control and disengagement coping on asthma outcomes via depressive symptoms, after controlling for demographic factors. Parents' secondary control and disengagement coping are related to children's asthma outcomes. Secondary control coping may support parents' mental health and children's asthma control in low-income urban families.

Enrolment in an Asthma Management Program during Pregnancy and Adherence with Inhaled Corticosteroids

DEFF Research Database (Denmark)

Baarnes, Camilla Boslev; Hansen, A V; Ulrik, Charlotte Suppli

2016-01-01

BACKGROUND: Poor adherence with inhaled corticosteroids (ICS) is a major problem in asthma and according to previous studies not least during pregnancy. OBJECTIVE: Our aim was to assess if enrolment in an asthma management program, and by that close monitoring, can improve self-reported and docum......BACKGROUND: Poor adherence with inhaled corticosteroids (ICS) is a major problem in asthma and according to previous studies not least during pregnancy. OBJECTIVE: Our aim was to assess if enrolment in an asthma management program, and by that close monitoring, can improve self......-reported and documented adherence with ICS in pregnant women with asthma. METHODS: Pregnant women with doctor-diagnosed asthma, currently being prescribed ICS, referred during a 12-month period to the outpatient respiratory clinic, were consecutively included in the study. They had follow-up visits every 4 weeks during...

Enhancing Pediatric Asthma Care and Nursing Education Through an Academic Practice Partnership.

Science.gov (United States)

McClure, Natasha; Lutenbacher, Melanie; O'Kelley, Ellen; Dietrich, Mary S

Home environmental assessments and interventions delivered via academic practice partnerships (APP) between clinics and schools of nursing may be a low or no cost delivery model of pediatric asthma care and professional education. Patients receive enhanced clinical resources that can improve self-management and healthcare utilization. Additionally, students can practice chronic disease management skills in actual patient encounters. To describe outcomes of the implementation of an APP between a school of nursing and a pediatric asthma specialty clinic (PASC) to deliver a home visit program (HVP). The HVP was designed to reduce emergency department visits and asthma related hospitalizations in PASC patients and provide clinical experiences for nursing students. PASC referred patients to the HVP based on their level of asthma control. Students provided an individualized number of home visits to 17 participants over a nine month period. A 12-month pre- and post-HVP comparison of emergency department visits and asthma related hospitalizations was conducted. Additional information was gathered from stakeholders via an online survey, and interviews with APP partners and HVP families. Children had fewer asthma related hospitalizations post HVP. Findings suggest a reduction in exposure to environmental triggers, improved patient and family management of asthma, and increased PASC knowledge of asthma triggers in the home and increased student knowledge and skills related to asthma management. Multiple clinical and educational benefits may be realized through the development of APPs as an infrastructure supporting targeted interventions in home visits to pediatric asthma patients and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

School-based smoking prevention programs with the promise of long-term effects

Directory of Open Access Journals (Sweden)

Flay Brian R

2009-03-01

Full Text Available Abstract I provide a systematic review of trials of school-based smoking prevention programs that had at least 15 sessions, preferably with some in high school, that reported significant short-term effects, and that included long-term follow-up. This is supplemented with a description of some other programs that produce short-term effects that portend large long-term effects. I conclude that school-based programs can have long-term effects of practical importance it they: include 15 or more sessions over multiple years, including some in high school; use the social influence model and interactive delivery methods; include components on norms, commitment not to use, intentions not to use, and training and practice in the use of refusal and other life skills; and use peer leaders in some role. School-based programs of this type can reduce smoking onset by 25–30%, and school plus community programs can reduce smoking onset by 35–40% by the end of high school. Some early childhood programs that do not have smoking prevention as their main aim, including home nursing, the Good Behavior Game, the Positive Action program and others, seem to change the developmental trajectories of children so that they are less likely to engage in multiple problem behaviors, including smoking, as adolescents. This review makes it clear that effective school-based smoking prevention programs exist and can be adopted, adapted and deployed with success – and should be.

Prevalence of asthma among school children in Gaborone, Botswana.

African Journals Online (AJOL)

Data was collected using the validated International study of Asthma and Allergies in .... lowed up by phone or visited at home. Asthma case was defined based on the ISAAC criteria of wheezing in the ... the erroneous data entry record to reflect the participant .... work has shown difference in asthma prevalence within.

Optimizing community-level surveillance data for pediatric asthma management

Directory of Open Access Journals (Sweden)

Wande O. Benka-Coker

2018-06-01

Full Text Available Community-level approaches for pediatric asthma management rely on locally collected information derived primarily from two sources: claims records and school-based surveys. We combined claims and school-based surveillance data, and examined the asthma-related risk patterns among adolescent students.Symptom data collected from school-based asthma surveys conducted in Oakland, CA were used for case identification and determination of severity levels for students (high and low. Survey data were matched to Medicaid claims data for all asthma-related health care encounters for the year prior to the survey. We then employed recursive partitioning to develop classification trees that identified patterns of demographics and healthcare utilization associated with severity.A total of 561 students had complete matched data; 86.1% were classified as high-severity, and 13.9% as low-severity asthma. The classification tree consisted of eight subsets: three indicating high severity and five indicating low severity. The risk subsets highlighted varying combinations of non-specific demographic and socioeconomic predictors of asthma prevalence, morbidity and severity. For example, the subset with the highest class-prior probability (92.1% predicted high-severity asthma and consisted of students without prescribed rescue medication, but with at least one in-clinic nebulizer treatment. The predictive accuracy of the tree-based model was approximately 66.7%, with an estimated 91.1% of high-severity cases and 42.3% of low-severity cases correctly predicted.Our analysis draws on the strengths of two complementary datasets to provide community-level information on children with asthma, and demonstrates the utility of recursive partitioning methods to explore a combination of features that convey asthma severity. Keywords: Asthma, Classification, Risk stratification, Statistical data analysis, Disease management

Do Allergies Cause Asthma?

Science.gov (United States)

... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... Can I Deal With My Asthma? Allergy Testing Definition: Allergy-Triggered Asthma Asthma Center Asthma View more ...

The Role of School and Community-Based Programs in Aiding Latina/o High School Persistence

Science.gov (United States)

Harris, Donna M.; Kiyama, Judy Marquez

2015-01-01

This study documents the important role school and community-based programs have for sustaining the persistence of Latina/o high school students in an urban, low achieving school district. Consensus among student participants revealed these programs provided a safe space where students were able to develop "confianza" (mutual trust) with…

School-Based First Aid Training Programs: A Systematic Review.

Science.gov (United States)

Reveruzzi, Bianca; Buckley, Lisa; Sheehan, Mary

2016-04-01

This review examines the breadth of first aid training delivered to school students and the components that are age appropriate to adolescents. Eligible studies included school-based first aid interventions targeting students aged between 10 and 18 years. Online databases were searched, for peer-reviewed publications available as at August 2014. A total of 20 journal articles were relevant to the review. Research supported programs with longer durations (3 hours or more). Most programs taught resuscitation alone and few included content that was context-specific and relevant to the target group. The training experience of the facilitator did not appear to impact on student outcomes. Incorporating both practical and didactic components was found to be an important factor in delivering material and facilitating the retention of knowledge. Educational resources and facilitator training were found to be common features of effective programs. The review supports first aid in school curriculum and provides details of key components pertinent to design of school-based first aid programs. The findings suggest that first aid training may have benefits wider than the uptake and retention of knowledge and skills. There is a need for future research, particularly randomized controlled trials to aid in identifying best practice approaches. © 2016, American School Health Association.

A cross-sectional questionnaire study of the rules governing pupils’ carriage of inhalers for asthma treatment in secondary schools in North East England

Directory of Open Access Journals (Sweden)

Wendy Funston

2016-05-01

Full Text Available Objectives. The primary objective of this study was to assess the rules governing secondary school pupils’ carriage of inhalers for emergency treatment of asthma in the North East of England. Design. This study was based upon a postal questionnaire survey. Setting. The setting for this study was mainstream free-to-attend secondary schools which admit 16 year old pupils within the 12 Local Authority areas which make up the North East of England. Participants. All 153 schools meeting the inclusion criteria were invited to participate in the study, of which 106 (69% took part. Main Outcome Measures. Our three main outcome measures were: whether pupils are permitted to carry inhalers on their person while at school; whether advance permission is required for pupils to carry inhalers, and from whom; and whether the school has an emergency ‘standby’ salbutamol inhaler for use in asthma emergencies, as permitted since October 2014 under recent amendments to The Human Medicines Regulations 2012. Results. Of 98 schools submitting valid responses to the question, 99% (n = 97 permitted pupils to carry inhalers on their person while at school; the remaining school stored pupils’ inhalers in a central location within the school. A total of 22% of included schools (n = 22 required parental permission before pupils were permitted to carry inhalers. Of 102 schools submitting valid responses to the question, 44% (n = 45 had purchased a ‘standby’ salbutamol inhaler for use in asthma emergencies. Conclusions. Most secondary schools in North East England permit pupils to carry inhalers on their person. The requirement in a minority of schools for parental permission to be given possibly contravenes the standard ethical practices in clinical medicine for children of this age. Only a minority of schools hold a ‘standby’ salbutamol inhaler for use in asthma emergencies. Wider availability may improve outcomes for asthma emergencies occurring in schools.

School-based Yoga Programs in the United States: A Survey.

Science.gov (United States)

Butzer, Bethany; Ebert, Marina; Telles, Shirley; Khalsa, Sat Bir S

2015-01-01

Substantial interest has begun to emerge around the implementation of yoga interventions in schools. Researchers have found that yoga practices may enhance skills such as self-regulation and prosocial behavior, and lead to improvements in students' performance. These researchers, therefore, have proposed that contemplative practices have the potential to play a crucial role in enhancing the quality of US public education. The purpose of the present study was to provide a summary and comparison of school-based yoga programs in the United States. Online, listserv, and database searches were conducted to identify programs, and information was collected regarding each program's scope of work, curriculum characteristics, teacher-certification and training requirements, implementation models, modes of operation, and geographical regions. The online, listserv, and database searches took place in Boston, MA, USA, and New Haven, CT, USA. Thirty-six programs were identified that offer yoga in more than 940 schools across the United States, and more than 5400 instructors have been trained by these programs to offer yoga in educational settings. Despite some variability in the exact mode of implementation, training requirements, locations served, and grades covered, the majority of the programs share a common goal of teaching 4 basic elements of yoga: (1) physical postures, (2) breathing exercises, (3) relaxation techniques, and (4) mindfulness and meditation practices. The programs also teach a variety of additional educational, social-emotional, and didactic techniques to enhance students' mental and physical health and behavior. The fact that the present study was able to find a relatively large number of formal, school-based yoga programs currently being implemented in the United States suggests that the programs may be acceptable and feasible to implement. The results also suggest that the popularity of school-based yoga programs may continue to grow.

Exploration of the Influence of Factors Identified in the Literature on School-aged Children's Emotional Responses to Asthma.

Science.gov (United States)

Walker, Verónica García

Approximately 6.3 million US children suffer from asthma. The purpose of this study was to explore factors on school-aged children's emotional responses to asthma, N=85, ages 6-12. Correlations included Asthma related child emotional functioning QOL and (a) asthma severity, r=-0.30, pchild internalizing behaviors, r=-0.26, pchild externalizing behaviors r=-0.43, pasthma severity, r=-0.39, pchild internalizing behaviors, r=-0.22, pchild externalizing behaviors, r=-0.25; pasthma severity and child externalizing problems accounted for 26% of the variance in asthma related child emotional functioning QOL, F (4, 79)=7.051, pasthma severity, β=-0.31, pchild externalizing problem behaviors, β=-0.43, pasthma research should consider problem behaviors of school-aged children when addressing asthma related emotional functioning QOL. Copyright © 2016 Elsevier Inc. All rights reserved.

Prevalence of asthma among the adult general population of five Middle Eastern countries: results of the SNAPSHOT program.

Science.gov (United States)

Tarraf, Hesham; Aydin, Omur; Mungan, Dilsad; Albader, Mohammad; Mahboub, Bassam; Doble, Adam; Lahlou, Aaicha; Tariq, Luqman; Aziz, Fayaz; El Hasnaoui, Abdelkader

2018-05-11

Asthma is a common chronic respiratory disease leading to morbidity, mortality and impaired quality of life worldwide. Information on asthma prevalence in the Middle East is fragmented and relatively out-dated. The SNAPSHOT program was conducted to obtain updated information. SNAPSHOT is a cross-sectional epidemiological program carried out in five Middle Eastern countries (Egypt, Turkey, Kuwait, Saudi Arabia, and the United Arab Emirates, the latter three grouped into a Gulf cluster) to collect data on asthma, allergic rhinitis, benign prostatic hyperplasia and bipolar disorder. The survey was carried out by telephone in a random sample of the adult general population with quotas defined according to country demographics. The analysis presented in this paper focuses on asthma. Subjects were screened for asthma based on criteria from the global Asthma Insights and Reality studies. Current prevalence (last 12 months) was estimated. Multivariate logistic regression analyses were used to investigate risk factors related to asthma and the association with allergic rhinitis and other co-morbidities. Quality of life was assessed using the three-level EQ-5D questionnaire. 2124 out of the 33,486 subjects enrolled in the SNAPSHOT program fulfilled the criteria for asthma. The adjusted prevalence of asthma ranged from 4.4% [95% CI: 4.0-4.8%] in Turkey, to 6.7% [95% CI: 6.2-7.2%] in Egypt and 7.6% [95% CI: 7.1-8.0%] in the Gulf cluster. Prevalence was higher (p Middle East ranges from 4.4% to 7.6%, which is comparatively lower than the reported prevalence in Europe and North America. Asthma has a negative impact on quality of life, and is associated with high levels of co-morbid diseases, indicating a need for physicians to check for co-morbidities and ensure they are managed correctly in all asthma patients.

Towards Excellence in Asthma Management: final report of an eight-year program aimed at reducing care gaps in asthma management in Quebec.

Science.gov (United States)

Boulet, Louis-Philippe; Dorval, E; Labrecque, M; Turgeon, M; Montague, T; Thivierge, R L

2008-09-01

Asthma care in Canada and around the world persistently falls short of optimal treatment. To optimize care, a systematic approach to identifying such shortfalls or 'care gaps', in which all stakeholders of the health care system (including patients) are involved, was proposed. Several projects of a multipartner, multidisciplinary disease management program, developed to optimize asthma care in Quebec, was conducted in a period of eight years. First, two population maps were produced to identify regional variations in asthma-related morbidity and to prioritize interventions for improving treatment. Second, current care was evaluated in a physician-patient cohort, confirming the many care gaps in asthma management. Third, two series of peer-reviewed outcome studies, targeting high-risk populations and specific asthma care gaps, were conducted. Finally, a process to integrate the best interventions into the health care system and an agenda for further research on optimal asthma management were proposed. Key observations from these studies included the identification of specific patterns of noncompliance in using inhaled corticosteroids, the failure of increased access to spirometry in asthma education centres to increase the number of education referrals, the transient improvement in educational abilities of nurses involved with an asthma hotline telephone service, and the beneficial effects of practice tools aimed at facilitating the assessment of asthma control and treatment needs by general practitioners. Disease management programs such as Towards Excellence in Asthma Management can provide valuable information on optimal strategies for improving treatment of asthma and other chronic diseases by identifying care gaps, improving guidelines implementation and optimizing care.

Children with asthma by school age display aberrant immune responses to pathogenic airway bacteria as infants.

Science.gov (United States)

Larsen, Jeppe Madura; Brix, Susanne; Thysen, Anna Hammerich; Birch, Sune; Rasmussen, Morten Arendt; Bisgaard, Hans

2014-04-01

Asthma is a highly prevalent chronic lung disease that commonly originates in early childhood. Colonization of neonatal airways with the pathogenic bacterial strains Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae is associated with increased risk of later childhood asthma. We hypothesized that children with asthma have an abnormal immune response to pathogenic bacteria in infancy. We aimed to assess the bacterial immune response in asymptomatic infants and the association with later development of asthma by age 7 years. The Copenhagen Prospective Studies on Asthma in Childhood birth cohort was followed prospectively, and asthma was diagnosed at age 7 years. The immune response to H influenzae, M catarrhalis, and S pneumoniae was analyzed in 292 infants using PBMCs isolated and stored since the age of 6 months. The immune response was assessed based on the pattern of cytokines produced and T-cell activation. The immune response to pathogenic bacteria was different in infants with asthma by 7 years of age (P = .0007). In particular, prospective asthmatic subjects had aberrant production of IL-5 (P = .008), IL-13 (P = .057), IL-17 (P = .001), and IL-10 (P = .028), whereas there were no differences in T-cell activation or peripheral T-cell composition. Children with asthma by school age exhibited an aberrant immune response to pathogenic bacteria in infancy. We propose that an abnormal immune response to pathogenic bacteria colonizing the airways in early life might lead to chronic airway inflammation and childhood asthma. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Bisphenol A exposure and asthma development in school-age children: a longitudinal study.

Directory of Open Access Journals (Sweden)

Kyoung-Nam Kim

Full Text Available Although the effect of bisphenol A on various health outcomes has been extensively examined, few studies have investigated its effect on asthma.We hypothesized that exposure to bisphenol A in school-age children was associated with wheezing and asthma.Participants included 127 children aged 7-8 years without a previous asthma diagnosis in an elementary school in Seoul, Korea. Three surveys were conducted, each 2 years apart. Bisphenol A concentration was measured at the baseline survey, and PC20, which is defined as the methacholine concentration that induces a decrease in FEV1 of 20% from baseline, was measured at every survey. Associations between bisphenol A concentration at 7-8 years of age and wheezing, asthma, and PC20 at ages up to 11-12 years were examined using generalized estimating equations, a marginal Cox regression model, and a linear mixed model.The log-transformed creatinine-adjusted urinary bisphenol A concentration at 7-8 years was positively associated with wheezing (odds ratio, 2.48; 95% confidence interval, 1.15-5.31; P = .02 and asthma (hazard ratio, 2.13; 95% confidence interval, 1.51-3.00; P<.001 at ages up to 11-12 years. Bisphenol A was also negatively associated with PC20 (ß = -2.33; P = .02. When stratified by sex, the association between bisphenol A and asthma remained significant only in girls (hazard ratio, 2.45; 95% confidence interval, 2.18-2.76; P<.001.Increased urinary bisphenol A concentrations at 7-8 years old were positively associated with wheezing and asthma and negatively associated with PC20 at ages up to 11-12 years.

Analysis of School Food Safety Programs Based on HACCP Principles

Science.gov (United States)

Roberts, Kevin R.; Sauer, Kevin; Sneed, Jeannie; Kwon, Junehee; Olds, David; Cole, Kerri; Shanklin, Carol

2014-01-01

Purpose/Objectives: The purpose of this study was to determine how school districts have implemented food safety programs based on HACCP principles. Specific objectives included: (1) Evaluate how schools are implementing components of food safety programs; and (2) Determine foodservice employees food-handling practices related to food safety.…

School-based Yoga Programs in the United States: A Survey

Science.gov (United States)

Butzer, Bethany; Ebert, Marina; Telles, Shirley; Khalsa, Sat Bir S.

2016-01-01

Context Substantial interest has begun to emerge around the implementation of yoga interventions in schools. Researchers have found that yoga practices may enhance skills such as self-regulation and prosocial behavior, and lead to improvements in students’ performance. These researchers, therefore, have proposed that contemplative practices have the potential to play a crucial role in enhancing the quality of US public education. Objective The purpose of the present study was to provide a summary and comparison of school-based yoga programs in the United States. Design Online, listserv, and database searches were conducted to identify programs, and information was collected regarding each program’s scope of work, curriculum characteristics, teacher-certification and training requirements, implementation models, modes of operation, and geographical regions. Setting The online, listserv, and database searches took place in Boston, MA, USA, and New Haven, CT, USA. Results Thirty-six programs were identified that offer yoga in more than 940 schools across the United States, and more than 5400 instructors have been trained by these programs to offer yoga in educational settings. Despite some variability in the exact mode of implementation, training requirements, locations served, and grades covered, the majority of the programs share a common goal of teaching 4 basic elements of yoga: (1) physical postures, (2) breathing exercises, (3) relaxation techniques, and (4) mindfulness and meditation practices. The programs also teach a variety of additional educational, social-emotional, and didactic techniques to enhance students’ mental and physical health and behavior. Conclusions The fact that the present study was able to find a relatively large number of formal, school-based yoga programs currently being implemented in the United States suggests that the programs may be acceptable and feasible to implement. The results also suggest that the popularity of school-based

Development of a web-based, work-related asthma educational tool for patients with asthma

OpenAIRE

Ghajar-Khosravi, Shadi; Tarlo, Susan M; Liss, Gary M; Chignell, Mark; Ribeiro, Marcos; Levinson, Anthony J; Gupta, Samir

2013-01-01

BACKGROUND: Asthma is a common chronic condition. Work-related asthma (WRA) has a large socioeconomic impact and is increasing in prevalence but remains under-recognized. Although international guidelines recommend patient education, no widely available educational tool exists.OBJECTIVE: To develop a WRA educational website for adults with asthma.METHODS: An evidence-based database for website content was developed, which applied evidence-based website design principles to create a website pr...

Regular-soda intake independent of weight status is associated with asthma among US high school students.

Science.gov (United States)

Park, Sohyun; Blanck, Heidi M; Sherry, Bettylou; Jones, Sherry Everett; Pan, Liping

2013-01-01

Limited research shows an inconclusive association between soda intake and asthma, potentially attributable to certain preservatives in sodas. This cross-sectional study examined the association between regular (nondiet)-soda intake and current asthma among a nationally representative sample of high school students. Analysis was based on the 2009 national Youth Risk Behavior Survey and included 15,960 students (grades 9 through 12) with data for both regular-soda intake and current asthma status. The outcome measure was current asthma (ie, told by doctor/nurse that they had asthma and still have asthma). The main exposure variable was regular-soda intake (ie, drank a can/bottle/glass of soda during the 7 days before the survey). Multivariable logistic regression was used to estimate the adjusted odds ratios for regular-soda intake with current asthma after controlling for age, sex, race/ethnicity, weight status, and current cigarette use. Overall, 10.8% of students had current asthma. In addition, 9.7% of students who did not drink regular soda had current asthma, and 14.7% of students who drank regular soda three or more times per day had current asthma. Compared with those who did not drink regular soda, odds of having current asthma were higher among students who drank regular soda two times per day (adjusted odds ratio=1.28; 95% CI 1.02 to 1.62) and three or more times per day (adjusted odds ratio=1.64; 95% CI 1.25 to 2.16). The association between high regular-soda intake and current asthma suggests efforts to reduce regular-soda intake among youth might have benefits beyond improving diet quality. However, this association needs additional research, such as a longitudinal examination. Published by Elsevier Inc.

A School-Based Dental Program Evaluation: Comparison to the Massachusetts Statewide Survey.

Science.gov (United States)

Culler, Corinna S; Kotelchuck, Milton; Declercq, Eugene; Kuhlthau, Karen; Jones, Kari; Yoder, Karen M

2017-10-01

School-based dental programs target high-risk communities and reduce barriers to obtaining dental services by delivering care to students in their schools. We describe the evaluation of a school-based dental program operating in Chelsea, a city north of Boston, with a low-income and largely minority population, by comparing participants' oral health to a Massachusetts oral health assessment. Standardized dental screenings were conducted for students in kindergarten, third, and sixth grades. Outcomes were compared in bivariate analysis, stratified by grade and income levels. A greater percentage of Chelsea students had untreated decay and severe treatment need than students statewide. Yet, fewer Chelsea third graders had severe treatment need, and more had dental sealants. There was no significant difference in the percentage of Chelsea students having severe treatment need or dental sealants by income level. Students participating in our program do not have lower decay levels than students statewide. However, they do have lower levels of severe treatment need, likely due to treatment referrals. Our results confirm that school-based prevention programs can lead to increased prevalence of dental sealants among high-risk populations. Results provide support for the establishment of full-service school-based programs in similar communities. © 2017, American School Health Association.

Effectiveness of the Spirometry 360 Quality Improvement Program for Improving Asthma Care: A Cluster Randomized Trial.

