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IMPROVING ASTHMA MANAGEMENT IN SCHOOL-AGED CHILDREN USING AN ECOLOGICAL FRAMEWORK Judith Quaranta, PhD, RN, CPN, AE-C, FNAP. I have no conflicts to declare. Background. 8.3% of children have asthma; 53.7% had one or more asthma attacks Annual per-person medical cost of asthma: $3,266

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  1. IMPROVING ASTHMA MANAGEMENT IN SCHOOL-AGED CHILDREN USING AN ECOLOGICAL FRAMEWORKJudith Quaranta, PhD, RN, CPN, AE-C, FNAP

  2. I have no conflicts to declare

  3. Background • 8.3% of children have asthma; 53.7% had one or more asthma attacks • Annual per-person medical cost of asthma: $3,266 • Asthma 3rdleading cause of hospitalization <15 years • >10 million missed school days each year due to asthma • Barrier for school nurses to provide asthma education is lack of time • Parents have many misperceptions about asthma and lack basic asthma knowledge and asthma management skills, impacting asthma outcomes for their child with asthma.

  4. Ecological Approach McLeroy, Bibeau, Steckler, & Glanz (1988)

  5. Open Airways for Schools • American Lung Association school-based asthma education program designed to improve asthma management skills in children with asthma ages 8-11 • Usually taught in five to six 50-minute weekly sessions • teaches children to detect warning signs of asthma, to identify and avoid triggers, proper medication administration, and to make decisions about their health. • This program has been approved and recommended by the National Association of School Nurses, honored with a Health Education Research Award from the National Asthma Education and Prevention Program, and is endorsed by the Centers for Disease Control

  6. Methods Research Design A quasi-experimental pretest-posttest design was used. Binghamton University Human Subjects Research Review Committee approved the study. Participants convenience sample of children with asthma from local elementary schools (12 groups)

  7. Procedure • Nursing students became certified as Open Airways for Schools facilitators through the American Lung Association. School nurses arranged the location and the time to teach. Open Airways was taught at the schools • Parent handouts were sent home after each session. • Pre/posttests for child asthma management skills and parent asthma knowledge were completed prior to the Open Airways program and at completion.

  8. Results • 99 children with asthma completed the Open Airways for Schools curriculum • 4 school districts • 9 schools • District 1: 2 elementary schools • Districts 2 and 3: 1 elementary school each • District 4: 5 elementary schools • Ages 6-12 years • 60% male, 40% female

  9. Results • Paired sample t-tests evaluated the impact of attending Open Airways. • There was a statistically significant increase in asthma self-efficacy scores after attending the program (p <.001). • Specific areas that improved included are on Table 1 • No significant difference was found for parents.

  10. Conclusion An ecological approach has been shown to be an effective method to address the need for asthma education for the child with asthma. • Intrapersonal level: this intervention was successful in improving asthma self-efficacy for the children who attend Open Airways • Interpersonal level: Further research needs to be conducted to determine the best way to effect change in parents of children with asthma • Organizational level: Improved access to asthma education • Community level: Partnering with a School of Nursing provides manpower to provide the asthma education and addresses school nurse barrier of lack of time

  11. References Abu-Shaheen, A.K., Nofal, A. & Heena, H. (2016). Parental perceptions and practices toward childhood asthma. BioMed Research International. Retrieved from https://www.hindawi.com/journals/bmri/2016/6364194/abs/. i/2016/6364194/abs/ American Lung Association. (2018). Asthma and children fact sheet. Retrieved from https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/asthma/learn-about-asthma/asthma-children-facts-sheet.html Bhagavatheeswaran, K.S., Kasav, J.B., Singh, A.K., Mohan, S.K., & Joshi, A. (2016). Asthma-related knowledge, attitudes, practices (KAP) of parent of children with bronchial asthma: A hospital-based study. Annals of Tropical Medicine and Public Health [serial online]. Retrieved from http://atmph.org/text.asp?2016/9/1/23/168704 Centers for Disease Control and Prevention. (2018). Most recent asthma data. Retrieved from https://www.cdc.gov/asthma/most_recent_data.htm McLeroy, K., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15 (4), 351-377. Nurmagambetov ,T., Kuwahara, R., &Garbe, P. (2018). The economic burden of asthma in the United States: 2008-2013. Annals of the American Thoracic Society, 15(3). Retrieved from https://www.atsjournals.org/doi/full/10.1513/AnnalsATS.201703-259OC Pappalardo, A.A., Paulson, A., Bruscato, R., Thomas, L., Minier, M., & Martin, M.A. (2019). Chicago public school nurses examine barriers to school asthma care coordination. Public Health Nursing, 36(1), 36-44. https://doi-org.proxy.binghamton.edu/10.111/phn.12574 Quaranta, J.E., & Spencer, G.A. (2016). Barriers to asthma management as identified by school nurses. The Journal of School Nursing, 32(5), 365-373. doi: 10.1177/1059840516641189

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