Science.gov (United States)

Mangione-Smith, Rita; Zhou, Chuan; Corwin, Michael J; Taylor, James A; Rice, Fiona; Stout, James W

To determine the effectiveness of the Spirometry 360 distance learning quality improvement (QI) program for enhancing the processes and outcomes of care for children with asthma. Cluster randomized controlled trial involving 25 matched pairs of pediatric primary care practices. Practices were recruited from 2 practice-based research networks: the Slone Center Office-based Research Network at Boston University, Boston, Mass, and the Puget Sound Pediatric Research Network, Seattle, Wash. Study participants included providers from one of the 50 enrolled pediatric practices and 626 of their patients with asthma. Process measures assessed included spirometry test quality and appropriate prescription of asthma controller medications. Outcome measures included asthma-specific health-related quality of life, and outpatient, emergency department, and inpatient utilization for asthma. At baseline, 25.4% of spirometry tests performed in control practices and 50.4% of tests performed in intervention practices were of high quality. During the 6-month postintervention period, 28.7% of spirometry tests performed in control practices and 49.9% of tests performed in intervention practices were of high quality. The adjusted difference-of-differences analysis revealed no intervention effect on spirometry test quality. Adjusted differences-of-differences analysis also revealed no intervention effect on appropriate use of controller medications or any of the parent- or patient-reported outcomes examined. In this study, the Spirometry 360 distance learning QI program was ineffective in improving spirometry test quality or parent- or patient-reported outcomes. QI programs like the one assessed here may need to focus on practices with lower baseline performance levels or may need to be tailored for those with higher baseline performance. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

The Influence of Setting on Care Coordination for Childhood Asthma

Science.gov (United States)

Kelly, R. Patrick; Stoll, Shelley C.; Bryant-Stephens, Tyra; Janevic, Mary R.; Lara, Marielena; Ohadike, Yvonne U.; Persky, Victoria; Ramos-Valencia, Gilberto; Uyeda, Kimberly; Malveaux, Floyd J.

2015-01-01

Asthma affects 7.1 million children in the United States, disproportionately burdening African American and Latino children. Barriers to asthma control include insufficient patient education and fragmented care. Care coordination represents a compelling approach to improve quality of care and address disparities in asthma. The sites of The Merck Childhood Asthma Network Care Coordination Programs implemented different models of care coordination to suit specific settings—school district, clinic or health care system, and community—and organizational structures. A variety of qualitative data sources were analyzed to determine the role setting played in the manifestation of care coordination at each site. There were inherent strengths and challenges of implementing care coordination in each of the settings, and each site used unique strategies to deliver their programs. The relationship between the lead implementing unit and entities that provided (1) access to the priority population and (2) clinical services to program participants played a critical role in the structure of the programs. The level of support and infrastructure provided by these entities to the lead implementing unit influenced how participants were identified and how asthma care coordinators were integrated into the clinical care team. PMID:26232778

My Child Is Diagnosed with Asthma, Now What?: Motivating Parents to Help Their Children Control Asthma

Science.gov (United States)

Stepney, Cesalie; Kane, Katelyn; Bruzzese, Jean-Marie

2011-01-01

Pediatric asthma is often undiagnosed, and therefore untreated. It negatively impacts children's functioning, including school attendance and performance, as well as quality of life. Schoolwide screening for asthma is becoming increasingly common, making identification of possible asthma particularly relevant for school nurses. Nurses may need to…

Medication education program for Indian children with asthma: A feasibility stud.

Science.gov (United States)

Grover, C; Goel, N; Armour, C; Van Asperen, P P; Gaur, S N; Moles, R J; Saini, B

2016-01-01

It is postulated that children with asthma who receive an interactive, comprehensive, culturally relevant education program would improve their asthma knowledge (AK), asthma control, and adherence compared with children receiving usual care. The aim of this study was to develop, implement, and evaluate the efficacy of a culturally relevant asthma education intervention for children with asthma and their parents in India. Children with asthma (7-12 years) and their parents were recruited from an outpatient clinic in a Chest Diseases Hospital in New Delhi, and were randomly assigned to either an intervention or usual care group. At baseline, outcome data collected included pediatric asthma caregiver quality of life (PACQL, primary outcome), AK, asthma control, adherence, inhaler technique, action plan ownership, and goal achievement. These data were collected again at 1 and 6 months after baseline. Outcomes were compared within and between groups using ANOVA techniques. Forty parent-child pairs were recruited. Of these, 24 pairs of children with asthma and their parents received the educational intervention. The PACQL significantly improved from baseline to 6 months in the intervention (5.87 ± 0.94-7.00 ± 0.03) versus the usual care group (5.90 ± 0.52-6.34 ± 0.56) (P management skills.

Indigenous healthcare worker involvement for Indigenous adults and children with asthma.

Science.gov (United States)

Chang, Anne B; Taylor, Brett; Masters, I Brent; Laifoo, Yancy; Brown, Alexander Dh

2010-05-12

.23; 95% CI 0.59 to 1.87), parents' asthma skill score (SMD 0.67; 95% CI 0.28 to 1.06) and days absent from school (100% school-aged children in the intervention group missed children's asthma skill score; both were limited to one study only and the direction favoured IHW group. There were no studies in adults. The involvement of IHW in asthma programs targeted for their own ethnic group in 2 small trials was beneficial in improving most, but not all asthma outcomes in children with asthma. It is very likely that involvement of an IHW is beneficial. However as exacerbation frequency was not significantly different between groups, we cannot be confident of the results in all settings. Nevertheless, given the complexity of health outcomes and culture as well as the importance of self-determination for indigenous peoples, the practice of including IHW in asthma education programs for indigenous children and adults with asthma is justified, but should be subject to further randomised controlled trials.

Investigating Stakeholder Attitudes and Opinions on School-Based Human Papillomavirus Vaccination Programs

Science.gov (United States)

Nodulman, Jessica A.; Starling, Randall; Kong, Alberta S.; Buller, David B.; Wheeler, Cosette M.; Woodall, W. Gill

2015-01-01

Background: In several countries worldwide, school-based human papillomavirus (HPV) vaccination programs have been successful; however, little research has explored US stakeholders' acceptance toward school-based HPV vaccination programs. Methods: A total of 13 focus groups and 12 key informant interviews (N?=?117; 85% females; 66% racial/ethnic…

Improving asthma-related health outcomes among low-income, multiethnic, school-aged children: results of a demonstration project that combined continuous quality improvement and community health worker strategies.

Science.gov (United States)

Fox, Patrick; Porter, Patricia G; Lob, Sibylle H; Boer, Jennifer Holloman; Rocha, David A; Adelson, Joel W

2007-10-01

The purpose of this work was to improve asthma-related health outcomes in an ethnically and geographically disparate population of economically disadvantaged school-aged children by using a team-based approach using continuous quality improvement and community health workers. A demonstration project was conducted with 7 community clinics treating approximately 3000 children with asthma 5 to 18 years of age. The overall clinic population with asthma was assessed for care-process changes through random cross-sectional chart reviews at baseline and 24 months (N = 560). A subset of patients with either moderate or severe persistent asthma or poorly controlled asthma (N = 405) was followed longitudinally for specific asthma-related clinical outcomes, satisfaction with care, and confidence managing asthma by family interview at baseline and at 12 or 24 months. Patient-centered and care-process outcomes included patient/parent assessment of quality of care and confidence in self-management, asthma action plan review, and documentation of guideline-based indicators of quality of care. Direct clinical outcomes included daytime and nighttime symptoms, use of rescue medications, acute care and emergency department visits, hospitalizations, and missed school days. Each clinic site's degree of adherence to the intervention model was evaluated and ranked to examine the correlation between model adherence and outcomes. Cross-sectional data showed clinic-wide improvements in the documentation of asthma severity, review of action plans, health services use, and asthma symptoms. At follow-up in the longitudinal sample, fewer patients reported acute visits, emergency department visits, hospitalizations, frequent daytime and nighttime symptoms, and missed school days compared with baseline. More patients reported excellent or very good quality of care and confidence in asthma self-management. Linear regression analysis of the clinical sites' model adherence ranks against site

School-Based Mental Health Program Evaluation: Children's School Outcomes and Acute Mental Health Service Use

Science.gov (United States)

Kang-Yi, Christina D.; Mandell, David S.; Hadley, Trevor

2013-01-01

Background: This study examined the impact of school-based mental health programs on children's school outcomes and the utilization of acute mental health services. Methods: The study sample included 468 Medicaid-enrolled children aged 6 to 17 years who were enrolled 1 of 2 school-based mental health programs (SBMHs) in a metropolitan area…

45 CFR 2516.600 - How are funds for school-based service-learning programs distributed?

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false How are funds for school-based service-learning... (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS Distribution of Funds § 2516.600 How are funds for school-based service-learning programs distributed? (a) Of...

Effects of a 12-week, school-based obesity management program on obese primary school children

Directory of Open Access Journals (Sweden)

Han Gyu Kim

2010-03-01

Full Text Available Purpose:This study was designed to determine the effects of a school-based obesity-management program on obese primary school children. Methods:A total of 995 children (6&#8211;12 years old in a primary school were screened in March 2008, and of those, 101 obese students (44 boys and 57 girls, body mass index (BMI ?#249;5 percentile were enrolled for a study group. The school- based, obesity management program, which includes physical exercise and nutritional education, was conducted as part of an extracurricular program for 12 weeks. The measurement of height, weight, waist circumference, blood pressure (BP, and bioelectrical impedance analysis (BIA was performed before and after the program. Results:Height and weight increased significantly (P&lt;0.05. The BMI and obesity index decreased significantly (P&lt;0.01. Systolic and diastolic BP decreased significantly (P&lt;0.01. BMI decreased in 61.4% of boys and 66.7% of girls. Protein and basal metabolic rate (BMR increased significantly on the BIA (P&lt;0.01. Fat decreased significantly (P&lt;0.05. The total body water (TBW and percent body fat (PBF decreased significantly (P&lt;0.01. The changes in protein, fat, TBW, PBF, and BMR significantly correlated to the change in BMI (P&lt;0.05. In a multiple logistic regression analysis, BMI change was significantly correlated to the changes in protein and fat content (P&lt;0.01. Conclusion:The school-based obesity management program is a very effective way to manage obesity for obese primary school children.

Connecting and Networking for Schools

Science.gov (United States)

Resources for connecting and networking for schools through e-newsletters, finding school IAQ Champions and other EPA school programs such as Asthma, Energy Star, Clean School Bus USA, School Flag, etc.

Predicting asthma in preschool children with asthma symptoms: study rationale and design

NARCIS (Netherlands)

E.H.D. Hafkamp-De Groen (Esther); H.F. Lingsma (Hester); D. Caudri (Daan); A.H. Wijga (Alet); V.W.V. Jaddoe (Vincent); E.W. Steyerberg (Ewout); J.C. de Jongste (Johan); H. Raat (Hein)

2012-01-01

textabstractBackground: In well-child care it is difficult to determine whether preschool children with asthma symptoms actually have or will develop asthma at school age. The PIAMA (Prevention and Incidence of Asthma and Mite Allergy) Risk Score has been proposed as an instrument that predicts

A workshop on asthma management programs and centers in Brazil: reviewing and explaining concepts*

Science.gov (United States)

Stelmach, Rafael; Neto, Alcindo Cerci; Fonseca, Ana Cristina de Carvalho Fernandez; Ponte, Eduardo Vieira; Alves, Gerardo; Araujo-Costa, Ildely Niedia; Lasmar, Laura Maria de Lima Belizário Facury; de Castro, Luci Keiko Kuromoto; Lenz, Maria Lucia Medeiros; Silva, Paulo; Cukier, Alberto; Alves, Alexssandra Maia; Lima-Matos, Aline Silva; Cardoso, Amanda da Rocha Oliveira; Fernandes, Ana Luisa Godoy; de São-José, Bruno Piassi; Riedi, Carlos Antônio; Schor, Deborah; Peixoto, Décio Medeiros; Brandenburg, Diego Djones; Camillo, Elineide Gomes dos Santos; Serpa, Faradiba Sarquis; Brandão, Heli Vieira; Lima, João Antonio Bonfadini; Pio, Jorge Eduardo; Fiterman, Jussara; Anderson, Maria de Fátima; Cardoso, Maria do Socorro de Lucena; Rodrigues, Marcelo Tadday; Pereira, Marilyn Nilda Esther Urrutia; Antila, Marti; Martins, Sonia Maria; Guimarães, Vanessa Gonzaga Tavares; Mello, Yara Arruda Marques; de Andrade, Wenderson Clay Correia; Salibe-Filho, William; Caldeira, Zelina Maria da Rocha; da Cruz-Filho, Álvaro Augusto Souza; Camargos, Paulo

2015-01-01

Objective: To report the results of a workshop regarding asthma management programs and centers (AMPCs) in Brazil, so that they can be used as a tool for the improvement and advancement of current and future AMPCs. Methods: The workshop consisted of five presentations and the corresponding group discussions. The working groups discussed the following themes: implementation of asthma management strategies; human resources needed for AMPCs; financial resources needed for AMPCs; and operational maintenance of AMPCs. Results: The workshop involved 39 participants, from all regions of the country, representing associations of asthma patients (n = 3), universities (n = 7), and AMPCs (n = 29). We found a direct relationship between a lack of planning and the failure of AMPCs. Based on the experiences reported during the workshop, the common assumptions about AMPCs in Brazil were the importance of raising awareness of managers; greater community participation; interdependence between primary care and specialized care; awareness of regionalization; and use of medications available in the public health system. Conclusions: Brazil already has a core of experience in the area of asthma management programs. The implementation of strategies for the management of chronic respiratory disease and their incorporation into health care system protocols would seem to be a natural progression. However, there is minimal experience in this area. Joint efforts by individuals with expertise in AMPCs could promote the implementation of asthma management strategies, thus speeding the creation of treatment networks, which might have a multiplier effect, precluding the need for isolated centers to start from zero. PMID:25750669

45 CFR 2516.300 - Who may participate in a school-based service-learning program?

Science.gov (United States)

2010-10-01

...-learning program? 2516.300 Section 2516.300 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS Eligibility To Participate § 2516.300 Who may participate in a school-based service-learning program? Students...

Asthma: Not Just a Childhood Condition.

Science.gov (United States)

Strauss, Kandra

2002-01-01

Asthma has grown to epidemic proportions among school-age children, and nearly 10 million U.S. adults suffer from it. This paper describes asthma and its triggers and explains how to take measures to manage asthma symptoms within the school (e.g., dusting regularly and keeping medications available). A sidebar presents tips on controlling asthma…

Pharmacy Asthma Care Program (PACP) improves outcomes for patients in the community.

Science.gov (United States)

Armour, Carol; Bosnic-Anticevich, Sinthia; Brillant, Martha; Burton, Debbie; Emmerton, Lynne; Krass, Ines; Saini, Bandana; Smith, Lorraine; Stewart, Kay

2007-06-01

Despite national disease management plans, optimal asthma management remains a challenge in Australia. Community pharmacists are ideally placed to implement new strategies that aim to ensure asthma care meets current standards of best practice. The impact of the Pharmacy Asthma Care Program (PACP) on asthma control was assessed using a multi-site randomised intervention versus control repeated measures study design. Fifty Australian pharmacies were randomised into two groups: intervention pharmacies implemented the PACP (an ongoing cycle of assessment, goal setting, monitoring and review) to 191 patients over 6 months, while control pharmacies gave their usual care to 205 control patients. Both groups administered questionnaires and conducted spirometric testing at baseline and 6 months later. The main outcome measure was asthma severity/control status. 186 of 205 control patients (91%) and 165 of 191 intervention patients (86%) completed the study. The intervention resulted in improved asthma control: patients receiving the intervention were 2.7 times more likely to improve from "severe" to "not severe" than control patients (OR 2.68, 95% CI 1.64 to 4.37; p<0.001). The intervention also resulted in improved adherence to preventer medication (OR 1.89, 95% CI 1.08 to 3.30; p = 0.03), decreased mean daily dose of reliever medication (difference -149.11 microg, 95% CI -283.87 to -14.36; p=0.03), a shift in medication profile from reliever only to a combination of preventer, reliever with or without long-acting beta agonist (OR 3.80, 95% CI 1.40 to 10.32; p=0.01) and improved scores on risk of non-adherence (difference -0.44, 95% CI -0.69 to -0.18; p=0.04), quality of life (difference -0.23, 95% CI -0.46 to 0.00; p=0.05), asthma knowledge (difference 1.18, 95% CI 0.73 to 1.63; p<0.01) and perceived control of asthma questionnaires (difference -1.39, 95% CI -2.44 to -0.35; p<0.01). No significant change in spirometric measures occurred in either group. A pharmacist

45 CFR 2516.100 - What is the purpose of school-based service-learning programs?

Science.gov (United States)

2010-10-01

...-learning programs? 2516.100 Section 2516.100 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS Eligibility To Apply § 2516.100 What is the purpose of school-based service-learning programs? The purpose of...

A national survey of school-based, adolescent suicide prevention programs.

Science.gov (United States)

Garland, A; Shaffer, D; Whittle, B

1989-11-01

A national survey of suicide prevention programs was conducted to determine the number, distribution and content of school-based, curriculum programs for adolescents. One hundred fifteen programs were identified. The total number of students and schools targeted for prevention efforts more than doubled during the academic years 1984/1985 to 1986/1987. Content of the programs was similar, with nearly all including information on suicide warning signs and other facts, as well as on accessing community mental health resources. Most included a separate component for school staff and parents. Ninety-five percent subscribed to the view that suicide is most commonly a response to extreme stress or pressure and could happen to anyone. Possible negative implications of this "stress model" of suicide were discussed. While this survey plays an important first step in providing a description of these programs, more evaluative research is needed to determine what effect, if any, these programs have on suicidal behavior.

Effects of a german asthma disease management program using sickness fund claims data.

Science.gov (United States)

Windt, Roland; Glaeske, Gerd

2010-08-01

The purpose of this study was to assess outcomes of a nationwide asthma disease management (DM) program in Germany. A retrospective observational study with propensity-score matching was performed using claims data of sickness funds exclusively. Effects were analyzed on the basis of a match of 317 program participants and nonparticipants with similar propensity score and age. Hospitalization or oral corticosteroid user rates were comparable in both groups, whereas there are significantly more subjects in the DM group with a prescription of an inhaled corticosteroid and fewer with a prescription of a cromolyn/reproterol combination. There are also less "doctor hoppers" in the DM group, defined as subjects with antiasthmatic drug prescriptions of at least three physicians. The results suggest that the impact of a nationwide disease management program for asthma is weak in respect of clinically relevant endpoints, but there are indications that medication in a DM program approximates asthma guidelines more closely.

Effectiveness of a school-based physical activity injury prevention program

NARCIS (Netherlands)

Collard, D.C.M.; Verhagen, E.A.L.M.; Chin A Paw, M.J.M.; Knol, D.L.; van Mechelen, W.

2010-01-01

Objective: To study the effects of a school-based injury prevention program on physical activity injury incidence and severity. Design: Cluster randomized controlled trial performed from January 1, 2006, through July 31, 2007. Setting: Forty Dutch primary schools. Participants: Atotal of 2210

Asthma control and productivity loss in those with work-related asthma: A population-based study.

Science.gov (United States)

Wong, Alyson; Tavakoli, Hamid; Sadatsafavi, Mohsen; Carlsten, Chris; FitzGerald, J Mark

2017-06-01

In Canada, asthma is the third leading cause of work loss, yet little is known about the associated productivity loss. The goal of this study was to look at the relationship between asthma control and productivity loss, particularly contrasting those with work-related asthma (WRA) and non-work-related asthma (NWRA). A population-based random sample of adults with asthma in British Columbia, Canada, was prospectively recruited. Asthma control was graded according to Global Initiative for Asthma classification, while productivity loss and presence of WRA was assessed using questionnaires. Ordinal regression models were then used to associate WRA with asthma control. Generalized linear models were applied to estimate the average productivity loss associated with different levels of asthma control among those with WRA and NWRA. The study included 300 employed adults. Sixty (20%) had WRA. The odds of being controlled were significantly lower in those with WRA (OR = 0.23, 95% CI: 0.09, 0.56; P asthma had a significant difference in productivity loss due to presenteeism ($659.1 [95% CI: 12.9, 1581.5; P = 0.04]), but not absenteeism ($88.7 [95% CI: -86.5, 279.6; P = 0.35]), when compared to those with NWRA and uncontrolled asthma. There was no significant difference when a similar comparison was made for those with controlled or partially controlled asthma. WRA is associated with worse asthma control and increased productivity loss. Presenteeism makes a significant contribution to productivity loss and should be considered when evaluating the overall economic burden of asthma, particularly WRA.

Association between asthma and physical activity in Korean adolescents: the 3rd Korea Youth Risk Behavior Web-based Survey (KYRBWS-III).

Science.gov (United States)

Kim, Jae-Woo; So, Wi-Young; Kim, Yeon Soo

2012-12-01

Asthma is the leading chronic illness among children and adolescents in several nations. This study investigated the association between asthma and physical activity (PA). The findings in this study are based on the data obtained from the 2007 3rd Korea Youth Risk Behavior Web-Based Survey (KYRBWS-III), a cross-sectional survey of health-risk behaviours among a representative sample of Korean middle- and high-school students aged 13-18 years. This survey is conducted annually by the Korea Centers for Disease Control and Prevention. The 72 943 study subjects were selected using the complex sampling design of the survey. The association between asthma and PA was assessed by conducting multiple logistic regression analyses of the data by using the statistical software SPSS 17.0 Complex Sample. Compared with the adolescents without current asthma, significantly fewer adolescents with current asthma had a sedentary time of 3 h or less per day (odds ratio, 0.86; 95% confidence interval, 0.75-0.97). Sedentary time was defined as time spent watching television, surfing the Internet, or playing computer games and excluded the time spent doing homework or study during leisure time. The analysis was adjusted for age, gender, family affluence level (FAL), obesity, allergic rhinitis, atopy and smoking. With regard to participation in adequate vigorous or moderate PA, strengthening exercise or physical education class, no significant differences were found between the adolescent students with current asthma and those without current asthma. In addition, it was found that all PA had no significant differences in their effects on asthma severity (medication, inability to work and absence from school). Our results show that the amount of sedentary time influenced asthma prevalence; however, PA did not influence asthma prevalence in Korean adolescents.

Culture-specific programs for children and adults from minority groups who have asthma.

Science.gov (United States)

McCallum, Gabrielle B; Morris, Peter S; Brown, Ngiare; Chang, Anne B

2017-08-22

studies ranged from very low to low. For our primary outcome (asthma exacerbations during follow-up), the quality of evidence was low for all outcomes. In adults, use of a culture-specific programme, compared to generic programmes or usual care did not significantly reduce the number of participants from two studies with 294 participants for: exacerbations with one or more exacerbations during follow-up (odds ratio (OR) 0.80, 95% confidence interval (CI) 0.50 to 1.26), hospitalisations over 12 months (OR 0.83, 95% CI 0.31 to 2.22) and exacerbations requiring oral corticosteroids (OR 0.97, 95% CI 0.55 to 1.73). However, use of a culture-specific programme, improved asthma quality of life scores in 280 adults from two studies (mean difference (MD) 0.26, 95% CI 0.17 to 0.36) (although the MD was less then the minimal important difference for the score). In children, use of a culture-specific programme was superior to generic programmes or usual care in reducing severe asthma exacerbations requiring hospitalisation in two studies with 305 children (rate ratio 0.48, 95% CI 0.24 to 0.95), asthma control in one study with 62 children and QoL in three studies with 213 children, but not for the number of exacerbations during follow-up (OR 1.55, 95% CI 0.66 to 3.66) or the number of exacerbations (MD 0.18, 95% CI -0.25 to 0.62) among 100 children from two studies. The available evidence showed that culture-specific education programmes for adults and children from minority groups are likely effective in improving asthma-related outcomes. This review was limited by few studies and evidence of very low to low quality. Not all asthma-related outcomes improved with culture-specific programs for both adults and children. Nevertheless, while modified culture-specific education programs are usually more time intensive, the findings of this review suggest using culture-specific asthma education programmes for children and adults from minority groups. However, more robust RCTs are needed to

Asthma control in children

DEFF Research Database (Denmark)

Pedersen, Søren

2016-01-01

The goal of asthma management is to achieve disease control. Poorly controlled asthma is associated with an increased number of days lost from school, exacerbations and days in hospital. Furthermore, children with uncontrolled asthma have more frequent contacts with the health-care system. Recent...... studies have added new information about the effects of poorly controlled asthma on a range of important, but less studied outcomes, including risk of obesity, daily physical activity, cardiovascular fitness, stress, concentration and focused attention, learning disabilities and risk of depression. From...... these studies it seems that poor asthma control may have a greater impact on the child than previously thought. This may have important long-term consequences for the child such as an increased risk of life-style associated diseases and poorer school performance. The level of control seems to be the most...

The Process of Adoption of Evidence-based Tobacco Use Prevention Programs in California Schools

Science.gov (United States)

Little, Melissa A.; Pokhrel, Pallav; Sussman, Steve; Rohrbach, Louise Ann

2014-01-01

Although there are a number of research-validated substance use prevention programs available for wide-scale dissemination, very little is known about the factors that influence adoption of evidence-based prevention programs in schools. We tested a model of the mechanisms of program adoption in schools that was guided by diffusion of innovations and social ecological theories. Cross-sectional data were collected from a sample of school district and county office of education tobacco use prevention education coordinators throughout California. Structural equation modeling was used to test the effects of community- and organizational variables on the adoption of prevention programs via school administrators’ beliefs and the organization’s receipt of funding for the program. Results supported the hypothesis that the process of adoption begins with forming beliefs about the program, leading to adoption through the receipt of funding. In addition, we found direct effects of various community- and organizational-level factors on beliefs, receipt of funding, and adoption. These results are likely to inform policies that affect school districts’ use of evidence-based substance use prevention programming, which should ultimately lead to reductions in negative health outcomes among adolescents. Specifically, this study identifies various factors that could be targeted for improvement to enhance evidence-based program adoption. To our knowledge, this is the first study to empirically elucidate the process of adoption of evidence-based tobacco prevention programs in schools. PMID:24398826

Gender differences in effects of obesity and asthma on adolescent lung function: Results from a population-based study.

Science.gov (United States)

Chen, Yi-Chun; Huang, Yu-Li; Ho, Wen-Chao; Wang, Yu-Chun; Yu, Yang-Hao

2017-04-01

To investigate lung function associated with asthma and body mass index (BMI) among adolescents at 96 northern Taiwan junior high schools participating in an asthma screening program. The questionnaires and lung function test results measured for 3669 boys and 3523 girls were included in this study for data analysis. Measures of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ) and FEV 1 /FVC ratio were compared by sex, asthma status and BMI. Overall mean FVC levels were similar between students with and without asthma, 3.71 L vs. 3.71 L for boys (p = 0.991) and 2.79 vs. 2.78 for girls (p = 0.517). The overall mean FEV 1 levels were also similar between girls with and without asthma. Asthmatic boys had lower FEV 1 than non-asthmatic boys. Mean FEV 1 /FVC was significantly lower in students with asthma than those without asthma. Mean FVC and FEV 1 increased with BMI in both sexes. A lower mean FEV 1 /FVC was observed among students with asthma and high BMI, and was more pronounced in boys than in girls. Multivariable regression analysis also showed that FEV 1 /FVC ratios were negatively associated with asthma and high BMI, stronger in boys than in girls for asthma (β = -2.176 (standard errors (SE) = 0.268) vs. -1.085 (SE = 0.258) and for BMI (β = -0.309 (SE = 0.025) vs. -0.218 (SE = 0.029)). This northern Taiwan study suggests that FEV 1 /FVC is negatively associated with asthma and high BMI in adolescents, stronger for boys than for girls.

Know How to Use Your Asthma Inhaler

Medline Plus

Full Text Available ... Asthma-related Missed School Days among Children aged 5–17 Years Asthma Severity among Adults with Current Asthma Asthma Severity among Children with Current Asthma Overuse of quick-relief medication among persons with active asthma Use of long-term control ...

Know How to Use Your Asthma Inhaler

Medline Plus

Full Text Available ... Health Care Coverage among Children Asthma-related Missed School Days among Children aged 5–17 Years Asthma ... FastStats Survey Questions Resources for Health Professionals and Schools Healthcare Professionals Public Health Professionals School and Childcare ...

Planning for Sustainability of an Evidence-Based Mental Health Promotion Program in Canadian Elementary Schools.

Science.gov (United States)

Leadbeater, Bonnie J; Gladstone, Emilie J; Sukhawathanakul, Paweena

2015-09-01

Substantial research illuminates many factors effecting the implementation of evidence-based mental health promotion programs in schools; however, research on how schools plan for sustaining their investments in these programs is limited. In this qualitative study, we elicited descriptions of opportunities and challenges for sustainability. We interviewed 24 individuals from schools involved in a longitudinal, qualitative research project that followed uptake and implementation of the evidence-based WITS Programs across 2 years (Leadbeater et al. 2012). WITS stands for Walk away, Ignore, Talk it out and Seek help and the online WITS Programs focus on preventing peer victimization ( www.witsprograms.ca ). Our findings suggest that sustainability planning in schools is not merely a next step following high quality implementation, but rather involves multiple ongoing processes that need to be anticipated and supported by school leadership and program champions and developers in order to realize investments in evidence-based programs.

Pharmacy Asthma Care Program (PACP) improves outcomes for patients in the community

Science.gov (United States)

Armour, Carol; Bosnic‐Anticevich, Sinthia; Brillant, Martha; Burton, Debbie; Emmerton, Lynne; Krass, Ines; Saini, Bandana; Smith, Lorraine; Stewart, Kay

2007-01-01

Background Despite national disease management plans, optimal asthma management remains a challenge in Australia. Community pharmacists are ideally placed to implement new strategies that aim to ensure asthma care meets current standards of best practice. The impact of the Pharmacy Asthma Care Program (PACP) on asthma control was assessed using a multi‐site randomised intervention versus control repeated measures study design. Methods Fifty Australian pharmacies were randomised into two groups: intervention pharmacies implemented the PACP (an ongoing cycle of assessment, goal setting, monitoring and review) to 191 patients over 6 months, while control pharmacies gave their usual care to 205 control patients. Both groups administered questionnaires and conducted spirometric testing at baseline and 6 months later. The main outcome measure was asthma severity/control status. Results 186 of 205 control patients (91%) and 165 of 191 intervention patients (86%) completed the study. The intervention resulted in improved asthma control: patients receiving the intervention were 2.7 times more likely to improve from “severe” to “not severe” than control patients (OR 2.68, 95% CI 1.64 to 4.37; p<0.001). The intervention also resulted in improved adherence to preventer medication (OR 1.89, 95% CI 1.08 to 3.30; p = 0.03), decreased mean daily dose of reliever medication (difference −149.11 μg, 95% CI −283.87 to −14.36; p = 0.03), a shift in medication profile from reliever only to a combination of preventer, reliever with or without long‐acting β agonist (OR 3.80, 95% CI 1.40 to 10.32; p = 0.01) and improved scores on risk of non‐adherence (difference −0.44, 95% CI −0.69 to −0.18; p = 0.04), quality of life (difference −0.23, 95% CI −0.46 to 0.00; p = 0.05), asthma knowledge (difference 1.18, 95% CI 0.73 to 1.63; p<0.01) and perceived control of asthma questionnaires (difference −1.39, 95% CI −2.44 to −0.35; p<0

Developing and Implementing a Citywide Asthma Action Plan: A Community Collaborative Partnership.

Science.gov (United States)

Staudt, Amanda Marie; Alamgir, Hasanat; Long, Debra Lynn; Inscore, Stephen Curtis; Wood, Pamela Runge

2015-12-01

Asthma affects 1 in 10 children in the United States, with higher prevalence among children living in poverty. Organizations in San Antonio, Texas, partnered to design and implement a uniform, citywide asthma action plan to improve asthma management capacity in schools. The asthma action plan template was modified from that of the Global Initiative for Asthma. School personnel were trained in symptom recognition, actions to take, and use of equipment before the asthma action plan implementation. The annual Asthma Action Plan Summit was organized as a forum for school nurses, healthcare providers, and members of the community to exchange ideas and strategies on implementation, as well as to revise the plan. The asthma action plan was implemented in all 16 local school districts. Feedback received from school nurses suggests that the citywide asthma action plan resulted in improved asthma management and student health at schools. The evidence in this study suggests that community organizations can successfully collaborate to implement a citywide health initiative similar to the asthma action plan.

Evaluating a School-Based Day Treatment Program for Students with Challenging Behaviors

Science.gov (United States)

Hickman, Antoine Lewis

2014-01-01

Jade County Public Schools has provided school-based therapeutic day treatment in its public schools for more than 10 years. This program was adopted by the school system to provide an intervention in the school and classroom to address the challenging behaviors of students with emotional and behavioral disorders. Currently, three human services…

Evaluation of the effectiveness of a school-based cannabis prevention program.

Science.gov (United States)

Ariza, Carles; Pérez, Anna; Sánchez-Martínez, Francesca; Diéguez, Marta; Espelt, Albert; Pasarín, M Isabel; Suelves, Josep M; De la Torre, Rafael; Nebot, Manuel

2013-09-01

The effectiveness of a cannabis prevention program in high school students was assessed. A quasi-experimental study was designed to evaluate the effectiveness of an intervention implemented in an intervention group (IG) with 39 schools compared with a control group (CG) of 47 schools not exposed to the intervention. Of 224 secondary schools in Barcelona, 86 were assessed in the 2005-2006 school year through a personal questionnaire administered at baseline and 15 months after the intervention. Participants consisted of 4848 ninth graders (14-15 year-olds), 2803 assigned to the IG and 2043 to the CG, according to the type and size of the school and the socioeconomic status of the school's neighborhood. The intervention consisted of a school-based cannabis prevention program (xkpts.com), with four sessions and 16 activities, implemented over 6-10h, with materials for parents and web-based student involvement. Last-month cannabis use was assessed at baseline and at 15 months' follow-up. Process evaluation indicators were assessed. At 15 months follow-up, 8.2% of boys and 8.3% of girls in the IG became last-month cannabis users versus 11.8% of boys and 11.6% of girls in the CG. These differences were statistically significant (p=0.003), representing a 29% reduction in last-month cannabis users in the IG compared with the CG. The incidence of last-month cannabis use was lowest in classrooms that adhered to the program protocol. The xkpts.com program was effective in preventing progression to last-month cannabis use. Effectiveness was higher in classrooms that adhered closely to the protocol. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Effectiveness of Evidence-Based Asthma Interventions.

Science.gov (United States)

Kennedy, Suzanne; Bailey, Ryan; Jaffee, Katy; Markus, Anne; Gerstein, Maya; Stevens, David M; Lesch, Julie Kennedy; Malveaux, Floyd J; Mitchell, Herman

2017-06-01

Researchers often struggle with the gap between efficacy and effectiveness in clinical research. To bridge this gap, the Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS) study adapted an efficacious, randomized controlled trial that resulted in evidence-based asthma interventions in community health centers. Children (aged 5-12 years; N = 590) with moderate to severe asthma were enrolled from 3 intervention and 3 geographically/capacity-matched control sites in high-risk, low-income communities located in Arizona, Michigan, and Puerto Rico. The asthma intervention was tailored to the participant's allergen sensitivity and exposure, and it comprised 4 visits over the course of 1 year. Study visits were documented and monitored prospectively via electronic data capture. Asthma symptoms and health care utilization were evaluated at baseline, and at 6 and 12 months. A total of 314 intervention children and 276 control children were enrolled in the study. Allergen sensitivity testing (96%) and home environmental assessments (89%) were performed on the majority of intervention children. Overall study activity completion (eg, intervention visits, clinical assessments) was 70%. Overall and individual site participant symptom days in the previous 4 weeks were significantly reduced compared with control findings (control, change of -2.28; intervention, change of -3.27; difference, -0.99; P asthma in these high-need populations. Copyright © 2017 by the American Academy of Pediatrics.

The Impact of Violence Prevention Programs on School Based Violent Behaviors

Science.gov (United States)

Reed-Reynolds, Shelly

2011-01-01

This dissertation study focused on the potential effect that various violence prevention program strategies implemented within the k-12 school setting have on the frequency of school based violent behaviors. The 2005-06 and 2003-04 School Survey on Crime and Safety (SSOCS:2006 & SSOCS:2004) was utilized as the secondary data source for this…

Association of maternal diabetes and child asthma.

Science.gov (United States)

Azad, Meghan B; Becker, Allan B; Kozyrskyj, Anita L

2013-06-01

Perinatal programming is an emerging theory for the fetal origins of chronic disease. Maternal asthma and environmental tobacco smoke (ETS) are two of the best-known triggers for the perinatal programming of asthma, while the potential role of maternal diabetes has not been widely studied. To determine if maternal diabetes is associated with child asthma, and if so, whether it modifies the effects of ETS exposure and maternal asthma. We studied 3,574 Canadian children, aged 7-8 years, enrolled in a population-based birth cohort. Standardized questionnaires were completed by the children's parents, and data were analyzed by multivariable logistic regression. Asthma was reported in 442 children (12.4%). Compared to those without asthma, asthmatic children were more likely to have mothers (P = 0.003), but not fathers (P = 0.89), with diabetes. Among children without maternal history of diabetes, the likelihood of child asthma was 1.4-fold higher in those exposed to ETS (adjusted odds ratio, 1.40; 95% confidence interval, 1.13-1.73), and 3.6-fold higher in those with maternal asthma (3.59; 2.71-4.76). Among children born to diabetic mothers, these risks were amplified to 5.7-fold (5.68; 1.18-27.37) and 11.3-fold (11.30; 2.26-56.38), respectively. In the absence of maternal asthma or ETS, maternal diabetes was not associated with child asthma (0.65, 0.16-2.56). Our findings suggest that maternal diabetes may contribute to the perinatal programming of child asthma by amplifying the detrimental effects of ETS exposure and maternal asthma. Copyright © 2012 Wiley Periodicals, Inc.

“Yet” ~ A Brief School-Based Program for Fourth Graders

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Sandra L. Rogelberg

2016-12-01

Full Text Available “Yet” is a school-based youth development program intended to introduce elementarygrade students to concepts of growth mindset, self-leadership, resilience and self-talk to promote healthy coping strategies to persist in tasks toward more positive educational outcomes.  Drawing from psychology, education, and management literature focusing on self-leadership, the “Yet” program encourages interaction and internalization of concepts such as “growing the brain,” and “stinkin’ thinking,” while modeling how to reframe set-backs to things students have not mastered…”yet,” and practicing adaptive self-talk to promote coping and persistence.  This unique program holds promise because it is approximately 30 minutes long, occurs within the context of a regular school day, and can be implemented with a high measure of fidelity because it is script-based.  The success of the program may be augmented by principal and teacher support along with online videos.

Community pharmacy-based asthma services--what do patients prefer?

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Naik Panvelkar, Pradnya; Armour, Carol; Saini, Bandana

2010-12-01

Patient preferences can influence the outcomes of treatment and so understanding and organizing health-care services around these preferences is vital. To explore patient preferences for types of community pharmacy-based asthma services, to investigate the influence of "experience" in molding preferences for such services, and to identify aspects of the services that patients prefer over others. Semistructured face-to-face interviews were conducted with a convenience sample of two types of asthma patients: (1) those naïve to a specialized asthma service and (2) those who had experienced a specialized asthma service. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Eighteen interviews were conducted (8 experienced patients, 10 naïve patients). The majority of the patients wanted the pharmacist to play a greater role in their asthma management. Patients experiencing increased levels of service had increased levels of expectations as well as more specific preferences for various aspects of the service. The key aspects of an asthma service that all patients wanted their pharmacists to provide were the provision of information about asthma and its medications, lung function testing and monitoring of their asthma, and checking/correcting their inhaler technique. Patients also expressed a desire for skilled communication and behavioral aspects from the pharmacist such as friendliness, empathy, attentiveness, and dedicated time. Patients highlighted the importance of privacy in the pharmacy. There was a high level of satisfaction toward the currently delivered asthma service among both naïve and experienced patients. The provision of the specialized service was associated with increased patient loyalty to the particular pharmacy. All patients indicated a willingness to participate in future pharmacy-delivered specialized asthma services. Elements of the specialized pharmacy-based asthma services important from a patient's perspective were

The Child’s Voice in Determining Program Acceptability for a School-Based Mindfulness Intervention

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Megan McCabe

2017-12-01

Full Text Available School-based mindfulness interventions have been shown to be effective in reducing mental health symptoms. However, comparatively little research has investigated the acceptability of these programs from the perspective of the children. Program acceptability underpins engagement, and more engaging programs are also more efficacious (Cowan & Sheridan, 2003; Mautone et al., 2009 yet there is little literature which has considered the acceptability of school-based mindfulness programs. To address this gap, semi-structured interviews were conducted with upper primary aged children (N = 30 who had participated in a six week mindfulness program in four Australian primary schools. Thematic analysis of interviews revealed children found the program to be acceptable. Children reported that they enjoyed doing the mindfulness program, would recommend it to others, and learned about relaxing as well as felt relaxed while doing the program. Children also highlighted the use of culturally appropriate teaching materials and possible stigmatisation as threats to the acceptability of the program. The results of the study support the acceptability of mindfulness programs in school settings, grounded in the unique perspective of the child.

Work-Related Asthma in Korea - Findings from the Korea Work-Related Asthma Surveillance (KOWAS) program, 2004-2009.

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Kwon, Soon-Chan; Song, Jaechul; Kim, Yong-Kyu; Calvert, Geoffrey M

2015-01-01

To determine the incidence and epidemiological characteristics of work-related asthma in Korea. During 2004-2009, the Korea Work-Related Asthma Surveillance (KOWAS) program collected data on new cases of work-related asthma from occupational physicians, allergy and chest physicians, regional surveillance systems, and workers' compensation schemes. The incidence was calculated on the basis of industry, occupation, sex, age, and region. In addition, the distribution of causal agents was determined. During the study period, 236 cases of work-related asthma were reported, with 77 cases from more than 1 source. A total of 22.0% (n=52) were reported by occupational physicians, 52.5% (n=124) by allergy and chest physicians, 24.2% (n=57) by regional surveillance systems, and 43.2% (n=102) by workers' compensation schemes. The overall average annual incidence was 3.31 cases/million workers, with a rate of 3.78/million among men and 2.58/million among women. The highest incidence was observed in the 50-59-year age group (7.74/million), in the Gyeonggi/Incheon suburb of Seoul (8.50/million), in the furniture and other instrument manufacturing industries (67.62/million), and among craft and related trades workers (17.75/million). The most common causal agents were isocyanates (46.6%), flour/grain (8.5%), metal (5.9%), reactive dyes (5.1%), and solvents (4.2%). The incidence of work-related asthma in Korea was relatively low, and varied according to industry, occupation, gender, age, and region. Data provided by workers' compensation schemes and physician reports have been useful for determining the incidence and causes of work-related asthma.

Know How to Use Your Asthma Inhaler

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Full Text Available ... CDC Publications on Asthma National Asthma Control Program America Breathing Easier Guide for State Programs Interventions Community ... over their asthma. Quick Links Asthma Action Plan America Breathing Easier [PDF – 1.1 MB] ASL Asthma ...

A qualitative study exploring adolescents' experiences with a school-based mental health program.

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Garmy, Pernilla; Berg, Agneta; Clausson, Eva K

2015-10-21

Supporting positive mental health development in adolescents is a major public health concern worldwide. Although several school-based programs aimed at preventing depression have been launched, it is crucial to evaluate these programs and to obtain feedback from participating adolescents. This study aimed to explore adolescents' experiences with a -based cognitive-behavioral depression prevention program. Eighty-nine adolescents aged 13-15 years were divided into 12 focus groups. The focus group interviews were analyzed using qualitative content analysis. Three categories and eight subcategories were found to be related to the experience of the school-based program. The first category, intrapersonal strategies, consisted of the subcategories of directed thinking, improved self-confidence, stress management, and positive activities. The second category, interpersonal awareness, consisted of the subcategories of trusting the group and considering others. The third category, structural constraints, consisted of the subcategories of negative framing and emphasis on performance. The school-based mental health program was perceived as beneficial and meaningful on both individual and group levels, but students expressed a desire for a more health-promoting approach.

Asthma Education Program for First Nations Children: An exemplar of the Knowledge-to-Action Framework

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Maureen L Douglas

2013-01-01

Full Text Available BACKGROUND: The prevalence of asthma in Aboriginal children is 6% to 14%. Gaps in knowledge regarding asthma and its management exist in First Nations (FN communities, and culturally relevant education and resources are required. Studies have recommended that the children’s asthma education program, the ‘Roaring Adventures of Puff’, be modified through partnership with FN communities to be culturally appropriate.

The Effectiveness of Web-Based Asthma Self-Management System, My Asthma Portal (MAP): A Pilot Randomized Controlled Trial.

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Ahmed, Sara; Ernst, Pierre; Bartlett, Susan J; Valois, Marie-France; Zaihra, Tasneem; Paré, Guy; Grad, Roland; Eilayyan, Owis; Perreault, Robert; Tamblyn, Robyn

2016-12-01

Whether Web-based technologies can improve disease self-management is uncertain. My Asthma Portal (MAP) is a Web-based self-management support system that couples evidence-based behavioral change components (self-monitoring of symptoms, physical activity, and medication adherence) with real-time monitoring, feedback, and support from a nurse case manager. The aim of this study was to compare the impact of access to a Web-based asthma self-management patient portal linked to a case-management system (MAP) over 6 months compared with usual care on asthma control and quality of life. A multicenter, parallel, 2-arm, pilot, randomized controlled trial was conducted with 100 adults with confirmed diagnosis of asthma from 2 specialty clinics. Asthma control was measured using an algorithm based on overuse of fast-acting bronchodilators and emergency department visits, and asthma-related quality of life was assessed using the Mini-Asthma Quality of Life Questionnaire (MAQLQ). Secondary mediating outcomes included asthma symptoms, depressive symptoms, self-efficacy, and beliefs about medication. Process evaluations were also included. A total of 49 individuals were randomized to MAP and 51 to usual care. Compared with usual care, participants in the intervention group reported significantly higher asthma quality of life (mean change 0.61, 95% CI 0.03 to 1.19), and the change in asthma quality of life for the intervention group between baseline and 3 months (mean change 0.66, 95% CI 0.35 to 0.98) was not seen in the control group. No significant differences in asthma quality of life were found between the intervention and control groups at 6 (mean change 0.46, 95% CI -0.12 to 1.05) and 9 months (mean change 0.39, 95% CI -0.2 to 0.98). For poor control status, there was no significant effect of group, time, or group by time. For all self-reported measures, the intervention group had a significantly higher proportion of individuals, demonstrating a minimal clinically

Case Study of a School-Based Universal Dating Violence Prevention Program

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Michele Cascardi

2014-09-01

Full Text Available Evaluation of universal dating violence prevention programs has rapidly expanded in the past two decades. Many programs demonstrate change in attitudes supportive of dating violence, and a few show evidence of behavior change; however, detailed analysis of process and fidelity of program implementation is generally neglected. An important goal of prevention research is to identify successful initiatives that can be replicated and disseminated in the field. The purpose of the current case study is to document the implementation process of a middle school–based dating violence prevention curriculum in economically disadvantaged urban neighborhoods. Particular attention is given to the school context, such as the process of school and teacher recruitment, the program model, and classroom implementation of the dating violence prevention program in four areas: teacher training, student outcomes, program fidelity, and student engagement. Nine health and physical education teachers from six urban middle schools participated. Results describe effective strategies to secure school participation and engagement, and provide evidence regarding methods to train health and physical education teachers in low-income, urban neighborhoods. Furthermore, classroom observations demonstrate that teachers successfully implemented the five-lesson curriculum, which resulted in positive student outcomes to prevent dating violence. This case study represents an important step in deepening our understanding of the mechanisms of program delivery.

Development of a web-based, work-related asthma educational tool for patients with asthma.

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Ghajar-Khosravi, Shadi; Tarlo, Susan M; Liss, Gary M; Chignell, Mark; Ribeiro, Marcos; Levinson, Anthony J; Gupta, Samir

2013-01-01

Asthma is a common chronic condition. Work-related asthma (WRA) has a large socioeconomic impact and is increasing in prevalence but remains under-recognized. Although international guidelines recommend patient education, no widely available educational tool exists. To develop a WRA educational website for adults with asthma. An evidence-based database for website content was developed, which applied evidence-based website design principles to create a website prototype. This was subsequently tested and serially revised according to patient feedback in three moderated phases (one focus group and two interview phases), followed by face validation by asthma educators. Patients (n=10) were 20 to 28 years of age; seven (70%) were female, three (30%) were in university, two (20%) were in college and five (50%) were currently employed. Key format preferences included: well-spaced, bulleted text; movies (as opposed to animations); photos (as opposed to cartoons); an explicit listing of website aims on the home page; and an exploding tab structure. Participants disliked integrated games and knowledge quizzes. Desired informational content included a list of triggers, prevention⁄control methods, currently available tools and resources, a self-test for WRA, real-life scenario presentations, compensation information, information for colleagues on how to react during an asthma attack and a WRA discussion forum. The website met the perceived needs of young asthmatic patients. This resource could be disseminated widely and should be tested for its effects on patient behaviour, including job choice, workplace irritant⁄allergen avoidance and⁄or protective equipment, asthma medication use and physician prompting for management of WRA symptoms.

Assessing the impact of a remote digital coaching engagement program on patient-reported outcomes in asthma.

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Rasulnia, Mazi; Burton, Billy Stephen; Ginter, Robert P; Wang, Tracy Y; Pleasants, Roy Alton; Green, Cynthia L; Lugogo, Njira

2017-08-11

Low adherence and poor outcomes provide opportunity for digital coaching to engage patients with uncontrolled asthma in their care to improve outcomes. To examine the impact of a remote digital coaching program on asthma control and patient experience. We recruited 51 adults with uncontrolled asthma, denoted by albuterol use of >2 times per week and/or exacerbations requiring corticosteroids, and applied a 12-week patient-centered remote digital coaching program using a combination of educational pamphlets, symptom trackers, best peak flow establishment, physical activity, and dietary counseling, as well as coaches who implemented emotional enforcement to motivate disease self-management through telephone, text, and email. Baseline and post-intervention measures were quality of life (QOL), spirometry, Asthma Control Test (ACT), Asthma Symptom Utility Index (ASUI), rescue albuterol use, and exacerbation history. Among 51 patients recruited, 40 completed the study. Eight subjects required assistance reading medical materials. Significant improvements from baseline were observed for Patient-Reported Outcomes Measurement Information System mental status (p = 0.010), body weight, and outpatient exacerbation frequency (p = 0.028). The changes from baseline in ACT (p = 0.005) were statistically significant but did not achieve the pre-specified minimum clinically important difference (MCID), whereas for ASUI, the MCID and statistical significance were achieved. Spirometry and rescue albuterol use were no different. A patient-oriented, remote digital coaching program that utilized trained health coaches and digital materials led to statistically significant improvement in mental status, outpatient exacerbations, body weight, and ASUI. Digital coaching programs may improve some outcomes in adults with uncontrolled asthma.

Asthma Risk Profiles of Children Participating in an Asthma Education and Management Program

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Wilson, Candice; Rapp, Kristi Isaac; Jack, Leonard, Jr.; Hayes, Sandra; Post, Robert; Malveaux, Floyd

2015-01-01

Background: Focused risk assessment is essential in the effective management of asthma. Purpose: This study identified and examined correlations among areas of pediatric asthma risk and determined associations between these risks and demographic characteristics. Methods: This exploratory study identified risk factors that affect asthma management…

Asthma and the Achievement Gap among Urban Minority Youth

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Basch, Charles E.

2011-01-01

Objectives: To outline the prevalence and disparities of asthma among school-aged urban minority youth, causal pathways through which poorly controlled asthma adversely affects academic achievement, and proven or promising approaches for schools to address these problems. Methods: Literature review. Results: Asthma is the most common chronic…

Research on psychosocial aspects of asthma in the Arab world: a literature review.

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Al-Khateeb, Anas J; Al Khateeb, Jamal M

2015-01-01

The importance of psychosocial factors in the management of bronchial asthma has long been recognized. This paper offers a review of research published in the English language related to psychosocial aspects of bronchial asthma in Arab countries. Several databases (PubMed, Science Direct, Springer Link, ERIC, and PsychInfo) were searched using the following keywords: bronchial asthma, Arab countries, Algiers, Bahrain, Comoros, Djibouti, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Mauritania, Morocco, Oman, Palestine (West Bank, Gaza), Qatar, Saudi Arabia, Syria, Tunisia, Sudan, Somalia; United Arab Emirates, and Yemen. Thirty-two studies were conducted in 9 Arab countries. Almost all studies found were published in the last fourteen years with an apparent increasing rate in the last five years. In descending order, these studies addressed: knowledge of and attitudes toward asthma, quality of life, behavioral and emotional problems and factors related to academic achievement. The main results of the studies reviewed were: (a) physicians', school staff's, and parents' knowledge of and attitudes toward asthma were generally unsatisfactory, (b) in-service asthma education programs significantly impacted parent and staff knowledge and attitudes, and asthma management practices, (c) quality of life in children and adolescents was significantly adversely affected by asthma, (d) asthma was a common cause of school absenteeism, and had a significant negative impact on academic achievement of students, and (e) students with asthma had significantly higher rates of behavioral and emotional difficulties compared to students without asthma. The paper concludes with a discussion about the implications of these results and a call for further research in this area.

Role of urbanization and air pollution in adolescent asthma: a mass screening in Taiwan.

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Lin, R S; Sung, F C; Huang, S L; Gou, Y L; Ko, Y C; Gou, H W; Shaw, C K

2001-10-01

The prevalence of asthma in school children in Taiwan is increasing. This study used mass screening among middle school children in Taiwan to determine the prevalence of asthma and related factors. Data were collected from parents using a self-reported questionnaire and from children using the International Study of Asthma and Allergies in Childhood (ISAAC) video questionnaire. Six study teams conducted the survey nationwide in 1995-1996, with the assistance of middle school nurses and teachers. Among the 1,018,031 students at 795 middle schools who returned questionnaires, 8.5% had a history of asthma (ranging in prevalence from 4.2% to 13% in 25 areas). The prevalence of asthma was higher in boys than in girls (10.0% vs 7%) and was highest in more urbanized areas (11.2%), followed by moderately urbanized areas (7.4%) and less urbanized and rural areas (6.5%). Controlling for age, family smoking, family incense burning, and parental education level, multivariate logistic regression models indicated that children living in an area with heavy air pollution were more likely to have asthma than those in an area with no or light pollution (odds ratio, OR = 2.01 and 95% confidence interval, CI = 1.94-2.09 based on parental ranking of pollution level, or OR = 1.30 and 95% CI = 1.18-1.42 based on pollution level reported by the Environmental Protection Administration). Adolescent asthma in Taiwan is most prevalent in the most urbanized areas and decreases in prevalence in less urbanized areas. This study also found that higher parental education level and higher area air pollution were associated with higher adolescent asthma prevalence.

Oral health knowledge and attitudes of primary school teachers toward school-based oral health programs in Abha-Khamis, Saudi Arabia

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Shreyas Tikare

2017-01-01

Conclusions: The oral health knowledge among primary school teachers was found to be good with positive attitudes toward school-based oral health programs. The most significant barriers in implementing a school oral health program were administrative barriers. There is a need for concerned school authorities and health policy makers to address these barriers and to promote oral health in the community.

Evaluation of school-based reproductive health education program for adolescent girls.

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Golbasi, Zehra; Taskin, Lale

2009-01-01

To evaluate the effectiveness of school-based reproductive health education for adolescent girls on the reproductive knowledge level of the girls. This research was carried out as a quasi-experimental study at two vocational girls high schools, one of which was used as the study school and the other as the control school. The study group (97 students) consisted of three classes representing every grade. The control group consisted of students selected likewise (92 students). Reproductive health education was given to students in the study group for 10 weeks; the control group was not subjected to any educational program. The impact of the program was evaluated with reproductive health knowledge test designed for this study. A pretest evaluated baseline knowledge, and a posttest measured the gain in knowledge. Baseline knowledge score of students in study and control group were similar and low (p > 0.05). We found that the reproductive health knowledge level of students in the study group increased significantly after the program of education. Post-test knowledge scores (75.03 +/- 13.82) of the students in the study group were higher than those of the control group (36.65 +/- 14.17). The results showed students' low baseline knowledge and a good ability to learn. A school-based reproductive health education is needed to promote knowledge and prevention in reproductive health among teenagers.

School-Based Smoking Prevention Programs for Middle School Students in Nowshahr- Iran: a Randomized Controlled Trial

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Maryam Khazaee-Pool

2016-11-01

Full Text Available Background: Smoking among youths is a main public health concern, and detecting predictors of smoking is essential for designing preventive programs. Any interventional program should plan with highlighting on behavioral change models and based on operative interventional program. So, this study aimed to investigate school-based smoking prevention programs for middle school students in Nowshahr, Iran.Materials and Methods: A quasi-experimental study was performed with 280 male students aged 15-17 years selected by multistage sampling. For this purpose, 6 middle schools were randomly recruited from male students in Nowshahr- Iran. Then, 140 students were randomly chosen for each the experimental and the control groups. After pretest, educational program based on Health Belief Model were performed in experimental group. Also, post-test was applied four months after interventional program in both experimental and control group.Results: Based on the results, the prevalence of smoking was higher at age 14 old in both experimental (38.7% and control (30 % groups. About 35% of participants in the experimental group and 33.6% in control group had smoker father. Additionally, 10% in experimental group and 7.8% in control group had smoker mother. Most main cause for smoking in 57.9% of the experimental group and 52.63% of the control group was reducing anxiety. Results also shown that there was a significant difference between students in the experimental and control groups after performing educational program in the mean scores of perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, and preventive behaviors of smoking (P < 0.05.Conclusion: By performing educational program, it was found that the prevalence of cigarette smoking was decreased in the intervention group. So, with a better understanding of factors affecting on this complex behavior (cigarette smoking, it can be a valuable phase to

Goals, beliefs, and concerns of urban caregivers of middle and older adolescents with asthma.

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Gibson-Scipio, Wanda; Krouse, Helene J

2013-04-01

Caregiver goals, an integral part of a partnership for asthma management, have been found to influence asthma outcomes in children. These goals are likely to change during the transitional period of adolescence to address the needs of teenagers as they mature and assume greater responsibilities for their own care. Little is known about the goals, beliefs, and concerns of caregivers as they begin to shift responsibilities for asthma management to teens. This study sought to identify the asthma management goals, beliefs, and concerns of primarily African American caregivers of urban middle and older adolescents. Fourteen caregivers of urban African American adolescents aged 14-18 years with asthma participated in a focus group session. An iterative process was used to identify themes from the session related to asthma management goals, concerns, and beliefs of caregivers. Caregivers identified goals that related to supporting their teens' progress toward independent asthma self-management. They described significant concerns related to the teens' ability to implement asthma self-management, especially in school settings. Caregivers also revealed beliefs that represented knowledge deficits related to asthma medications and factors that improved or worsened asthma. Most caregivers identified grave concerns about school policies regarding asthma medication administration and the lack of knowledge and support provided by teachers and staff for their teen. Caregivers are an invaluable resource in the care of adolescents with asthma. An opportunity exists to improve caregiver understanding of asthma medications and to provide support through improvements in asthma care for adolescents in school-based settings.

Adolescents' responses to a school-based prevention program promoting healthy eating at school

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Hermans, R.C.J.; Bruin, H. de; Larsen, J.K.; Mensink, F.; Hoek, A.C.

2017-01-01

Background: To improve the effectiveness of school-based obesity prevention programs, it is essential to understand the views and behaviors of the target group. The present study aimed to get a better understanding of adolescents' food and health perceptions and their willingness to be involved in a

Effects of Participation in a Martial Arts-Based Antibullying Program in Elementary Schools

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Twemlow, Stuart W.; Biggs, Bridget K.; Nelson, Timothy D.; Vernberg, Eric M.; Fonagy, Peter; Twemlow, Stephen W.

2008-01-01

This study evaluated the Gentle Warrior Program, a traditional martial arts-based intervention to reduce aggression in children, as it was implemented in three elementary schools. The sample consisted of 254 children in grades 3, 4, and 5 who participated in the Gentle Warrior Program as part of a larger school violence intervention. Results…

Water-based exercise for adults with asthma.

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Grande, Antonio Jose; Silva, Valter; Andriolo, Brenda N G; Riera, Rachel; Parra, Sergio A; Peccin, Maria S

2014-07-17

Asthma is a common condition characterised by airway inflammation and airway narrowing, which can result in intermittent symptoms of wheezing, coughing and chest tightness, possibly limiting activities of daily life. Water-based exercise is believed to offer benefits for people with asthma through pollen-free air, humidity and effects of exercise on physical function. To evaluate the effectiveness and safety of water-based exercise for adults with asthma. We searched the Cochrane Airways Group Specialised Register of Trials (CAGR), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED), PsycINFO, the Latin American and Caribbean Health Science Information Database (LILACS), the Physiotherapy Evidence Database (PEDro), the System for Information on Grey Literature in Europe (SIGLE) and Google Scholar on 13 May 2014. We handsearched ongoing clinical trial registers and meeting abstracts of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the British Thoracic Society (BTS). We included all randomised controlled trials (RCTs) of adults with asthma comparing a water-based exercise group versus one or more of the following groups: usual care, land-based exercise, non-exercise. Two review authors (AJG, VS) independently extracted data from the primary studies using a standard form developed for this purpose, which includes methods, participants, interventions and outcomes. We contacted trial authors to request additional data. Data were input by one review author and were double-checked by a second review author. In this systematic review, we provide a narrative synthesis of available evidence from three small studies including 136 adult participants. The studies were at high risk of bias. No meta-analysis was possible because of methodological and interventional heterogeneity between included

Tobacco Product Use Among Youths With and Without Lifetime Asthma - Florida, 2016.

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Reid, Keshia M; Forrest, Jamie R; Porter, Lauren

2018-06-01

The increasing availability of diverse tobacco products has led to complex tobacco product use patterns among youths (1). Use by youths of products containing nicotine in any form is unsafe (2); among young persons with asthma, use of combustible tobacco products, particularly cigarettes, is associated with worsening symptoms, poor asthma control, and an increased need for medical management (3,4). Studies suggest that youths with asthma adopt health risk behaviors, including tobacco product use, at rates similar to or higher than those of youths without asthma (3-7); however, these studies are often limited to a partial list of tobacco product types among high school students. To assess current use (≥1 days during the past 30 days) of one or more of five tobacco product types (cigarettes, electronic cigarettes [defined as e-cigarettes, e-cigars, vape pipes, vaping pens, e-hookah, and hookah pens], hookah, smokeless tobacco, or cigars) among Florida middle school (grades 6-8) and high school (grades 9-12) students with or without a previous medical diagnosis of asthma, the Florida Department of Health analyzed data from the 2016 Florida Youth Tobacco Survey (FYTS). In 2016, 11.1% of middle school and 27.9% of high school students with asthma, and 7.9% of middle school and 24.2% of high school students without asthma, reported any current tobacco product use. Current use of each tobacco product type was considerably higher among students with asthma than among those without asthma. E-cigarettes were the most commonly used tobacco product type reported by middle and high school students with asthma (7.9% and 19.6%, respectively) and without asthma (5.8% and 17.2%, respectively). Statewide tobacco prevention strategies could help reduce all forms of tobacco product use among youths, particularly among those with asthma.

Know How to Use Your Asthma Inhaler

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Full Text Available ... Controlling Tools for Control Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers ... Case Studies Open Airways for Schools Asthma Care Training Wee Wheezers Adventures of Puff Inner City Asthma ...

Know How to Use Your Asthma Inhaler

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Full Text Available ... Profile Tables and Graphs Asthma Call-back Survey Technical Information Prevalence Tables BRFSS Prevalence Data NHIS Prevalence ... Case Studies Open Airways for Schools Asthma Care Training Wee Wheezers Adventures of Puff Inner City Asthma ...

Know How to Use Your Asthma Inhaler

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Full Text Available ... Obesity Percentage of People with Asthma who Smoke Insurance coverage and barriers to care for people with ... Asthma NCHS Asthma FastStats Survey Questions Resources for Health Professionals and Schools Healthcare Professionals Public Health Professionals ...

Maternal depressive symptoms across early childhood and asthma in school children: findings from a Longitudinal Australian Population Based Study.

Science.gov (United States)

Giallo, Rebecca; Bahreinian, Salma; Brown, Stephanie; Cooklin, Amanda; Kingston, Dawn; Kozyrskyj, Anita

2015-01-01

There is a growing body of evidence attesting to links between early life exposure to stress and childhood asthma. However, available evidence is largely based on small, genetically high risk samples. The aim of this study was to explore the associations between the course of maternal depressive symptoms across early childhood and childhood asthma in a nationally representative longitudinal cohort study of Australian children. Participants were 4164 children and their biological mothers from the Longitudinal Study of Australian Children. Latent class analysis identified three trajectories of maternal depressive symptoms across four biennial waves from the first postnatal year to when children were 6-7 years: minimal symptoms (74.6%), sub-clinical symptoms (20.8%), and persistent and increasing high symptoms (4.6%). Logistic regression analyses revealed that childhood asthma at age 6-7 years was associated with persistent and increasing high depressive symptoms after accounting for known risk factors including smoking during pregnancy and maternal history of asthma (adjusted OR 2.36, 95% CI 1.61-3.45), p.001). Our findings from a nationally representative sample of Australian children provide empirical support for a relationship between maternal depressive symptoms across the early childhood period and childhood asthma. The burden of disease from childhood asthma may be reduced by strengthening efforts to promote maternal mental health in the early years of parenting.

Maternal depressive symptoms across early childhood and asthma in school children: findings from a Longitudinal Australian Population Based Study.

Directory of Open Access Journals (Sweden)

Rebecca Giallo

Full Text Available There is a growing body of evidence attesting to links between early life exposure to stress and childhood asthma. However, available evidence is largely based on small, genetically high risk samples. The aim of this study was to explore the associations between the course of maternal depressive symptoms across early childhood and childhood asthma in a nationally representative longitudinal cohort study of Australian children. Participants were 4164 children and their biological mothers from the Longitudinal Study of Australian Children. Latent class analysis identified three trajectories of maternal depressive symptoms across four biennial waves from the first postnatal year to when children were 6-7 years: minimal symptoms (74.6%, sub-clinical symptoms (20.8%, and persistent and increasing high symptoms (4.6%. Logistic regression analyses revealed that childhood asthma at age 6-7 years was associated with persistent and increasing high depressive symptoms after accounting for known risk factors including smoking during pregnancy and maternal history of asthma (adjusted OR 2.36, 95% CI 1.61-3.45, p.001. Our findings from a nationally representative sample of Australian children provide empirical support for a relationship between maternal depressive symptoms across the early childhood period and childhood asthma. The burden of disease from childhood asthma may be reduced by strengthening efforts to promote maternal mental health in the early years of parenting.

Know How to Use Your Asthma Inhaler

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Full Text Available ... Missed School Days among Children aged 5–17 Years Asthma Severity among Adults with Current Asthma Asthma ... different file formats (PDF, DOC, PPT, MPEG) on this site? Adobe PDF file Microsoft PowerPoint file Microsoft ...

The effectiveness of newly developed written asthma action plan in improvement of asthma outcome in children.

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Lakupoch, Kingthong; Manuyakorn, Wiparat; Preutthipan, Aroonwan; Kamalaporn, Harutai

2017-09-17

Providing asthma education about controller medication use and appropriate management of asthma exacerbation are the keys to improving the disease outcome. Many asthma guidelines recommend that physicians provide written asthma action plan (WAAP) to all of their asthmatic patients. However, the benefit of WAAP is unclear. Thus, we have created a new WAAP which is simplified in Thai and more user friendly. To determine the effectiveness of the newly developed asthma action plan in management of children with asthma. Asthmatic children who meet inclusion criteria all received the WAAP and they were followed up for 6 months with measurement of outcome variables, such as asthma exacerbation that required emergency room visit, unscheduled OPD visit, admission and school absence in order to compare with the past 6 months before receiving the WAAP. The analyzed outcomes of forty-nine children show significantly reduced emergency room visit (P-value 0.005), unscheduled OPD visit (P-value 0.046), admission days (P-value 0.026) and school absence days (P-value 0.022). Well controlled group and mild severity group were not the factors that contribute to decreased emergency room visit but step up therapy may be the co-factor to decreased ER visit. The results of this study suggest that the provision of newly developed WAAP is useful for improving self-care of asthma patients and reducing asthma exacerbation.

A population-based prescription study of asthma drugs during pregnancy

DEFF Research Database (Denmark)

Olesen, Charlotte; Thrane, Nana; Nielsen, G.L.

2001-01-01

Background: Among the goals of gestational asthma, therapy is optimisation of pulmonary function. According to the US Food and Drug Administration, no asthma drugs can be considered ‘safe’ during pregnancy. Fear of adverse fetal effects may thus lead to restrictive use of asthma drugs during...... pregnancy, and no population-based studies concerning gestational asthma therapy exist. Objectives: To examine whether asthma drugs or changing intensity of asthma therapy during pregnancy was associated with deviations from expected values of gestational age, birth weight, length at birth, or malformations....... Methods: The Birth Registry was used to identify all 15,756 primiparous women who gave birth in the County of North Jutland between 1991 and 1996. According to the North Jutland Prescription Database, 303 of these women received prescriptions for asthma drugs during pregnancy. Women who did not purchase...

Associated factors to repeated consultations to the urgencies service for asthma in pediatric patient: Implications for an educational program

International Nuclear Information System (INIS)

Rodriguez Martinez, Carlos; Sossa, Monica Patricia

2004-01-01

Bronchial asthma is one of the most frequent respiratory diseases in childhood. Recurrent emergency department visits for asthma produce anxiety and high costs for the system of health and for the family. It is important to know the factors related to these recurrent emergency department visits to assist the targeting of appropriate future interventions aimed at reducing this avoidable presentation. The objective of the present study was to identify factors associated with recurrent emergency department visits for asthma in children liable to be modified by means of an education program. Data obtained from a survey of parents of 146 pediatric patients with asthma attending an asthma clinic and educational program were examined. Parents completed an asthma knowledge and attitudes questionnaire that also included other socio demographic and illness-related variables, including the number of consultations to emergency department by their children asthma in the previous 6 months. Of the 146 asthmatic patients enrolled, 41 (28.1%) consulted repeatedly to the emergency department for asthma. After controlling for age of the patient, educational level of the parents, and functional severity of the disease, we found that parents who reported that they attended to emergency room because asthma attacks of their children were severe enough to go elsewhere (OR, 4.57; CL95%, 1.76- 11.85; P = 0.002), parents who reported that asthma medications should be administered only in symptomatic moments (OR 278, CL 95%, 1.05 - 7.33, P = 0.038 and parents that did not recognize the fact that asthma attacks can be avoided if medications are administered when there are no symptoms (between asthma attacks) (OR 2.61; CL95%; 1.03 - 7.02; p = 0,045), had a greater probability to attend rapidly the emergency room because of asthma of their children. The fact that parents of asthmatic patients have thought that asthma medications should be administered only in symptomatic patients, that they hadn

A Case Study of Culturally Relevant School-Based Programming for First Nations Youth: Improved Relationships, Confidence and Leadership, and School Success

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Crooks, Claire V.; Burleigh, Dawn; Snowshoe, Angela; Lapp, Andrea; Hughes, Ray; Sisco, Ashley

2015-01-01

Schools are expected to promote social and emotional learning skills among youth; however, there is a lack of culturally-relevant programming available. The Fourth R: Uniting Our Nations programs for Aboriginal youth include strengths-based programs designed to promote healthy relationships and cultural connectedness, and improve school success…

An evaluation of a community pharmacy-based rural asthma management service.

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Saini, Bandana; Filipovska, Julija; Bosnic-Anticevich, Sinthia; Taylor, Susan; Krass, Ines; Armour, Carol

2008-04-01

To compare the effect of a pharmacist-delivered rural asthma management service (RAMS) on health outcomes for people with asthma in a rural/regional area with 'standard care' delivered through community pharmacies. A parallel group controlled repeated measures study. Community pharmacies in Central West New South Wales. Standardised protocols and resources based on national asthma management guidelines, delivered by specially trained community pharmacists. Patients visited the pharmacy at baseline and 1, 3 and 6 months after baseline in the intervention group and at baseline plus 6 months after baseline in the control group. The intervention pharmacists (n = 12) were trained to deliver the RAMS model, while control pharmacists (n = 8) provided standard asthma care to their recruited patients. Fifty-one and 39 patients were recruited by intervention and control pharmacists. Asthma severity score which was a composite score based on recency, frequency and severity of asthma symptoms, and asthma history. Data compared at the final visit between groups indicated that the RAMS patient group demonstrated a significant reduction in the asthma severity scores (7.9 +/- 2.6 versus 10.4 +/- 2.6, P < 0.001); a reduction in the risk of non-adherence to medication scores (1.6 +/- 0.7 versus 2.3 +/- 1.1, P < 0.001); and an increase in the proportion of patients owning a written action plan (50% versus 23%, P = 0.04). These results indicated that the community pharmacy-based RAMS model can improve asthma outcomes for patients in rural settings, and similar models for asthma and other chronic diseases should be tested rigorously and adopted in rural primary care practice.

Association of consumption of products containing milk fat with reduced asthma risk in pre-school children : the PIAMA birth cohort study

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Wijga, AH; Smit, HA; Kerkhof, M; de Jongste, JC; Gerritsen, J; Neijens, HJ; Boshuizen, HC; Brunekreef, B

Background: Environment and lifestyle contribute to the development of asthma in children. Understanding the relevant factors in this relationship may provide methods of prevention. The role of diet in the development of asthma in pre-school children was investigated. Methods: Data from 2978

An ecological and theoretical deconstruction of a school-based obesity prevention program in Mexico.

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Safdie, Margarita; Cargo, Margaret; Richard, Lucie; Lévesque, Lucie

2014-08-10

Ecological intervention programs are recommended to prevent overweight and obesity in children. The National Institute of Public Health (INSP) in Mexico implemented a successful ecological intervention program to promote healthy lifestyle behaviors in school age children. This study assessed the integration of ecological principles and Social Cognitive Theory (SCT) constructs in this effective school-based obesity prevention program implemented in 15 elementary schools in Mexico City. Two coders applied the Intervention Analysis Procedure (IAP) to "map" the program's integration of ecological principles. A checklist gauged the use of SCT theory in program activities. Thirty-two distinct intervention strategies were implemented in one setting (i.e., school) to engage four different target-groups (students, parents, school representatives, government) across two domains (Nutrition and Physical Activity). Overall, 47.5% of the strategies targeted the school infrastructure and/or personnel; 37.5% of strategies targeted a key political actor, the Public Education Secretariat while fewer strategies targeted parents (12.5%) and children (3%). More strategies were implemented in the Nutrition domain (69%) than Physical Activity (31%). The most frequently used SCT construct within both intervention domains was Reciprocal Determinism (e.g., where changes to the environment influence changes in behavior and these behavioral changes influence further changes to the environment); no significant differences were observed in the use of SCT constructs across domains. Findings provide insight into a promising combination of strategies and theoretical constructs that can be used to implement a school-based obesity prevention program. Strategies emphasized school-level infrastructure/personnel change and strong political engagement and were most commonly underpinned by Reciprocal Determinism for both Nutrition and Physical Activity.

Description of the Design and Implementation of a School-Based Obesity Prevention Program Addressing Needs of Middle School Students

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Ward-Begnoche, Wendy L.; Gance-Cleveland, Bonnie; Harris, Margaret M.; Dean, Janice

2008-01-01

This article describes the design and implementation of a school-based obesity prevention program, the successes associated with its implementation, and challenges with development and application of the program's curriculum base. The program is described, including purpose and goals, content and structure of the curriculum, type and training of…

Technology-Based Interventions for Asthma-Can They Help Decrease Health Disparities?

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Baptist, Alan P; Islam, Nishat; Joseph, Christine L M

Asthma is a condition that has consistently demonstrated significant health outcome inequalities for minority populations. One approach used for care of patients with asthma is the incorporation of technology for behavioral modification, symptom monitoring, education, and/or treatment decision making. Whether such technological interventions can improve the care of black and inner-city patients is unknown. We reviewed all randomized controlled trial technological interventions from 2000 to 2015 performed in minority populations. A total of 16 articles met inclusion and exclusion criteria; all but 1 was performed in a childhood or adolescent age group. The interventions used MPEG audio layer-3 players, text messaging, computer/Web-based systems, video games, and interactive voice response. Many used tailored content and/or a specific behavior theory. Although the interventions were based on technology, most required additional special staffing. Subject user satisfaction was positive, and improvements were noted in asthma knowledge, medication adherence, asthma symptoms, and quality of life. Unfortunately, health care utilization (emergency department visits and/or hospitalizations) was typically not improved by the interventions. Although no single intervention modality was vastly superior, the computer-based interventions appeared to have the most positive results. In summary, technology-based interventions have a high level of user satisfaction among minority and urban/low-income individuals with asthma, and can improve asthma outcomes. Further large-scale studies are needed to assess whether such interventions can decrease health disparities in asthma. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

The burden of severe asthma in childhood and adolescence

DEFF Research Database (Denmark)

Fleming, Louise; Murray, Clare; Bansal, Aruna T

2015-01-01

U-BIOPRED aims to characterise paediatric and adult severe asthma using conventional and innovative systems biology approaches. A total of 99 school-age children with severe asthma and 81 preschoolers with severe wheeze were compared with 49 school-age children with mild/moderate asthma and 53...... in the severe wheeze cohort. Almost all participants in each cohort were atopic and had a normal body mass index. Asthma-related quality of life, as assessed by the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), was worse...... and mild/moderate cohorts were clinically very similar. Children with severe preschool wheeze or severe asthma are usually atopic and have impaired quality of life that is associated with poor control and airflow limitation: a very different phenotype from adult severe asthma. In-depth phenotyping...

Effects of a school-based pediatric obesity prevention program

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The purpose of this study was to evaluate a school-based pediatric obesity program for elementary children. Children (n = 782) were between the ages of 7 and 9 and in the 2nd grade. A total of 323 (189 males) children who exceeded the 85th percentile for BMI were randomized into an integrated health...

Asthma and respiratory symptoms among hairdressers in Denmark

DEFF Research Database (Denmark)

Lysdal, Susan Hovmand; Mosbech, Holger; Johansen, Jeanne Duus

2014-01-01

BACKGROUND: Hairdressers are at risk of developing occupational respiratory disorders due to persulfates and other hairdressing chemicals. METHODS: A register based questionnaire study comprising 7,840 graduates from hairdressing vocational schools was conducted. The postal questionnaire concerned....... CONCLUSIONS: Asthma and especially respiratory symptoms were commonly reported by hairdressers, but rarely reported as an occupational disease. Local exhaust ventilation was inconsistently used. Our results underline the need for improved measures to ascertain and prevent occupational asthma in hairdressers....

Asthma disease management-Australian pharmacists' interventions improve patients' asthma knowledge and this is sustained.

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Saini, Bandana; LeMay, Kate; Emmerton, Lynne; Krass, Ines; Smith, Lorraine; Bosnic-Anticevich, Sinthia; Stewart, Kay; Burton, Deborah; Armour, Carol

2011-06-01

To assess any improvements in knowledge of asthma patients after a tailored education program delivered by pharmacists and measure the sustainability of any improvements. To ascertain patients' perceptions about any changes in their knowledge. Ninety-six specially trained pharmacists recruited patients based on their risk of poor asthma control. A tailored intervention was delivered to patients based on individual needs and goals, and was conducted at three or four time points over six months. Asthma knowledge was assessed at the beginning and end of the service, and six and 12 months after it had ended. Patients' perceptions of the impact of the service on their knowledge were explored qualitatively in interviews. The 96 pharmacists recruited 570 patients, 398 (70%) finished. Asthma knowledge significantly improved as a result of the service (7.65 ± 2.36, n=561, to 8.78 ± 2.14, n=393). This improvement was retained for at least 12 months after the service. Patients reported how the knowledge and skills gained had led to a change in the way they managed their asthma. Improvements in knowledge are achievable and sustainable if pharmacists used targeted educational interventions. Pharmacist educational interventions are an efficient way to improve asthma knowledge in the community. Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All rights reserved.

[Process evaluation in relation to effectiveness assessment: experiences with school-based programs].

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Ariza, Carles; Villalbí, Joan R; Sánchez-Martínez, Francesca; Nebot, Manel

2011-06-01

Evaluation of public health interventions usually focus on the quality of design and research methods, and less on the quality of the intervention or process evaluation. In process evaluation of school-based interventions, key issues are how completely the intervention is carried out and adherence to the protocol. In addition, exploration of intermediate variables, such as those that influence (and often predict) preventable behavior, is highly useful. This article describes the basic concepts in this topic, using examples of the effectiveness of some preventive interventions carried out in schools. The interventions discussed were mainly quasi-experimental studies, based on data from programs promoted by public health teams in the city of Barcelona. Data from process evaluation of preventive programs in secondary schools that underwent formal assessment of their effectiveness is provided. The examples are drawn from preventive programs of HIV infection or unprotected sexual intercourse (PRESSEC program) and drug consumption prevention (the PASE, PASE.bcn and x kpts programs). These examples show why the intervention process influences the impact of the programs and their results. Thorough planning of process evaluation is essential to obtain valid indicators that will identify, in the effectiveness evaluation of the intervention, the most efficacious strategies to obtain positive outcomes. Copyright © 2011 Sociedad Española de Salud Pública y Administración Sanitaria. Published by Elsevier Espana. All rights reserved.

A school-based health education program can improve cholesterol values for middle school students.

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Cotts, T B; Goldberg, C S; Palma Davis, L M; Durussel-Weston, J E; Aaronson, S M; Lin, K; Eagle, K A

2008-09-01

This prospective study aimed to measure the impact of a school-based multidisciplinary education program on risk factors for atherosclerosis in sixth-grade students. A prospective study was performed in which patients served as their own controls. Healthy sixth-grade students from three middle schools in a city of approximately 100,000 were exposed to an educational program promoting healthful habits through behavioral and environmental change. Risk factors including body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP), cholesterol panel, and random blood glucose were measured before program initiation, then 5 months afterward. Of 711 sixth-graders at three middle schools, 287 (47% boys; mean age, 11.5 +/- 0.37 years) consented to participate in the study. The mean total cholesterol value decreased from 169 +/- 26 to 154 +/- 26 mg/dl (p value decreased from 86 +/- 25 to 84 +/- 23 mg/dl (p = 0.01), and the high-density lipoprotein (HDL) cholesterol value decreased from 56 +/- 13 to 50 +/- 13 mg/dl (p value decreased from 96 +/- 13 to 93 +/- 15 mm/dl (p = 0.01). The mean SBP did not change, showing 109 +/- 12.5 mmHg before the program and 108 +/- 11.5 mmHg afterward. The DBP decreased from 63.6 +/- 8.6 to 62.3 +/- 7.8 mmHg (p = 0.01). The Project Healthy Schools program is feasible and appears to be effective. The results showed significant improvement in risk factors for early atherosclerosis among sixth-grade students including total cholesterol, LDL cholesterol, random glucose levels, and diastolic blood pressure. Further study with a larger group and a longer follow-up period would be valuable.

Early childhood growth patterns and school-age respiratory resistance, fractional exhaled nitric oxide and asthma.

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Casas, Maribel; den Dekker, Herman T; Kruithof, Claudia J; Reiss, Irwin K; Vrijheid, Martine; de Jongste, Johan C; Jaddoe, Vincent W V; Duijts, Liesbeth

2016-12-01

Greater infant weight gain is associated with lower lung function and increased risk of childhood asthma. The role of early childhood peak growth patterns is unclear. We assessed the associations of individually derived early childhood peak growth patterns with respiratory resistance, fractional exhaled nitric oxide, wheezing patterns, and asthma until school-age. We performed a population-based prospective cohort study among 5364 children. Repeated growth measurements between 0 and 3 years of age were used to derive standard deviation scores (s.d.s) of peak height and weight velocities (PHV and PWV, respectively), and body mass index (BMI) and age at adiposity peak. Respiratory resistance and fractional exhaled nitric oxide were measured at 6 years of age. Wheezing patterns and asthma were prospectively assessed by annual questionnaires. We also assessed whether any association was explained by childhood weight status. Greater PHV was associated with lower respiratory resistance [Z-score (95% CI): -0.03 (-0.04, -0.01) per s.d.s increase] (n = 3382). Greater PWV and BMI at adiposity peak were associated with increased risks of early wheezing [relative risk ratio (95% CI): 1.11 (1.06, 1.16), 1.26 (1.11, 1.43), respectively] and persistent wheezing [relative risk ratio (95% CI): 1.09 (1.03, 1.16), 1.37 (1.17, 1.60), respectively] (n = 3189 and n = 3005, respectively). Childhood weight status partly explained these associations. No other associations were observed. PWV and BMI at adiposity peak are critical for lung developmental and risk of school-age wheezing. Follow-up studies at older ages are needed to elucidate whether these effects persist at later ages. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

School-Based Mental Health Programs in the United States: Present Status and a Blueprint for the Future.

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Pfeiffer, Steven I.; Reddy, Linda A.

1998-01-01

Provides overview of sociocultural and political factors in the United States that have influenced recent interest in school-based health and mental health programs. Describes four well-known programs and presents a new framework, the Tripartite Model of School-Based Mental Health Interventions, to stimulate thinking on future programs. Addresses…

Community-level moderators of a school-based childhood sexual assault prevention program.

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Morris, Matthew C; Kouros, Chrystyna D; Janecek, Kim; Freeman, Rachel; Mielock, Alyssa; Garber, Judy

2017-01-01

Childhood sexual abuse (CSA) is highly prevalent and associated with a wide variety of negative mental and physical health outcomes. School-based CSA education and prevention programs have shown promise, but it is unclear to what extent community-level characteristics are related to their effectiveness. The present cluster randomized controlled trial evaluated community-level moderators of the Safe@Lastprogramcomparedtoawaitlistcontrolcondition.(*) Knowledge gains from pre- to post-intervention were assessed in 5 domains: safe versus unsafe people; safe choices; problem-solving; clear disclosure; and assertiveness. Participants were 1177 students (46% White, 26% African American, 15% Hispanic, 4% Asian American, 6% Other) in grades 1 through 6 from 14 public schools in Tennessee. Multilevel models accounting for the nesting of children within schools revealed large effect sizes for the intervention versus control across all knowledge domains (d's ranged from 1.56 to 2.13). The effectiveness of the program was moderated by mean per capita income and rates of substantiated cases of child abuse and neglect in the community. Intervention effects were stronger for youth living in lower as compared to higher income counties, and for youth attending schools in counties with lower as compared to higher abuse/neglect rates. Child characteristics (sex, race) did not moderate intervention effects. This research identified two community-level factors that predicted the effectiveness of a CSA education and prevention program designed to improve children's knowledge of personal safety skills. School-based CSA prevention programs may require modification for communities with higher rates of child abuse and neglect. Copyright © 2016 Elsevier Ltd. All rights reserved.

Asthma and Adolescents: Review of Strategies to Improve Control

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Hennessy-Harstad, Ellen

2013-01-01

One of every 10 adolescents in the United States has asthma. Adolescents who lack asthma control are at increased risk for severe asthma episodes and death. The National Heart, Lung, and Blood Institute 2007 asthma guidelines and research studies indicated that school nurses are instrumental in assisting adolescents to monitor their asthma, learn…

Perceived parent financial burden and asthma outcomes in low-income, urban children.

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Patel, Minal R; Brown, Randall W; Clark, Noreen M

2013-04-01

The purpose of this study was to describe the demographic characteristics of low-income parents who perceive financial burden in managing their child's asthma and related associations with their children's asthma outcomes and clinical characteristics. We hypothesized that (1) identifiable differences between parents who do and do not report burden; (2) regardless of access to care, asthma outcomes would be worse for children whose parents perceive financial burden in obtaining care for their child's condition. Baseline data from a randomized trial evaluating the effect of a school-based asthma intervention were analyzed for this research. Eight hundred thirty-five parents were interviewed by telephone regarding their child's asthma management. Associations between demographic and clinical factors and perception of financial burden were examined using bivariate analysis. Multivariate regression analyses were used to examine associations between perceptions of financial burden and asthma outcomes, including emergency department visits, hospitalizations, and missed school days. Perceived financial burden was evident in 10% (n = 79) of parents. Female heads of household (χ2 (3) = 7.41; p financial burden. In models controlling for level of asthma control, income, and having a usual source of asthma care, parents who perceived financial burden were more likely to have children who had at least one emergency department visit (OR = 1.95; 95% CI = 1.15 to 3.29), hospitalization (OR = 3.99; 95% CI = 2.03 to 7.82), or missed school days due to asthma (OR = 3.26; 95% CI = 1.60 to 6.67) in the previous year. Our results supported our hypotheses. Among low-income parents of children with asthma, the majority do not perceive financial burden to obtaining care. However, among parents that do perceive burden, urgent care use and missed school days due to asthma for their child were significantly higher, regardless of family income and having a

Mobile phone-based asthma self-management aid for adolescents (mASMAA: a feasibility study

Directory of Open Access Journals (Sweden)

Rhee H

2014-01-01

Full Text Available Hyekyun Rhee,1 James Allen,2 Jennifer Mammen,1 Mary Swift21School of Nursing, 2Department of Computer Science, University of Rochester, Rochester, NY, USAPurpose: Adolescents report high asthma-related morbidity that can be prevented by adequate self-management of the disease. Therefore, there is a need for a developmentally appropriate strategy to promote effective asthma self-management. Mobile phone-based technology is portable, commonly accessible, and well received by adolescents. The purpose of this study was to develop and evaluate the feasibility and acceptability of a comprehensive mobile phone-based asthma self-management aid for adolescents (mASMAA that was designed to facilitate symptom monitoring, treatment adherence, and adolescent–parent partnership. The system used state-of-the-art natural language-understanding technology that allowed teens to use unconstrained English in their texts, and to self-initiate interactions with the system.Materials and methods: mASMAA was developed based on an existing natural dialogue system that supports broad coverage of everyday natural conversation in English. Fifteen adolescent–parent dyads participated in a 2-week trial that involved adolescents' daily scheduled and unscheduled interactions with mASMAA and parents responding to daily reports on adolescents' asthma condition automatically generated by mASMAA. Subsequently, four focus groups were conducted to systematically obtain user feedback on the system. Frequency data on the daily usage of mASMAA over the 2-week period were tabulated, and content analysis was conducted for focus group interview data.Results: Response rates for daily text messages were 81%–97% in adolescents. The average number of self-initiated messages to mASMAA was 19 per adolescent. Symptoms were the most common topic of teen-initiated messages. Participants concurred that use of mASMAA improved awareness of symptoms and triggers, promoted treatment adherence and

Asthma in inner city children: recent insights: United States.

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Dutmer, Cullen M; Kim, Haejin; Searing, Daniel A; Zoratti, Edward M; Liu, Andrew H

2018-04-01

Children living in US inner cities experience disparate burdens of asthma, especially in severity, impairment, exacerbations, and morbidity. Investigations seeking to better understand the factors and mechanisms underlying asthma prevalence, severity, and exacerbation in children living in these communities can lead to interventions that can narrow asthma disparities and potentially benefit all children with asthma. This update will focus on recent (i.e. late 2016-2017) advances in the understanding of asthma in US inner city children. Studies published in the past year expand understanding of asthma prevalence, severity, exacerbation, and the outcomes of guidelines-based management of these at-risk children, including: asthma phenotypes in US inner city children that are severe and difficult-to-control; key environmental determinants and mechanisms underlying asthma severity and exacerbations (e.g. allergy-mediated exacerbation susceptibility to rhinovirus); the importance of schools as a place for provocative exposures (e.g. mouse allergen, nitrogen dioxide) as well as a place where asthma care and outcomes can be improved; and the development and validation of clinically useful indices for gauging asthma severity and predicting exacerbations. These recent studies provide a trove of actionable findings that can improve asthma care and outcomes for these at-risk children.

Redesigning a large school-based clinical trial in response to changes in community practice.

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Gerald, Lynn B; Gerald, Joe K; McClure, Leslie A; Harrington, Kathy; Erwin, Sue; Bailey, William C

2011-06-01

Asthma exacerbations are seasonal with the greatest risk in elementary-age students occurring shortly after returning to school following summer break. Recent research suggests that this seasonality in children is primarily related to viral respiratory tract infections. Regular hand washing is the most effective method to prevent the spread of viral respiratory infections; unfortunately, achieving hand washing recommendations in schools is difficult. Therefore, we designed a study to evaluate the effect of hand sanitizer use in elementary schools on exacerbations among children with asthma. To describe the process of redesigning the trial in response to changes in the safety profile of the hand sanitizer as well as changes in hand hygiene practice in the schools. The original trial was a randomized, longitudinal, subject-blinded, placebo-controlled, community-based crossover trial. The primary aim was to evaluate the incremental effectiveness of hand sanitizer use in addition to usual hand hygiene practices to decrease asthma exacerbations in elementary-age children. Three events occurred that required major modifications to the original study protocol: (1) safety concerns arose regarding the hand sanitizer's active ingredient; (2) no substitute placebo hand sanitizer was available; and (3) community preferences changed regarding hand hygiene practices in the schools. The revised protocol is a randomized, longitudinal, community-based crossover trial. The primary aim is to evaluate the incremental effectiveness of a two-step hand hygiene process (hand hygiene education plus institutionally provided alcohol-based hand sanitizer) versus usual care to decrease asthma exacerbations. Enrollment was completed in May 2009 with 527 students from 30 schools. The intervention began in August 2009 and will continue through May 2011. Study results should be available at the end of 2011. The changed design does not allow us to directly measure the effectiveness of hand

The Impact of a School-Based Cultural Awareness Program on Students Ethnic Identity and Self-Esteem

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Braswell, Charley Alexandria

2011-01-01

The purpose of this quantitative study was to examine the influences of a school-based cultural awareness program on ethnic identity and self-esteem in fifth grade early adolescents. The development and implementation of a school-based cultural awareness program was intended to offer students a basic foundation for the development and/or…

Prevalence of asthma and asthma-like symptoms in inner-city schoolchildren.

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Mvula, Mosanda; Larzelere, Michele; Kraus, Marjorie; Moisiewicz, Kathleen; Morgan, Connie; Pierce, Stephanie; Post, Robert; Nash, Theresa; Moore, Cleveland

2005-02-01

This study investigates the prevalence of asthma and asthma-related symptoms in New Orleans inner-city schoolchildren. A cross-sectional survey of 1535 elementary, middle, and high school children (aged 5-18) was conducted by using the International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire. Lifetime prevalence of wheezing was 39.4%, and lifetime prevalence of asthma was 24.4%. Wheezing during the previous 12 months was reported by 25.7% of the sample. Twenty-one percent of respondents reported having one or more attacks of wheezing per year, with 5.6% reporting four or more attacks per year. Many participants reported sleep disturbance (15.4%), with 6.2% reporting sleep disturbance more than once a week. The 12-month rate of speech limitation due to asthma exacerbation was 6.6%. Exercise-induced asthma was reported by 16.9% of the students, and nocturnal cough (not associated with cold) was reported by 27.3%. Overall, boys reported higher rates of symptoms than girls, and younger children (aged 6-7) reported greater symptoms than older children (aged 13-14). These findings show that prevalence of asthma in this population is elevated, and the ISAAC written questionnaire successfully identified inner-city children at risk for asthma in New Orleans.

School-based internet obesity prevention programs for adolescents: a systematic literature review.

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Whittemore, Robin; Chao, Ariana; Popick, Rachel; Grey, Margaret

2013-03-01

In response to the childhood obesity epidemic, numerous studies on school-based Internet obesity prevention interventions have been conducted. The purpose of this systematic review is to describe, synthesize, and evaluate the research on school-based Internet obesity prevention programs for adolescents. Medline, CINAHL, and PsycInfo were searched from January 1995 to August 2012 to locate relevant studies. Ninety-one reports were initially identified, with 12 meeting the inclusion criteria. Studies had variable control groups, program content, and sample characteristics. Though few authors reported on implementation processes or body mass index (BMI) outcomes, the majority of studies were effective in improving health behaviors in the short term. Most studies were judged to have a high or unclear risk of bias in at least two domains, thus the quality of evidence for this body of literature is moderate. Further research is needed to examine programs of longer duration, optimal dose and timing of programs, cost-effectiveness, and mediators and moderators of intervention outcomes.

The effects of combining Web-based eHealth with telephone nurse case management for pediatric asthma control: a randomized controlled trial.

Science.gov (United States)

Gustafson, David; Wise, Meg; Bhattacharya, Abhik; Pulvermacher, Alice; Shanovich, Kathleen; Phillips, Brenda; Lehman, Erik; Chinchilli, Vernon; Hawkins, Robert; Kim, Jee-Seon

2012-07-26

Asthma is the most common pediatric illness in the United States, burdening low-income and minority families disproportionately and contributing to high health care costs. Clinic-based asthma education and telephone case management have had mixed results on asthma control, as have eHealth programs and online games. To test the effects of (1) CHESS+CM, a system for parents and children ages 4-12 years with poorly controlled asthma, on asthma control and medication adherence, and (2) competence, self-efficacy, and social support as mediators. CHESS+CM included a fully automated eHealth component (Comprehensive Health Enhancement Support System [CHESS]) plus monthly nurse case management (CM) via phone. CHESS, based on self-determination theory, was designed to improve competence, social support, and intrinsic motivation of parents and children. We identified eligible parent-child dyads from files of managed care organizations in Madison and Milwaukee, Wisconsin, USA, sent them recruitment letters, and randomly assigned them (unblinded) to a control group of treatment as usual plus asthma information or to CHESS+CM. Asthma control was measured by the Asthma Control Questionnaire (ACQ) and self-reported symptom-free days. Medication adherence was a composite of pharmacy refill data and medication taking. Social support, information competence, and self-efficacy were self-assessed in questionnaires. All data were collected at 0, 3, 6, 9, and 12 months. Asthma diaries kept during a 3-week run-in period before randomization provided baseline data. Of 305 parent-child dyads enrolled, 301 were randomly assigned, 153 to the control group and 148 to CHESS+CM. Most parents were female (283/301, 94%), African American (150/301, 49.8%), and had a low income as indicated by child's Medicaid status (154/301, 51.2%); 146 (48.5%) were single and 96 of 301 (31.9%) had a high school education or less. Completion rates were 127 of 153 control group dyads (83.0%) and 132 of 148 CHESS

How much do health care providers value a community-based asthma care program? – a survey to collect their opinions on the utilities of and barriers to its uptake

Directory of Open Access Journals (Sweden)

McLimont Susan

2009-05-01

Full Text Available Abstract Background A comprehensive asthma care program (ACP based on Canadian Asthma Consensus Guidelines was implemented in 8 primary care sites in Ontario, Canada. A survey was distributed to health care providers' (HCPs to collect their opinions on the utilities of and barriers to the uptake of the ACP. Methods A 39-item self-administered survey was mailed to 184 HCPs and support staff involved in delivering the ACP at the end of implementation. The items were presented in mixed formats with most items requiring responses on a five-point Likert scale. Distributions of responses were analyzed and compared across types of HCPs and sites. Results Of the 184 surveys distributed, 108 (59% were returned, and of that, 83 were completed by HCPs who had clinical contact with the patients. Overall, 95% of the HCPs considered the ACP useful for improving asthma care management. Most HCPs favored using the asthma care map (72%, believed it decreased uncertainties and variations in patient management (91%, and considered it a convenient and reliable source of information (86%. The most commonly reported barrier was time required to complete the asthma care map. Over half of the HCPs reported challenges to using spirometry, while almost 40% identified barriers to using the asthma action plan. Conclusion Contrary to the notion that physicians believe that guidelines foster cookbook medicine, our study showed that HCPs believed that the ACP offered an effective and reliable approach for enhancing asthma care and management in primary care.

Promoting Sustained Breastfeeding of Infants at Risk for Asthma: Explaining the "Active Ingredients" of an Effective Program Using Intervention Mapping.

Science.gov (United States)

Mesters, Ilse; Gijsbers, Barbara; Bartholomew, L Kay

2018-01-01

Infants whose parents and/or siblings have a history of asthma or allergy may profit from receiving exclusive breastfeeding during the first 6 months of life. This is expected to diminish the chance of developing childhood asthma and/or atopic disease. Ongoing breastfeeding for 6 months seems challenging for many women. An educational program was developed using Intervention Mapping as a logic model to guide development and was found successful in improving breastfeeding rates at 6 months postpartum, improving knowledge and beliefs about breastfeeding for 6 months, after exposure to the program compared to controls. Intervention elements included an evidence- and theory-based booklet addressed during pre- and postnatal home visits by trained assistants. This paper elucidates the inner workings of the program by systematically describing and illustrating the steps for intervention development.

Effects of a Self-Management Educational Program for the Control of Childhood Asthma.

Science.gov (United States)

Perez, Maria Gabriela; Feldman, Lya; Caballero, Fernan

1999-01-01

Evaluates the effects of a self-management educational program on 29 children and their parents. Program consists of six sessions of information giving and cognitive-behavioral strategies for the children, and two talks and a brochure for the parents. Results indicate a significant effect on children's asthma knowledge and practice of…

School-Based Peer Mentoring in High School: A Program Evaluation Study

Science.gov (United States)

Cooper, Felicia Cecile

2017-01-01

The dissertation is an initial investigation of a peer mentoring program in a suburban high school in the southeastern United States. Additionally, the Peer Mentoring Program (PMP) study examined whether the Program improves academic performance and attendance, and decreases referrals. Utilizing an experimental design, a Participant and a…

Increased ultrafine particles and carbon monoxide concentrations are associated with asthma exacerbation among urban children

Science.gov (United States)

Evans, Kristin A.; Halterman, Jill S.; Hopke, Philip K.; Fagnano, Maria; Rich, David Q.

2014-01-01

Objectives Increased air pollutant concentrations have been linked to several asthma-related outcomes in children, including respiratory symptoms, medication use, and hospital visits. However, few studies have examined effects of ultrafine particles in a pediatric population. Our primary objective was to examine the effects of ambient concentrations of ultrafine particles on asthma exacerbation among urban children and determine whether consistent treatment with inhaled corticosteroids could attenuate these effects. We also explored the relationship between asthma exacerbation and ambient concentrations of accumulation mode particles, fine particles (≤ 2.5 micrograms [μm]; PM2.5), carbon monoxide, sulfur dioxide, and ozone. We hypothesized that increased 1 to 7 day concentrations of ultrafine particles and other pollutants would be associated with increases in the relative odds of an asthma exacerbation, but that this increase in risk would be attenuated among children receiving school-based corticosteroid therapy. Methods We conducted a pilot study using data from 3–10 year-old children participating in the School-Based Asthma Therapy trial. Using a time-stratified case-crossover design and conditional logistic regression, we estimated the relative odds of a pediatric asthma visit treated with prednisone (n=96 visits among 74 children) associated with increased pollutant concentrations in the previous 7 days. We re-ran these analyses separately for children receiving medications through the school-based intervention and children in a usual care control group. Results Interquartile range increases in ultrafine particles and carbon monoxide concentrations in the previous 7 days were associated with increases in the relative odds of a pediatric asthma visit, with the largest increases observed for 4-day mean ultrafine particles (interquartile range=2088 p/cm3; OR=1.27; 95% CI=0.90–1.79) and 7-day mean carbon monoxide (interquartile range=0.17 ppm; OR=1.63; 95

The Effectiveness of Psycho-Educational School-Based Child Sexual Abuse Prevention Training Program on Turkish Elementary Students

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Cecen-Erogul, Ayse Rezan; Kaf Hasirci, Ozlem

2013-01-01

In Turkey, there is neither systematic nor structured child sexual abuse prevention programs for school-aged children in school settings. The main purpose of this study was to investigate the effectiveness of a school-based child sexual abuse prevention program on elementary school (4th grade) students. Quasi-experimental design with pretest,…

Know How to Use Your Asthma Inhaler

Medline Plus

Full Text Available ... the Nation Fact Sheet State Data Profiles (2011) Work-related Asthma NCHS Asthma FastStats Survey Questions Resources for Health Professionals and Schools Healthcare Professionals Public Health Professionals ...

The School for Science and Math at Vanderbilt: An Innovative Research-Based Program for High School Students

Science.gov (United States)

Eeds, Angela; Vanags, Chris; Creamer, Jonathan; Loveless, Mary; Dixon, Amanda; Sperling, Harvey; McCombs, Glenn; Robinson, Doug

2014-01-01

The School for Science and Math at Vanderbilt (SSMV) is an innovative partnership program between a Research I private university and a large urban public school system. The SSMV was started in 2007 and currently has 101 students enrolled in the program, with a total of 60 students who have completed the 4-yr sequential program. Students attend the SSMV for one full day per week during the school year and 3–6 wk in the summers following their ninth- to 11th-grade years, with each grade of 26 students coming to the Vanderbilt campus on a separate day. The research-based curriculum focuses on guiding students through the process of learning to develop questions and hypotheses, designing projects and performing analyses, and communicating results of these projects. The SSMV program has elevated the learning outcomes of students as evidenced by increased achievement scores relative to a comparison group of students; has provided a rigorous research-based science, technology, engineering, and mathematics elective curriculum that culminates in a Summer research internship; has produced 27 Intel and Siemens semifinalists and regional finalists over the past 4 yr; and has supported the development of writing and communication skills resulting in regional and national oral presentations and publications in scientific journals. PMID:26086660

Effects of a School-Based Instrumental Music Program on Verbal and Visual Memory in Primary School Children: A Longitudinal Study

OpenAIRE

Roden, Ingo; Kreutz, Gunter; Bongard, Stephan

2012-01-01

This study examined the effects of a school-based instrumental training program on the development of verbal and visual memory skills in primary school children. Participants either took part in a music program with weekly 45 minutes sessions of instrumental lessons in small groups at school, or they received extended natural science training. A third group of children did not receive additional training. Each child completed verbal and visual memory tests for three times over a period of 18 ...

Evidence based guidelines for the prevention, identification, and management of occupational asthma.

Science.gov (United States)

Nicholson, P J; Cullinan, P; Taylor, A J Newman; Burge, P S; Boyle, C

2005-05-01

Occupational asthma is the most frequently reported work related respiratory disease in many countries. This work was commissioned by the British Occupational Health Research Foundation to assist the Health and Safety Executive in achieving its target of reducing the incidence of occupational asthma in Great Britain by 30% by 2010. The guidelines aim to improve the prevention, identification, and management of occupational asthma by providing evidence based recommendations on which future practice can be based. The literature was searched systematically using Medline and Embase for articles published in all languages up to the end of June 2004. Evidence based statements and recommendations were graded according to the Royal College of General Practitioner's star system and the revised Scottish Intercollegiate Guidelines Network grading system. A total of 474 original studies were selected for appraisal from over 2500 abstracts. The systematic review produced 52 graded evidence statements and 22 recommendations based on 223 studies. Evidence based guidelines have become benchmarks for practice in healthcare and the process used to prepare them is well established. This evidence review and its recommendations focus on interventions and outcomes to provide a robust approach to the prevention, identification, and management of occupational asthma, based on and using the best available medical evidence. The most important action to prevent cases of occupational asthma is to reduce exposure at source. Thereafter surveillance should be performed for the early identification of symptoms, including occupational rhinitis, with additional functional and immunological tests where appropriate. Effective management of workers suspected to have occupational asthma involves the identification and investigation of symptoms suggestive of asthma immediately they occur. Those workers who are confirmed to have occupational asthma should be advised to avoid further exposure completely

Epidemiological study of risk factors in pediatric asthma

African Journals Online (AJOL)

EL-HAKIM

Methods: This cross sectional study involved 206 asthmatic children, 5 to 15 years old. They were enrolled from the School ... exercise-induced asthma while 64.6% stated that emotional stress triggered their symptoms. ... Keywords: asthma severity; asthma triggers; children; residence; risk factors; smoking; social status.

[Prevalence of asthma and determination of symptoms as risk indicators].

Science.gov (United States)

Mancilla-Hernández, Eleazar; Medina-Ávalos, Miguel Alejandro; Barnica-Alvarado, Raúl Humberto; Soto-Candia, Diego; Guerrero-Venegas, Rosario; Zecua-Nájera, Yahvéh

2015-01-01

Asthma is a chronic inflammatory airway disease whose prevalence has increased, especially in developed countries; the results of studies of asthma prevalence vary in different populations and even within the same country; in Mexico we observed fluctuations in prevalence of asthma from 7% to 33%. To determine the prevalence of asthma and severity of symptoms as risk indicators in school population in cities in various states of Mexico. A descriptive study of detection of asthma prevalence and analytical-comparative observational study of determination of symptoms of asthma. The surveys were applied to preschool, elementary, middle and high school population, in the cities of Puebla, Puebla; Tulancingo, Hidalgo; Tlaxcala, Tlaxcala, and Cancún, Quintana Roo; new validated questionnaire was used as instrument: Asthma Diagnostic Questionnaire for Epidemiologic Studies, consisting of eight questions with summation value for diagnosis. 8,754 surveys showed a 14% prevalence in Puebla, 17% in Tulancingo, 7% in Tlaxcala, and 14% in Cancún; average in four cities surveyed was 13%; the strength of association with asthma symptoms in descending order with significant odds ratio were: recurrent wheezing, breathlessness, chest tightness, recurrent cough, cough cold, recurrent cold symptoms, predominantly nocturnal cough, cough that increases with exercise. The average prevalence of asthma in the surveyed cities was 13% and the main symptoms indicators of risk of asthma in school children were: recurrent wheezing, breathlessness, chest tightness and recurrent cough.

Understanding Children with Asthma: Trouble and Triggers

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Lim, JungHa; Wood, Beatrice L.; Cheah, PoAnn

2009-01-01

Asthma is one of the most common illnesses of childhood; in the United States, nearly 9% of children have the condition (Federal Interagency Forum on Child and Family Statistics, 2006). Among children with chronic illnesses, asthma is the most common cause for school absence and hospitalization (Akinbami, 2006). Asthma is a chronic disorder of the…

Predicting asthma in preschool children with asthma-like symptoms : Validating and updating the PIAMA risk score

NARCIS (Netherlands)

Hafkamp-de Groen, Esther; Lingsma, Hester F.; Caudri, Daan; Levie, Deborah; Wijga, Alet; Koppelman, Gerard H.; Duijts, Liesbeth; Jaddoe, Vincent W. V.; Smit, Henriette A.; Kerkhof, Marjan; Moll, Henriette A.; Hofman, Albert; Steyerberg, Ewout W.; de Jongste, Johan C.; Raat, Hein

2013-01-01

Background: The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) risk score predicts the probability of having asthma at school age among preschool children with suggestive symptoms. Objective: We sought to externally validate the PIAMA risk score at different ages and in ethnic and

A School-Based Program for Overweight and Obese Adolescents: A Randomized Controlled Trial

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Pbert, Lori; Druker, Susan; Barton, Bruce; Schneider, Kristin L.; Olendzki, Barbara; Gapinski, Mary A.; Kurtz, Stephen; Osganian, Stavroula

2016-01-01

Background: Given the dramatic increase in adolescent overweight and obesity, models are needed for implementing weight management treatment through readily accessible venues. We evaluated the acceptability and efficacy of a school-based intervention consisting of school nurse-delivered counseling and an afterschool exercise program in improving…

Food Safety Programs Based on HACCP Principles in School Nutrition Programs: Implementation Status and Factors Related to Implementation

Science.gov (United States)

Stinson, Wendy Bounds; Carr, Deborah; Nettles, Mary Frances; Johnson, James T.

2011-01-01

Purpose/Objectives: The objectives of this study were to assess the extent to which school nutrition (SN) programs have implemented food safety programs based on Hazard Analysis and Critical Control Point (HACCP) principles, as well as factors, barriers, and practices related to implementation of these programs. Methods: An online survey was…

Know How to Use Your Asthma Inhaler

Medline Plus

Full Text Available ... Case Studies Open Airways for Schools Asthma Care Training Wee Wheezers Adventures of Puff Inner City Asthma ... Mixed Methods 5. Purpose Informs Design Other Evaluation Resources Multimedia ... USA.gov TOP

The puzzle of immune phenotypes of childhood asthma.

Science.gov (United States)

Landgraf-Rauf, Katja; Anselm, Bettina; Schaub, Bianca

2016-12-01

Asthma represents the most common chronic childhood disease worldwide. Whereas preschool children present with wheezing triggered by different factors (multitrigger and viral wheeze), clinical asthma manifestation in school children has previously been classified as allergic and non-allergic asthma. For both, the underlying immunological mechanisms are not yet understood in depth in children. Treatment is still prescribed regardless of underlying mechanisms, and children are not always treated successfully. This review summarizes recent key findings on the complex mechanisms of the development and manifestation of childhood asthma. Whereas traditional classification of childhood asthma is primarily based on clinical symptoms like wheezing and atopy, novel approaches to specify asthma phenotypes are under way and face challenges such as including the stability of phenotypes over time and transition into adulthood. Epidemiological studies enclose more information on the patient's disease history and environmental influences. Latest studies define endotypes based on molecular and cellular mechanisms, for example defining risk and protective single nucleotide polymorphisms (SNPs) and new immune phenotypes, showing promising results. Also, regulatory T cells and recently discovered T helper cell subtypes such as Th9 and Th17 cells were shown to be important for the development of asthma. Innate lymphoid cells (ILC) could play a critical role in asthma patients as they produce different cytokines associated with asthma. Epigenetic findings showed different acetylation and methylation patterns for children with allergic and non-allergic asthma. On a posttranscriptional level, miRNAs are regulating factors identified to differ between asthma patients and healthy controls and also indicate differences within asthma phenotypes. Metabolomics is another exciting chapter important for endotyping asthmatic children. Despite the development of new biomarkers and the discovery of

Asthma-like symptoms, diagnostic tests, and asthma medication use in children and adolescents: a population-based nationwide survey.

Science.gov (United States)

Ferreira-Magalhães, Manuel; Sá-Sousa, Ana; Morais-Almeida, Mário; Pité, Helena; Azevedo, Luis Filipe; Azevedo, Maria Inês; Bugalho-Almeida, António; Fonseca, João Almeida

2016-01-01

This study aimed to estimate the prevalence of asthma-like symptoms, current asthma (CA), asthma diagnostic tests, and inhaled medication use in a nationwide pediatric population (Pediatric-specific data from a cross-sectional, population-based telephone survey (INAsma study) in Portugal were analyzed. CA was defined as lifetime asthma and (1) wheezing, (2) waking with breathlessness, or (3) asthma attack in the previous 12 months, and/or (4) taking asthma medication at the time of the interview. In total, 716 children were included. The prevalence of asthma-like symptoms was 39.4% [95% confidence interval (95% CI): 35.7-43.3]. The most common symptoms were waking with cough (30.9%) and wheezing (19.1%). The prevalence of CA was 8.4% (95% CI: 6.6-10.7). Among children with CA, 79.9% and 52.9% reported prior allergy testing and pulmonary function testing (PFT), respectively. Inhaled medication use in the previous 12 months was reported by 67.6% (reliever inhalers, 40.1%; controller inhalers, 41.5%). Those who only used inhaled reliever medications experienced more asthma attacks [odds ratio (OR): 2.69]. Significantly fewer children with CA living in rural areas than those living in urban areas had undergone PFT or used inhaled medication (OR: 0.06 for PFT, 0.20 for medication]. The prevalence of CA in the Portuguese pediatric population was 8.4%. Only half of children with CA had ever undergone PFT; more than half did not use controller inhalers, and those who only used reliever inhalers reported more asthma attacks. These findings suggest that asthma management has been substandard, mainly in rural areas.

Know How to Use Your Asthma Inhaler

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Full Text Available ... Visits to a Health Care Provider(s) among Children Health Care Coverage among Children Asthma-related Missed School Days among Children aged 5–17 Years Asthma Severity among Adults with ...

Social and Emotional Learning through a Teaching Personal and Social Responsibility Based After-School Program for Disengaged Middle-School Boys

Science.gov (United States)

Gordon, Barrie; Jacobs, Jenn M.; Wright, Paul M.

2016-01-01

This study examined a long-term afterschool leadership program situated in a Midwestern university town in the US. The activity-based program for boys considered to be disengaged with school and at risk for dropping out of education, was based on the Teaching Personal and Social Responsibility (TPSR) model. The program curriculum was strongly…

Webinar: Know the Drill for Healthy IAQ: Training School Staff and Occupants to Reduce Indoor Asthma Triggers

Science.gov (United States)

A page to register to view the first webinar in the IAQ Knowledge-to-Action Professional Training Webinar Series: Know the Drill for Healthy IAQ: Training School Staff and Occupants to Reduce Indoor Asthma Triggers

Computer-Based Junior High/Intermediate School Program of Transitional Bilingual Education, Community School District 3, Manhattan. Final Evaluation Report, 1992-93. OREA Report.

Science.gov (United States)

Duque, Diana L.

The Computer-Based Junior High/Intermediate School Program of Transitional Bilingual Education was a federally funded program in its third year of operation in one intermediate school and two junior high schools in Manhattan (New York) in 1992-93. During this period, it served 244 native Spanish-speaking, limited-English-proficient (LEP) students…

Medication education program for Indian children with asthma: A ...

African Journals Online (AJOL)

Faculty of Pharmacy, The University of Sydney, Australia, 1Department of Respiratory ... Key words: Asthma education, asthma knowledge, asthma usual care, ..... are single unit dry powder devices); ***Some children used types of devices.

New ideas in asthma and allergy research: creating a multidisciplinary graduate school

Science.gov (United States)

Björkstén, Bengt; Graninger, Göran; Ekman, Gunilla Jacobsson

2003-01-01

The spring term of 2001 saw the start of a new, unique graduate research training program at the Centre for Allergy Research at the Karolinska Institutet in Stockholm, Sweden. The program was created to bridge the gaps between basic, clinical, social, and behavioral sciences and to establish a global approach to the study of asthma and allergy. A reflection, two years on, discusses the strategies that are key to this model’s success and the challenges in introducing a multidisciplinary research program. PMID:12975463

Bridging Public Health and Education: Results of a School-Based Physical Activity Program to Increase Student Fitness.

Science.gov (United States)

Barrett-Williams, Shannon L; Franks, Padra; Kay, Christi; Meyer, Adria; Cornett, Kelly; Mosier, Brian

Power Up for 30 (PU30) is a schoolwide intervention that encourages schools to provide an additional 30 minutes of physical activity during the school day, beyond physical education. The objective of this study was to evaluate the impact of PU30 on Georgia public elementary schools and their students. A total of 719 of 1320 public elementary schools in Georgia that were sent a baseline survey about school physical activity during October 2013 to September 2014 completed the survey, 160 of which were asked to complete a second survey. In the interim (March to June 2015), half (80) of these schools implemented the PU30 program. The interim surveys, which were completed during March to June 2015, assessed opportunities for student physical activity and staff member professional development focused on student physical activity. Compared with schools that had not implemented the program, more schools using the PU30 program reported offering before- and after-school physical activity programs. Forty-four of 78 (57%) PU30 schools compared with 20 of 53 (38%) non-PU30 schools offered before-school physical activity programs. Likewise, more PU30 schools than non-PU30 schools offered after-school physical activity programs (35% vs 16%), and a greater proportion of students at PU30 schools compared with non-PU30 schools met fitness benchmarks: recess 5 days per week (91% [288 of 323] vs 80% [273 of 341]), offering ≥11 minutes per day of classroom-based physical activity (39% [53 of 136] vs 25% [47 of 189] for kindergarten through second grade; 20% [37 of 187] vs 6% [9 of 152] for grades 3 through 5), and receiving physical activity-related professional development time (42% [136 of 323] vs 14% [48 of 341]). The surveys provided a statewide picture of the physical activity opportunities offered to students and staff members in Georgia elementary schools and demonstrated the effective use of a comprehensive, multicomponent program to offer more school-based physical activity

A cross-sectional content analysis of Android applications for asthma.

Science.gov (United States)

Househ, Mowafa; Hossain, Nassif; Jamal, Amr; Zakaria, Nasriah; Elmetwally, Ashraf; Alsalamah, Majid; Khalifa, Mohamed

2017-06-01

Providing patients opportunities for self-management and education about their disease, asthma applications designed for use on an Android operating system can have positive health outcomes across the range of demographics who use mHealth applications. This study provides a content analysis of freely available Google Android Platform Mobile Applications for Asthma. A list of applications was collected on 26 October 2014, using the search feature of the Google Play Android platform and using the words and phrases "Asthma," "Lung Function" and "Peak Flow." Each application was coded for its approach to asthma self-management, based on categories adapted by Huckvale et al., which are based on the Global Initiative for Asthma and the National Asthma Education and Prevention Program. The characteristics of the 15 asthma applications are described. Most of the asthma applications' primary function focused on patient self-monitoring and self-assessment. Using the HON Code, we found low health information quality across all asthma applications. Android asthma applications can have positive outcomes in helping patients as they provide opportunities for self-management and education about their disease. Future research should continue to monitor and evaluate the development and use of mHealth Asthma Applications. Based on these findings, and their indication of a gap in existing research, subsequent studies can continue to evaluate the development and use of mHealth Asthma Applications with increasing methodological consistency to improve the quality of in-app health information.

Promoting Sustained Breastfeeding of Infants at Risk for Asthma: Explaining the “Active Ingredients” of an Effective Program Using Intervention Mapping

Directory of Open Access Journals (Sweden)

Ilse Mesters

2018-03-01

Full Text Available Infants whose parents and/or siblings have a history of asthma or allergy may profit from receiving exclusive breastfeeding during the first 6 months of life. This is expected to diminish the chance of developing childhood asthma and/or atopic disease. Ongoing breastfeeding for 6 months seems challenging for many women. An educational program was developed using Intervention Mapping as a logic model to guide development and was found successful in improving breastfeeding rates at 6 months postpartum, improving knowledge and beliefs about breastfeeding for 6 months, after exposure to the program compared to controls. Intervention elements included an evidence- and theory-based booklet addressed during pre- and postnatal home visits by trained assistants. This paper elucidates the inner workings of the program by systematically describing and illustrating the steps for intervention development.

Promoting Sustained Breastfeeding of Infants at Risk for Asthma: Explaining the “Active Ingredients” of an Effective Program Using Intervention Mapping

Science.gov (United States)

Mesters, Ilse; Gijsbers, Barbara; Bartholomew, L. Kay

2018-01-01

Infants whose parents and/or siblings have a history of asthma or allergy may profit from receiving exclusive breastfeeding during the first 6 months of life. This is expected to diminish the chance of developing childhood asthma and/or atopic disease. Ongoing breastfeeding for 6 months seems challenging for many women. An educational program was developed using Intervention Mapping as a logic model to guide development and was found successful in improving breastfeeding rates at 6 months postpartum, improving knowledge and beliefs about breastfeeding for 6 months, after exposure to the program compared to controls. Intervention elements included an evidence- and theory-based booklet addressed during pre- and postnatal home visits by trained assistants. This paper elucidates the inner workings of the program by systematically describing and illustrating the steps for intervention development. PMID:29616209

School Breakfast Program and school performance.

Science.gov (United States)

Meyers, A F; Sampson, A E; Weitzman, M; Rogers, B L; Kayne, H

1989-10-01

To test the hypothesis that participation in the School Breakfast Program by low-income children is associated with improvements in standardized achievement test scores and in rates of absence and tardiness, children in grades 3 through 6 were studied in the Lawrence, Mass, public schools, where the School Breakfast Program was begun at the start of the second semester 1986-1987 school year. The changes in scores on a standardized achievement test and in rates of absence and tardiness before and after the implementation of the School Breakfast Program for children participating in the program were compared with those of children who also qualified but did not participate. Controlling for other factors, participation in the School Breakfast Program contributed positively to the 1987 Comprehensive Tests of Basic Skills battery total scale score and negatively to 1987 tardiness and absence rates. These findings suggest that participation in the School Breakfast Program is associated with significant improvements in academic functioning among low-income elementary school children.

Encouraging Physical Activity in Pediatric Asthma: A Case–Control Study of the Wonders of Walking (WOW) Program

Science.gov (United States)

Walders-Abramson, Natalie; Wamboldt, Frederick S.; Curran-Everett, Douglas; Zhang, Lening

2010-01-01

Summary Objectives The complex overlap between asthma and obesity may be explained in part by activity avoidance in asthma. We compared responses to a walking intervention between matched groups of children with and without asthma. We expected youth with asthma to have lower baseline and post-intervention activity levels. Psychosocial, demographic, and physiologic correlates of activity were also examined. Design/Participants We compared baseline and post-intervention activity levels among 59 children aged 10–16 with well-controlled asthma and 59 healthy matched controls. Participants completed spirometry, physical examination, anthropometric measurement, and psychosocial questionnaires. Intervention/Outcome Measure Participants wore blinded calibrated pedometers for a baseline typical activity week, returning to complete the Wonders of Walking (WOW) intervention, followed by a week of post-intervention pedometer monitoring. Results Contrary to expectation, no differences between cases (median steps = 6,348/day) and controls (median steps = 6,825/day) in baseline activity were found. Response to the WOW intervention was comparable, with both groups demonstrating an increase of approximately 1,485 steps per day (equivalent to more than 5 additional miles walked during the post-intervention week). Health beliefs did not correlate to activity at baseline or intervention response. No significant associations between activity and asthma control, FEV1, or duration of diagnosis were found. Intervention response was comparable across racial/ethnic groups, children versus adolescents, and between normal weight and overweight youth. Conclusions Contrary to expectation, we found similar rates of objectively measured physical activity among youth with well-controlled asthma and controls. Importantly, we documented statistically significant increases in physical activity across both groups following a brief, pedometer-based intervention. The intervention was successful even

Encouraging physical activity in pediatric asthma: a case-control study of the wonders of walking (WOW) program.

Science.gov (United States)

Walders-Abramson, Natalie; Wamboldt, Frederick S; Curran-Everett, Douglas; Zhang, Lening

2009-09-01

The complex overlap between asthma and obesity may be explained in part by activity avoidance in asthma. We compared responses to a walking intervention between matched groups of children with and without asthma. We expected youth with asthma to have lower baseline and post-intervention activity levels. Psychosocial, demographic, and physiologic correlates of activity were also examined. We compared baseline and post-intervention activity levels among 59 children aged 10-16 with well-controlled asthma and 59 healthy matched controls. Participants completed spirometry, physical examination, anthropometric measurement, and psychosocial questionnaires. INTERVENTION/OUTCOME MEASURE: Participants wore blinded calibrated pedometers for a baseline typical activity week, returning to complete the Wonders of Walking (WOW) intervention, followed by a week of post-intervention pedometer monitoring. Contrary to expectation, no differences between cases (median steps = 6,348/day) and controls (median steps = 6,825/day) in baseline activity were found. Response to the WOW intervention was comparable, with both groups demonstrating an increase of approximately 1,485 steps per day (equivalent to more than 5 additional miles walked during the post-intervention week). Health beliefs did not correlate to activity at baseline or intervention response. No significant associations between activity and asthma control, FEV1, or duration of diagnosis were found. Intervention response was comparable across racial/ethnic groups, children versus adolescents, and between normal weight and overweight youth. Contrary to expectation, we found similar rates of objectively measured physical activity among youth with well-controlled asthma and controls. Importantly, we documented statistically significant increases in physical activity across both groups following a brief, pedometer-based intervention. The intervention was successful even among typically sedentary groups, and represents an effective

The association between school-to-work programs and school performance.

Science.gov (United States)

Welsh, Erin C; Appana, Savi; Anderson, Henry A; Zierold, Kristina M

2014-02-01

The School-to-Work (STW) Opportunities Act was passed to aid students in transitioning from education to employment by offering work-based learning opportunities. In the United States, 72% of high schools offer work-based learning opportunities for credit. This is the first study to describe school performance and school-based behaviors among students enrolled in STW programs and compare them with nonworking and other-working students. In 2003, a questionnaire was administered to five school districts and one large urban school in Wisconsin. Between 2008 and 2010, analyses were completed to characterize STW students and compare them with other students. Of the 6,519 students aged 14-18 years included in the analyses, 461 were involved in an STW program (7%), 3,108 were non-working (48%), and 2,950 were other-working students (45%). Compared with other students, STW students were less likely to have a grade point average >2.0, more likely to have three or more unexcused absences from school, and more likely to spend performance. School-to-Work students reported poorer academic performance and more unhealthy school-related behaviors compared with nonworking students and other-working students. Whereas many factors have a role in why students perform poorly in school, more research on students enrolled in STW programs is needed to understand whether participating has a negative impact on students' academic achievement. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Personalizing the Approach to Childhood Asthma

Science.gov (United States)

... to Childhood Asthma Share | Personalizing the approach to childhood asthma Published Online: March 24, 2104 Clinicians treating asthmatic ... classifying 1,041 asthmatics who participated in the Childhood Asthma Management Program (CAMP) clinical trial that assessed long- ...

Expanding Free School-based Human Papilloma Virus (HPV Vaccination Programs to Include School-aged Males in Nova Scotia, Canada

Directory of Open Access Journals (Sweden)

Hannah Krater-Melamed

2017-06-01

Full Text Available Bill 70 (HPV Vaccine Act was presented to the Nova Scotia House of Assembly with the aim of expanding the current Nova Scotia school-based HPV vaccination program to include males. In recent years, increased awareness of HPV and HPV-caused cancers has led to the implementation of school-based female HPV vaccination programs across Canada. Changing guidelines, based on recent evidence, suggest that males should also be included in these programs. Program expansion to include males aims to reduce the prevalence of HPV-causing cancers and their ensuing costs, to promote equal access to healthcare services, and to make Nova Scotia a leader in HPV prevention. Support from the Canadian public and high profile political actors along with pressure from other provinces and interest groups, including the Society of Obstetricians and Gynaecologists of Canada, influenced the passing of the HPV Vaccine Act. In order to implement this reform, the provincial financial commitment to the previous HPV program was expanded to cover the cost of male vaccination.

Immigration and acculturation-related factors and asthma morbidity in Latino children.

Science.gov (United States)

Koinis-Mitchell, Daphne; Sato, Amy F; Kopel, Sheryl J; McQuaid, Elizabeth L; Seifer, Ronald; Klein, Robert; Esteban, Cynthia; Lobato, Debra; Ortega, Alexander N; Canino, Glorisa; Fritz, Gregory K

2011-01-01

This article presents a summary of findings from asthma studies focusing on immigration and acculturation-related factors. A study examining associations between these processes, family cohesion and social support networks, and asthma morbidity in a sample of Dominican and Puerto Rican caregivers residing in the mainland U.S., is also described. Latino children with asthma (n = 232), ages 7-16 (49% female) and their caregivers completed interview-based questionnaires on immigration and acculturation-related processes, family characteristics, and asthma morbidity. The frequency of ED use due to asthma may be higher for children of caregivers born in Puerto Rico. Acculturative stress levels were higher for Puerto Rican born caregivers residing in the mainland U.S. Asthma-related educational and intervention programs for Latino children and families should be tailored to consider the effects that the immigration and acculturation experience can have on asthma management. Specific family-based supports focused on decreasing stress related to the acculturation process, and increasing social and family support around the asthma treatment process may help to reduce asthma morbidity in Latino children.

Sensitization predicts asthma development among wheezing toddlers in secondary healthcare.

Science.gov (United States)

Boersma, Nienke A; Meijneke, Ruud W H; Kelder, Johannes C; van der Ent, Cornelis K; Balemans, Walter A F

2017-06-01

Some wheezing toddlers develop asthma later in childhood. Sensitization is known to predict asthma in birth cohorts. However, its predictive value in secondary healthcare is uncertain. This study examines the predictive value of sensitization to inhalant allergens among wheezing toddlers in secondary healthcare for the development of asthma at school age (≥6 years). Preschool children (1-3 years) who presented with wheezing in secondary healthcare were screened on asthma at school age with the International Study of Asthma and Allergies in Childhood questionnaire. The positive and negative predictive value (PPV and NPV) of specific IgE to inhalant allergens (cut-off concentration 0.35 kU/L) and several non-invasive variables from a child's history (such as hospitalization, eczema, and parental atopy) were calculated. The additional predictive value of sensitization when combined with non-invasive predictors was examined in multivariate analysis and by ROC curves. Of 116 included children, 63% developed asthma at school age. Sensitization to inhalant allergens was a strong asthma predictor. The odds ratio (OR), PPV and NPV were 7.4%, 86%, and 55%, respectively. Eczema (OR 3.4) and hospital admission (OR 2.6) were significant non-invasive determinants. Adding sensitization to these non-invasive predictors in multivariate analysis resulted in a significantly better asthma prediction. The area under the ROC curve increased from 0.70 with only non-invasive predictors to 0.79 after adding sensitization. Sensitization to inhalant allergens is a strong predictor of school age asthma in secondary healthcare and has added predictive value when combined with non-invasive determinants. Pediatr Pulmonol. 2017;52:729-736. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Adherence to pharmacotherapy improves school performance in children with rhinitis and asthma.

Science.gov (United States)

Sánchez, J; Sánchez, A; Cardona, R

2018-03-17

Adherence to pharmacotherapy reduces symptoms of asthma and rhinitis, however, little is known of its impact on school performance. To evaluate the impact of pharmacotherapy in absenteeism and school performance in a child population. A cross-sectional study, carried out in eight schools. All participants and their parents were given a questionnaire assessing parameters related to respiratory diseases and pharmacotherapy. Data on school performance was obtained from the academic history of each child who participated in the study. Adherence to pharmacotherapy was classified as a correct use of therapy for more than five days per week. 1109 children agreed to participate. Students were divided into two groups: symptomatic (36%) and asymptomatic (63%). The symptomatic group had a higher frequency of school absenteeism (1 vs. 3.1days/year/patient pperformance (failed: 20% vs. 33% pperformance to the asymptomatic group and it was significantly different from the no-adherent group. Respiratory symptoms are associated with poor school performance and with an increase in school absenteeism, but adherence to pharmacotherapy can reduce these negative impacts in children. Copyright © 2018 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

Asthma Education and Intervention Program: Partnership for Asthma Trigger-Free Homes (PATH)

Science.gov (United States)

2010-02-01

College Award # W81XWH-07-1-0469 Abt Associates Inc. Final Report p. 158 • Obtaining disease prevention and managemen t tools. Study design~rs intend...suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704...children without asthma for each asthma trigger. A t -test was used to determine if these two means were statistically different from each other. Page

Methodological issues of optimization the sanitary-educational assistance for children with asthma during the health care reform of Ukraine

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S. N. Nedelskaya

2013-08-01

Full Text Available Entry. Asthma remains the medical, social, economic issue of the day of modern society and industry of health protection. Research works on questions asthma are sanctified to mainly the improvement of diagnostics and treatment of asthma and a sanitary-educational help is underestimated. In the modern terms of structural alteration of network of establishments of health care in Ukraine a sanitary-educational help must be an effective complex in strategy of therapy of patients with asthma. Research aim. To ground importance, modern forms and methods of sanitary -educational help in providing of control above asthma on the stage of structural reorganization of establishments of health care in Ukraine. Materials and research methods. Scientifically-methodical literature was analyzed on general questions of organization and realization of sanitary-educational work in asthma. Long-term of own experience of realization of this work is generalized in the conditions of stationary treatment of patients with asthma. Research results. Sanitary-educational work in a form of education in the program "Asthma school". General practitioner, as a key figure of establishments of primary medical and sanitary help, must own the psychological methods including medical-psychology programs of before- and after graduation medical education. Conclusions. In providing of effective control above bronchial asthma in children a sanitary-educational help must be logical continuation and addition of curative help. Application of the educational programs and volume of work of doctors at their implementation must be legislatively lighted up in "Protocols of diagnostics and treatment of bronchial asthma for children".

[Effectiveness of a school-based program to prevent obesity].

Science.gov (United States)

Pérez Solís, D; Díaz Martín, J J; Álvarez Caro, F; Suárez Tomás, I; Suárez Menéndez, E; Riaño Galán, I

2015-07-01

Intervention for childhood obesity is a public health priority. The purpose of this study was to evaluate the effectiveness of an elementary school-based intervention against obesity in children. Non-randomised controlled trial was conducted on children from first to fifth grade from two public schools of Avilés (Spain). The intervention lasted for 2 school years comprising healthy diet workshops, educational chats, educational meetings, informative written material, and promotion of physical activities. Primary outcome measure was body mass index z-score. Secondary outcomes included: obesity and overweight prevalence, waist circumference, dietary habits, and physical activity. A total of 382 (177 girls, 205 boys) out of 526 pupils of both schools were included in the study. Complete anthropometric data were obtained in 340 of the 382 individuals. Compared to children in control group, those in intervention group decreased body mass index z-score from 1.14 to 1.02 (P=.017), and improved KIDMED score from 7.33 to 7.71 points (P=.045). The percentage of students who carried on an optimal diet increased from 42.6% to 52.3% (P=.021). There were no statistical differences in the prevalence of obesity and overweight, or in waist circumference between the intervention and control groups. This school-based program resulted in modest beneficial changes in body mass index and diet quality. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Obesity Prevention Interventions in US Public Schools: Are Schools Using Programs That Promote Weight Stigma?

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Kenney, Erica L; Wintner, Suzanne; Lee, Rebekka M; Austin, S Bryn

2017-12-28

Despite substantial research on school-based obesity prevention programs, it is unclear how widely they are disseminated. It is also unknown whether schools use obesity programs that inadvertently promote weight stigma or disordered weight-control behaviors. In spring 2016, we distributed an online survey about school wellness programming to a simple random sample of US public school administrators (N = 247 respondents; 10.3% response rate). We analyzed survey responses and conducted immersion/crystallization analysis of written open-ended responses. Slightly less than half (n = 117, 47.4%) of schools offered any obesity prevention program. Only 17 (6.9%) reported using a predeveloped program, and 7 (2.8%) reported using a program with evidence for effectiveness. Thirty-seven schools (15.0%) reported developing intervention programs that focused primarily on individual students' or staff members' weight rather than nutrition or physical activity; 28 schools (11.3% of overall) used staff weight-loss competitions. School administrators who reported implementing a program were more likely to describe having a program champion and adequate buy-in from staff, families, and students. Lack of funding, training, and time were widely reported as barriers to implementation. Few administrators used educational (n = 12, 10.3%) or scientific (n = 6, 5.1%) literature for wellness program decision making. Evidence-based obesity prevention programs appear to be rarely implemented in US schools. Schools may be implementing programs lacking evidence and programs that may unintentionally exacerbate student weight stigma by focusing on student weight rather than healthy habits. Public health practitioners and researchers should focus on improving support for schools to implement evidence-based programs.

Endotoxin, ergosterol, fungal DNA and allergens in dust from schools in Johor Bahru, Malaysia- associations with asthma and respiratory infections in pupils.

Science.gov (United States)

Norbäck, Dan; Markowicz, Pawel; Cai, Gui-Hong; Hashim, Zailina; Ali, Faridah; Zheng, Yi-Wu; Lai, Xu-Xin; Spangfort, Michael Dho; Larsson, Lennart; Hashim, Jamal Hisham

2014-01-01

There are few studies on associations between respiratory health and allergens, fungal and bacterial compounds in schools in tropical countries. The aim was to study associations between respiratory symptoms in pupils and ethnicity, chemical microbial markers, allergens and fungal DNA in settled dust in schools in Malaysia. Totally 462 pupils (96%) from 8 randomly selected secondary schools in Johor Bahru, Malaysia, participated. Dust was vacuumed from 32 classrooms and analysed for levels of different types of endotoxin as 3-hydroxy fatty acids (3-OH), muramic acid, ergosterol, allergens and five fungal DNA sequences. Multiple logistic regression was applied. Totally 13.1% pupils reported doctor's diagnosed asthma, 10.3% wheeze and 21.1% pollen or pet allergy. Indian and Chinese children had less atopy and asthma than Malay. Carbon dioxide levels were low (380-690 ppm). No cat (Fel d1), dog (Can f 1) or horse allergens (Ecu cx) were detected. The levels of Bloomia tropicalis (Blo t), house dust mite allergens (Der p 1, Der f 1, Der m 1) and cockroach allergens (Per a 1 and Bla g 1) were low. There were positive associations between levels of Aspergillus versicolor DNA and daytime breathlessness, between C14 3-OH and respiratory infections and between ergosterol and doctors diagnosed asthma. There were negative (protective) associations between levels of C10 3-OH and wheeze, between C16 3-OH and day time and night time breathlessness, between cockroach allergens and doctors diagnosed asthma. Moreover there were negative associations between amount of fine dust, total endotoxin (LPS) and respiratory infections. In conclusion, endotoxin at school seems to be mainly protective for respiratory illness but different types of endotoxin could have different effects. Fungal contamination measured as ergosterol and Aspergillus versicolor DNA can be risk factors for respiratory illness. The ethnical differences for atopy and asthma deserve further attention.

Endotoxin, ergosterol, fungal DNA and allergens in dust from schools in Johor Bahru, Malaysia- associations with asthma and respiratory infections in pupils.

Directory of Open Access Journals (Sweden)

Dan Norbäck

Full Text Available There are few studies on associations between respiratory health and allergens, fungal and bacterial compounds in schools in tropical countries. The aim was to study associations between respiratory symptoms in pupils and ethnicity, chemical microbial markers, allergens and fungal DNA in settled dust in schools in Malaysia. Totally 462 pupils (96% from 8 randomly selected secondary schools in Johor Bahru, Malaysia, participated. Dust was vacuumed from 32 classrooms and analysed for levels of different types of endotoxin as 3-hydroxy fatty acids (3-OH, muramic acid, ergosterol, allergens and five fungal DNA sequences. Multiple logistic regression was applied. Totally 13.1% pupils reported doctor's diagnosed asthma, 10.3% wheeze and 21.1% pollen or pet allergy. Indian and Chinese children had less atopy and asthma than Malay. Carbon dioxide levels were low (380-690 ppm. No cat (Fel d1, dog (Can f 1 or horse allergens (Ecu cx were detected. The levels of Bloomia tropicalis (Blo t, house dust mite allergens (Der p 1, Der f 1, Der m 1 and cockroach allergens (Per a 1 and Bla g 1 were low. There were positive associations between levels of Aspergillus versicolor DNA and daytime breathlessness, between C14 3-OH and respiratory infections and between ergosterol and doctors diagnosed asthma. There were negative (protective associations between levels of C10 3-OH and wheeze, between C16 3-OH and day time and night time breathlessness, between cockroach allergens and doctors diagnosed asthma. Moreover there were negative associations between amount of fine dust, total endotoxin (LPS and respiratory infections. In conclusion, endotoxin at school seems to be mainly protective for respiratory illness but different types of endotoxin could have different effects. Fungal contamination measured as ergosterol and Aspergillus versicolor DNA can be risk factors for respiratory illness. The ethnical differences for atopy and asthma deserve further attention.

The PCDH1 gene and asthma in early childhood

DEFF Research Database (Denmark)

Mortensen, Li J; Kreiner-Møller, Eskil; Hakonarson, Hakon

2014-01-01

Previous studies have suggested that variants in the protocadherin-1 (PCDH1) gene, which is important for cell-cell adhesion, are associated with asthma, bronchial, hyperresponsiveness and atopic dermatitis in school children. Our aim was to associate common variants of the PCDH1 gene with longit......Previous studies have suggested that variants in the protocadherin-1 (PCDH1) gene, which is important for cell-cell adhesion, are associated with asthma, bronchial, hyperresponsiveness and atopic dermatitis in school children. Our aim was to associate common variants of the PCDH1 gene...... with longitudinally assessed asthma phenotypes and atopic dermatitis in early childhood. We analysed eight single-nucleotide polymorphisms in PCDH1 from 411 children born to asthmatic mothers from the Copenhagen Prospective Studies on Asthma in Childhood birth cohort. Asthma and atopic dermatitis were diagnosed...

The Academic Differences between Students Involved in School-Based Robotics Programs and Students Not Involved in School-Based Robotics Programs

Science.gov (United States)

Koumoullos, Michael

2013-01-01

This research study aimed to identify any correlation between participation in afterschool robotics at the high school level and academic performance. Through a sample of N = 121 students, the researcher examined the grades and attendance of students who participated in a robotics program in the 2011-2012 school year. The academic record of these…

Opportunities for technology-based HIV prevention programming among high school students in Cape Town, South Africa.

Science.gov (United States)

Ybarra, Michele L; Mwaba, Kelvin; Prescott, Tonya L; Roman, Nicolette V; Rooi, Bronwyn; Bull, Sheana

2014-01-01

One in three new cases of HIV in South Africa is among adolescents. Given that adolescents are particularly affected, scalable, and cost-effective prevention programs are urgently needed. This study aims to identify opportunities to integrate technology into youth HIV prevention efforts. In 2012, 1107 8th-11th graders completed a paper-and-pencil survey. Respondents were enrolled in one of three public high schools in Langa, a lower income community in Cape Town, South Africa. Eighty-nine percent of respondents have used text messaging (SMS) and 86% have gone online. If an HIV prevention program was offered online, 66% of youth would be somewhat or extremely likely to access it; slightly fewer (55%) felt the same about SMS-based programming. In comparison, 85% said they would be somewhat or extremely likely to access a school-based HIV prevention program. Interest in Internet- (60%) and SMS-based (54%) HIV prevention programming was similar for youth who had a self-appraised risk of HIV compared to youth who appraised their risk to be lower, as it was for youth who were tired of hearing messages about HIV prevention. Technology use is common - even among high school students who live in lower income communities. At the same time, these data reveal that it is not uncommon for youth to be tired of hearing messages about HIV prevention, and many of the typical topics key to HIV prevention have low interest levels among youth. HIV prevention researchers need to be mindful of the extent of existing programming that youth are exposed to. Technology-based programming may be especially amenable to meeting these requirements because of its novelty especially in developing countries, and because interactive functionality can be easily integrated into the program design. Given the preference for school- and Internet-based programming, it seems that a hybrid approach is likely feasible and acceptable.

Redesigning a large school-based clinical trial in response to changes in community practice

Science.gov (United States)

Gerald, Lynn B; Gerald, Joe K; McClure, Leslie A; Harrington, Kathy; Erwin, Sue; Bailey, William C

2011-01-01

Background Asthma exacerbations are seasonal with the greatest risk in elementary-age students occurring shortly after returning to school following summer break. Recent research suggests that this seasonality in children is primarily related to viral respiratory tract infections. Regular hand washing is the most effective method to prevent the spread of viral respiratory infections; unfortunately, achieving hand washing recommendations in schools is difficult. Therefore, we designed a study to evaluate the effect of hand sanitizer use in elementary schools on exacerbations among children with asthma. Purpose To describe the process of redesigning the trial in response to changes in the safety profile of the hand sanitizer as well as changes in hand hygiene practice in the schools. Methods The original trial was a randomized, longitudinal, subject-blinded, placebo-controlled, community-based crossover trial. The primary aim was to evaluate the incremental effectiveness of hand sanitizer use in addition to usual hand hygiene practices to decrease asthma exacerbations in elementary-age children. Three events occurred that required major modifications to the original study protocol: (1) safety concerns arose regarding the hand sanitizer’s active ingredient; (2) no substitute placebo hand sanitizer was available; and (3) community preferences changed regarding hand hygiene practices in the schools. Results The revised protocol is a randomized, longitudinal, community-based crossover trial. The primary aim is to evaluate the incremental effectiveness of a two-step hand hygiene process (hand hygiene education plus institutionally provided alcohol-based hand sanitizer) versus usual care to decrease asthma exacerbations. Enrollment was completed in May 2009 with 527 students from 30 schools. The intervention began in August 2009 and will continue through May 2011. Study results should be available at the end of 2011. Limitations The changed design does not allow us to

Impact of school-based educational programs on sexual behaviors among adolescents in northern Italy.

Science.gov (United States)

Bogani, Giorgio; Cromi, Antonella; Serati, Maurizio; Monti, Zelia; Apolloni, Chiara; Nardelli, Federica; Di Naro, Edoardo; Ghezzi, Fabio

2015-01-01

This article aimed to determine sexual behaviors among female and male adolescents in northern Italy. An anonymous self-administered questionnaire evaluating sexual attitudes was distributed in middle and high schools in northern Italy. Adolescents between 13 and 19 years of age were asked to participate at the survey. The study group included 664 participants. Overall, 164 (25%) adolescents had had at least one sexual intercourse. Among adolescents who have had sexual intercourse, 90 (55%) use condoms, 25 (15%) use hormonal contraception, and 49 (30%) do not use any contraception method. A total of 559 adolescents (84%) participated in school-based sexual education programs. This group had better knowledge on sexually transmitted diseases and contraception methods in comparison with adolescents who have never participated in such educational programs (p sexual behaviors was observed (p = 1.0). School-based sexual education programs improve knowledge of sexual transmitted diseases and contraception methods. However, this knowledge does not correlate to high-risk sexual behaviors reduction.

Do United States’ Teachers Know and Adhere to the National Guidelines on Asthma Management in the Classroom? A Systematic Review

Directory of Open Access Journals (Sweden)

Yudilyn Jaramillo

2015-01-01

Full Text Available Proper asthma management in schools is important in achieving optimum asthma control in children with asthma. The National Heart, Lung, and Blood Institute (NHLBI has developed guidelines on classroom asthma management. We conducted a systematic review to examine teacher knowledge of the NHLBI guidelines on asthma management in the classroom. We searched PubMed and EMBASE using search terms “asthma management,” “teacher(s,” “school teacher,” and “public school.” The inclusion criteria were articles published in English from 1994 to May 2014 that focus on schools in the United States (US. From 535 titles and abstracts, 9 studies met inclusion criteria. All studies reported that school teachers did not know the policies and procedures of asthma management. Teachers relied on school nurses to handle medical emergencies. Some studies identified that lack of full-time school nurses was a barrier to asthma management. Only one study showed directly that classroom teachers were not following the NHLBI guidelines on asthma management. Our literature review revealed that US teachers do not know the NHLBI guidelines on asthma management in the classroom. Future research should focus on interventions targeted toward training classroom teachers on asthma management as per NHLBI guidelines to ultimately improve asthma management in schools.

School-Based Sleep Education Programs for Short Sleep Duration in Adolescents: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Chung, Ka-Fai; Chan, Man-Sum; Lam, Ying-Yin; Lai, Cindy Sin-Yee; Yeung, Wing-Fai

2017-06-01

Insufficient sleep among students is a major school health problem. School-based sleep education programs tailored to reach large number of students may be one of the solutions. A systematic review and meta-analysis was conducted to summarize the programs' effectiveness and current status. Electronic databases were searched up until May 2015. Randomized controlled trials of school-based sleep intervention among 10- to 19-year-old students with outcome on total sleep duration were included. Methodological quality of the studies was assessed using the Cochrane's risk of bias assessment. Seven studies were included, involving 1876 students receiving sleep education programs and 2483 attending classes-as-usual. Four weekly 50-minute sleep education classes were most commonly provided. Methodological quality was only moderate, with a high or an uncertain risk of bias in several domains. Compared to classes-as-usual, sleep education programs produced significantly longer weekday and weekend total sleep time and better mood among students at immediate post-treatment, but the improvements were not maintained at follow-up. Limited by the small number of studies and methodological limitations, the preliminary data showed that school-based sleep education programs produced short-term benefits. Future studies should explore integrating sleep education with delayed school start time or other more effective approaches. © 2017, American School Health Association.

Coping with Childhood Asthma: Caretakers' Views.

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Mailick, Mildred D.; And Others

1994-01-01

Pilot study of 23 caretakers of African American and Hispanic school-aged children with asthma explored effects of asthma on families and coping strategies of caretakers. Found large and significant correlations between perceived impact in areas of financial burden, social and familial isolation, and personal strain. Caretakers reported using…

The "Generacion Diez" after-school program and Latino parent involvement with schools.

Science.gov (United States)

Riggs, Nathaniel R; Medina, Carmen

2005-11-01

The current study examines associations between participation in after-school programs and change in Latino parent involvement with schools. Hierarchical linear regression analyses demonstrated that parents of children who had higher after-school program attendance rates were significantly more likely to report increases in the quality of relationships with their children's teachers, frequency of parent-teacher contact, and engagement with their children's schooling over a two-year period. However, greater home educator contacts were related to decreases in quality and quantity of parent-school involvement. A primary implication is that attendance in school-based after-school programs may draw parents into children's regular-day school context. Editors' Strategic Implications The authors illustrate the promising practice of using after-school programs to promote parent involvement and to help integrate the often disparate family and school contexts for Latino children.

Using public policy to improve outcomes for asthmatic children in schools.

Science.gov (United States)

Lynn, Jewlya; Oppenheimer, Sophie; Zimmer, Lorena

2014-12-01

School-based services to improve asthma management need to be accompanied by public policies that can help sustain services, scale effective interventions, create greater equity across schools, and improve outcomes for children. Several national organizations, including the Centers for Disease Control and Prevention, have recommended specific public policies the adoption of which in school settings can improve asthma outcomes for children. Although many states and school districts have adopted some of these policies, adoption is not universal, and implementation is not always successful, leaving inequities in children's access to asthma services and supports. These issues can be addressed by changing public policy. Policy change is a complex process, but it is one that will benefit from greater involvement by asthma experts, including the researchers who generate the knowledge base on what services, supports, and policies have the best outcomes for children. Asthma experts can participate in the policy process by helping to build awareness of the need for school-based asthma policy, estimating the costs associated with policy options and with inaction, advocating for the selection of specific policies, assisting in implementation (including providing feedback), conducting the research that can evaluate the effectiveness of implementation, and ultimately providing information back into the policy process to allow for improvements to the policies. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Methods and issues in conducting a community-based environmental randomized trial

International Nuclear Information System (INIS)

Swartz, Lee J.; Callahan, Karen A.; Butz, Arlene M.; Rand, Cynthia S.; Kanchanaraksa, Sukon; Diette, Gregory B.; Krishnan, Jerry A.; Breysse, Patrick N.; Buckley, Timothy J.; Mosley, Adrian M.; Eggleston, Peyton A.

2004-01-01

The environment is suspected to play an important role in the prevalence and severity of asthma in inner-city children. This paper describes the implementation and baseline data of an inner-city community-based participatory research clinical trial designed to test the effectiveness of a pollutant and allergen control strategy on children's asthma morbidity. Participants were 100 elementary-school-aged children with asthma, graduates of a school-based asthma education program in East Baltimore. The intervention for half of the randomly assigned families consisted of environmental control education, allergen-proof encasements, pest extermination, and a HEPA air cleaner at the beginning of the study. Controls received the same at the end of the study. Participants visited a clinic for questionnaires, allergy skin testing, spirometry, and blood sample at baseline and 12 months. Home environments, NO 2 , O 3 , airborne particulates, and allergens were evaluated at baseline and at 6 and 12 months. Asthma morbidity and adherence was assessed quarterly. Collaboration with the community proved very beneficial in creating a study design and procedures acceptable to an inner-city community

Program Support and Value of Training in Mentors' Satisfaction and Anticipated Continuation of School-Based Mentoring Relationships

Science.gov (United States)

McQuillin, Samuel D.; Straight, Gerald G.; Saeki, Elina

2015-01-01

In this study, we tested a theoretical model of training practices in school-based mentoring by comparing the differences between two mentoring programs on mentor-reported program support, value of training, relationship satisfaction, and plans to continue mentoring. The two mentoring programs that we compared were conducted at the same school and…

Risk factors and prevalence of asthma and rhinitis among primary school children in Lisbon

Directory of Open Access Journals (Sweden)

P.N. Pegas

Full Text Available Aims: A cross-sectional study was carried out with the objective of identifying nutrition habits and housing conditions as risk factors for respiratory problems in schoolchildren in Lisbon. Material and methods: Between October and December 2008, parents of 900 students of the elementary schools of Lisbon were invited to answer a questionnaire of the International Study of Asthma and Allergies in Childhood Program (ISAAC. The response rate was 40 %. Logistic regression was used in the analysis of results. Results: The prevalence of asthma, allergic rhinitis and wheeze was 5.6 %, 43.0 % and 43.3 %, respectively. Risk factors independently associated with asthma were wheezing attacks, and dry cough at night not related to common cold in the last 12 months. Wheezing crises were found to affect children daily activities. Risk factors for wheeze were hay fever and the presence of a pet at home. A risk factor for rhinitis was cough at night. The frequent consumption of egg was also associated with increased risk of rhinitis. Conclusion: Contrarily to asthma, the prevalence of allergic rhinitis and wheeze increased in comparison with previous ISAAC studies. Wheezing attacks were associated with asthma and hay fever was identified as a risk factor of manifesting wheezing symptoms. Having pets at home was pointed out as a significant risk factor for rhinitis, but not smoking exposure, mould, plush toys, diet (except egg consumption, breastfeeding or other conditions. Resumo: Objectivos: Com o objectivo de identificar hábitos alimentares e características habitacionais como factores de risco para a prevalência de problemas respiratórios na população escolar do 1.° ciclo da cidade de Lisboa foi realizado um estudo transversal. Material e métodos: De Outubro a Dezembro de 2008, os pais de 900 alunos das escolas do 1° ciclo de Lisboa foram convidados a responder a um questionário similar ao do Programa Internacional de Estudo de Asma e Alergias na

Behavioral Contributions to Rehabilitation and Childhood Asthma

Science.gov (United States)

Creer, Thomas L.; And Others

1976-01-01

Described is the 12- to 18-month residential treatment program at the Children's Asthma Research Institute and Hospital, a behaviorally oriented rehabilitation program for children who suffer from chronic bronchial asthma. (IM)

[The comparison of the indoor environmental factors associated with asthma and related allergies among school-child between urban and suburban areas in Beijing].

Science.gov (United States)

Lü, Hai-bo; Deng, Fu-rong; Sun, Ji-dong; Wu, Shao-wei; Sun, Xiu-ming; Wang, Xin; Zhao, Yan-hua; Guo, Xin-biao

2010-07-01

To study the indoor environmental factors associated with the prevalence of asthma and related allergies among school children. A cluster sampling method was used and the ISAAC questionnaire was conducted. A total of 4612 elementary students under Grade Five of 7 schools were enrolled in the survey for the impact of indoor environmental factors on the prevalence of asthma and related allergies in several urban and suburban schools of Beijing. A total of 4060 sample were finally analyzed including 1992 urban and 2068 suburban. The prevalence of wheeze, allergic rhinoconjunctivitis and atopic eczema in the past 12 months was 3.1% (61/1992), 5.3% (106/1992), 1.1% (22/1992) among urban children while 1.3% (27/2068), 3.1% (65/2068), 1.0% (22/2068) among suburban children respectively. The prevalence of wheeze and allergic rhinoconjunctivitis of the past 12 months in urban were both significantly higher than that in suburban (χ(2) = 14.77, 11.93, P children (5.3% (105/1992), 29.4% (586/1992)) were significantly (χ(2) = 39.03, 147.22, P interior decoration had different influence on the prevalence of asthma and related allergies among school children in the two areas. The significant impact of passive smoking on having asthma ever among suburban children was observed (OR = 2.70, 95%CI = 1.17 - 6.23) while no significant result in urban (OR = 1.06, 95%CI = 0.71 - 1.58); the percentage of interior decoration was 84.0% (1673/1992) among urban children and 80.0% (1655/2068) among suburban children, there was significant impact of interior decoration on the prevalence of having eczema ever among urban children (OR = 1.57, 95%CI = 1.17 - 2.10) but no significant results were found in suburban sample (OR = 1.06, 95%CI = 0.76 - 1.48). The prevalence of asthma and related allergies among school children is much higher in urban areas than that in suburban areas and the indoor environmental factors such as passive smoking and interior decoration may differently explain the

A Meta-Analysis of School-Based Bullying Prevention Programs' Effects on Bystander Intervention Behavior

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Polanin, Joshua R.; Espelage, Dorothy L.; Pigott, Therese D.

2012-01-01

This meta-analysis synthesized bullying prevention programs' effectiveness at increasing bystander intervention in bullying situations. Evidence from 12 school-based programs, involving 12,874 students, indicated that overall the programs were successful (Hedges's g = 0.20, 95% confidence interval [CI] = 0.11 to 0.29, p = 0.001), with larger…

Predictors of middle school students' interest in participating in an incentive-based tobacco prevention and cessation program in connecticut.

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Morean, Meghan E; Camenga, Deepa R; Kong, Grace; Cavallo, Dana A; Schepis, Ty S; Krishnan-Sarin, Suchitra

2014-01-01

Behavioral incentives have been used to encourage smoking cessation in older adolescents, but the acceptability of incentives to promote a smoke-free lifestyle in younger adolescents is unknown. To inform the development of novel, effective, school-based interventions for youth, we assessed middle school students' interest in participating in an incentive-based tobacco abstinence program. We surveyed 988 students (grades 6-8) attending three Connecticut middle schools to determine whether interest in program participation varied as a function of (1) intrapersonal factors (i.e., demographic characteristics (sex, age, race), smoking history, and trait impulsivity) and/or (2) aspects of program design (i.e., prize type, value, and reward frequency). Primary analyses were conducted using multiple regression. A majority of students (61.8%) reported interest in program participation. Interest did not vary by gender, smoking risk status, or offering cash prizes. However, younger students, non-Caucasian students, behaviorally impulsive students, and students with higher levels of self-regulation were more likely to report interest. Inexpensive awards (e.g., video games) offered monthly motivated program interest. In sum, middle school students reported high levels of interest in an incentive-based program to encourage a tobacco-free lifestyle. These formative data can inform the design of effective, incentive-based smoking cessation and prevention programs in middle schools.

School Age Center Connections: Site-Based Management Strategies for Implementation of Quality Programs.

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Willis, Dahna R.

This paper describes the outcomes of a practicum that initiated site-based-management strategies to support the consistent implementation of a quality school-age child-care program. Implemented at a multisite child-care center, the program sought to enhance staff members' job satisfaction and maximize their opportunities for professional growth…

Making Childhood Asthma Management Education Happen in the Community: Translating Health Behavioral Research into Local Program.

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Krutzch, Christine B.; And Others

1987-01-01

A technology transfer project for getting initial community adoption of childhood asthma management programs is described. The evolution of the project, including development of programs, packaging considerations, establishment of partnerships, implementation, and evaluation are discussed. (Author/CH)

Sleep-disordered breathing in children with asthma: a systematic review on the impact of treatment

Directory of Open Access Journals (Sweden)

Sánchez T

2016-04-01

Full Text Available Trinidad Sánchez,1 José A Castro-Rodríguez,2 Pablo E Brockmann2,3 1Division of Pediatrics, School of Medicine, 2Department of Pediatric Cardiology and Pulmonology, Division of Pediatrics, School of Medicine, 3Sleep Medicine Center, Department of Neurology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile Background: The objective was to perform a systematic review in order to describe the relationship between asthma and sleep-disordered breathing (SDB in children, especially regarding the impact of treatment and management. Methods: We performed an electronic search in MEDLINE, EMBASE, and LILACS database. Study inclusion criteria were the following: 1 studies that examined the relationship between asthma/wheezing and SDB/obstructive sleep apnea (OSA; and 2 studies conducted in children <18 years of age. Primary outcomes were the prevalence of asthma and SDB, the tests used for diagnosis, and the influence of their treatment and management. Results: One thousand and twenty studies were identified, among which 32 were selected (n=143,343 children; 51% males; age [mean ± standard deviation] 8.4±2.5 years. Most studies (n=26 diagnosed SDB using questionnaires or clinical history. Nine studies performed a sleep study for diagnosing OSA. The diagnosis of asthma was based on clinical history (n=16, previous medical diagnosis (n=4, questionnaires (n=12, and spirometry (n=5. Children with asthma were more likely to develop habitual snoring and OSA, and children with SDB were more likely to develop asthma. Moreover, asthma was associated with more severe OSA, and the presence of SDB was associated with severe asthma. Treatment of SDB with adenotonsillectomy was associated with significant asthma improvement. Conclusion: The relationship between asthma and SDB appears to be bidirectional, and adenotonsillectomy appears to improve asthma control. Future trials on how asthma treatment could impact on SDB are needed

Changes in asthma control, work productivity, and impairment with omalizumab: 5-year EXCELS study results.

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Zazzali, James L; Raimundo, Karina P; Trzaskoma, Benjamin; Rosén, Karin E; Schatz, Michael

2015-01-01

Asthma poses a significant disease burden worldwide. Current guidelines emphasize achieving and maintaining asthma control. To describe longitudinal changes of asthma control and asthma-related work, school, and activity impairment for patients with moderate-to-severe asthma treated with omalizumab and those who did not receive omalizumab in a real-world setting. This study used 5 years of data from patients ages ≥12 years old with moderate-to-severe persistent allergic asthma who were enrolled in the Evaluating Clinical Effectiveness and Long-term Safety in Patients with Moderate-to-Severe Asthma observational study. Asthma control was assessed with the Asthma Control Test for 5 years, and asthma-related work, school, and activity impairment was measured with the Work Productivity/Activity Impairment-Asthma questionnaire for the first 2 years. The percentage of patients treated with omalizumab (n = 4930) and with well-controlled asthma (Asthma Control Test score, >20) increased from 45% at baseline to 61% at month 60, and it was 49% (baseline) and 67% (month 60) for the non-omalizumab-treated cohort (n = 2779). For new starters to omalizumab (n = 576), the percentage with well-controlled asthma increased from 25% at baseline to 51% at month 6, and to 60% at month 60. Patients in the omalizumab-treated cohort and those in the non-omalizumab-treated cohort experienced a reduction in asthma-related work, school, and activity impairment. The amount of improvement in asthma control achieved and the reduction in asthma-related work, school, and activity impairment were similar, regardless of asthma severity. On average, patients in the Evaluating Clinical Effectiveness and Long-term Safety in Patients with Moderate-to-Severe Asthma observational study who initiated omalizumab experienced clinically significant improvement in asthma control, which was observed within 6 months and persisted for 5 years.

Living with Asthma: Part I, Manual for Teaching Parents the Self-Management of Childhood Asthma.

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National Heart, Lung, and Blood Inst. (DHHS/NIH), Bethesda, MD. Div. of Lung Diseases.

The Living with Asthma Program is designed to teach asthma self-management skills to children (ages 8-12) with asthma and to give their parents the knowledge and behavior modification skills to help their children take over responsibility for managing the condition. Both groups receive training in problem solving and in ways to improve family…

School Health Connection Goes Electronic: Developing a Health Information Management System for New Orleans' School-Based Health Centers. Program Results Report

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Rastorfer, Darl

2011-01-01

From February 2008 through April 2011, School Health Connection, a program of the Louisiana Public Health Institute, developed an electronic health information management system for newly established school-based health centers in Greater New Orleans. School Health Connection was established as part of a broader effort to restore community health…

[Rhinitis and asthma as a cause of absenteeism and poor work/school performance in a population from Latin-American tropic].

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Sánchez, Jorge; Estarita, Javier; Salemi, Carolina

2016-01-01

Asthma and rhinitis are the most frequent chronic respiratory diseases. Their high impact is associated with the loss of working days, as well as a decrease in academic performance. To assess and compare the impact of rhinitis and asthma as causes of absenteeism and low work performance in a population of children and adults. A cross sectional study was performed in 10 schools of two cities in Colombia. The student population between 6 to 17 years, as well as the faculty staff over 18 were invited to participate. All of the participants filled a questionnaire assessing parameters related to clinical background, and a review of scores in Math and Spanish, curriculum vitae and number of missed day during the last academic period completed was performed. A total of 1,413 participants were enrolled. The frequency of asthma and/or rhinitis was 36%, there was a greater frequency of absenteeism in the population of children with respiratory symptoms (2.8 vs 1.2 days/year/patient, pperformance (0.43 vs 0.27, pabsenteeism and an improved performance. Both rhinitis and asthma are associated with lower performance in children and adults and absenteeism in the school; however, adequate treatment may improve clinical control and reduce backlash against job performance.

Stacked Deck: An Effective, School-Based Program for the Prevention of Problem Gambling

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Williams, Robert J.; Wood, Robert T.; Currie, Shawn R.

2010-01-01

School-based prevention programs are an important component of problem gambling prevention, but empirically effective programs are lacking. Stacked Deck is a set of 5-6 interactive lessons that teach about the history of gambling; the true odds and "house edge"; gambling fallacies; signs, risk factors, and causes of problem gambling; and…

Immigration and Acculturation-Related Factors and Asthma Morbidity in Latino Children*

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Sato, Amy F.; Kopel, Sheryl J.; McQuaid, Elizabeth L.; Seifer, Ronald; Klein, Robert; Esteban, Cynthia; Lobato, Debra; Ortega, Alexander N.; Canino, Glorisa; Fritz, Gregory K.

2011-01-01

Objective This article presents a summary of findings from asthma studies focusing on immigration and acculturation-related factors. A study examining associations between these processes, family cohesion and social support networks, and asthma morbidity in a sample of Dominican and Puerto Rican caregivers residing in the mainland U.S., is also described. Methods Latino children with asthma (n = 232), ages 7–16 (49% female) and their caregivers completed interview-based questionnaires on immigration and acculturation-related processes, family characteristics, and asthma morbidity. Results The frequency of ED use due to asthma may be higher for children of caregivers born in Puerto Rico. Acculturative stress levels were higher for Puerto Rican born caregivers residing in the mainland U.S. Conclusion Asthma-related educational and intervention programs for Latino children and families should be tailored to consider the effects that the immigration and acculturation experience can have on asthma management. Specific family-based supports focused on decreasing stress related to the acculturation process, and increasing social and family support around the asthma treatment process may help to reduce asthma morbidity in Latino children. PMID:21745811