Asthma education for all: Increasing community awareness through educational workshops for children and adults Betty Perez-Rivera, EdD, CHES Program Director Childhood Asthma Initiative Children’s Health Fund, New York City A Community Pediatrics Program of The Children’s Hospital at Montefiore APHA Annual Meeting Boston, MA November 4-8, 2006

Health Disparities: Issues Identified while working with patients/families with asthma in South Bronx Population Little or No Access to health care Lack of understanding about rights as a patient Language barriers Low literacy levels Misconceptions about the definition/implication of asthma as a chronic illness Additional issues: Co-morbidities, housing issues, domestic violence, mental health, and lack of continuous care due to constant changes in primary care provider, among others.

Educational Components Children’s Programming Asthma C.R.E.W. - Two (90-minute) interactive sessions compose one workshop - to teach children about asthma. Music/Asthma Programs – teaching children good breathing exercises while learning how to play an instrument and providing information about asthma. (Usually for asthmatic children) One-Hour Sessions – for undergraduate and graduate school students in the field of health education Professional Training – workshops to train health care and child care workers about asthma so that they can continue to train others to increase awareness. Literacy Curriculum Expansion - in the elementary schools Science Curriculum Expansion - in middle schools/high schools

Educational Components Adult Programming Adult Forums – targeting parents, teachers, health care administrators, members of the community – Full 90-minute workshops Characteristics of asthma and anatomy of the lung Asthma symptoms and triggers Medications – controllers and relievers – Mini-workshops Demonstration and discussion about Household products – detergents/daily use products will be discussed. There will be demonstrations of healthy alternatives. Demonstration of peak flow meters – discussion of what they, how they are used, and the way to read results for better use with the asthma action plan. Demonstration and discussion – asthma triggers. Common household triggers will be highlighted. Tips for reduction of exposure and health solutions will be discussed.

Curriculum Model Teacher Training BEFORE - project survey for students Student Introduction to Asthma Asthma Education added to academic curriculum AFTER - project survey for students Student Presentations Group Instruction Parents and School Personnel are invited to attend the presentations and to participate in group instruction. Parent Asthma Guides are provided.

Literacy Curriculum Expansion Format (1) Teacher Training Session Survey to determine what the student knows about asthma BEFORE participating in the project. Student Introduction to Asthma – Distribution of Asthma Books and resource information – Books are distributed for the students to keep free of charge – Forming groups, assigning the topic for research, and giving instructions for the project – Encourage students to use creative expressions – poetry, interviews, posters, literature search, role play, description of personal experiences with asthma, paintings, etc.

Literacy Curriculum Expansion Format------(2) Asthma information and education is incorporated into various aspects of the curriculum during a two week period. – Reading out loud from books about asthma – Turning questions about asthma in mathematical word problems – Role play and literature searches and discussion – Research in books and on the internet – Discussion about the anatomy of the lung and changes occurring in asthmatics, etc. Students complete the AFTER Survey to determine what they have learned. Students present their findings in a “Publishing Party” presentation. CAI Instructor provides an group instruction.

Educational Components Professional Education Train the Trainer Workshops – Understanding popular theories of health – Communication and Presentation Skills – Asthma 101 – Discussion of ways to deliver information and create programs that work for both children and adults Health Education Undergraduate and Graduate Student Workshops – General Information about asthma – Issues in health literacy (ways to understand and deliver the message) – Dealing with specialized populations – Informing the patient and their families about the impact of asthma as a chronic illness Seminars and Special Forums – Discussions of asthma as a growing problem for underserved populations – Clinical Issues – Community Education – Environmental Issues – Advocacy

Peer Education (special asthma presentations)

Instruction used: To dispel myths. To provide corrections to inaccurate information. To provide additional information about asthma characteristics, symptoms, triggers, and medications. To encourage incorporating the learning strategies to other subjects. Group Instruction-Post Presentations

Linking Asthma Education to Primary Care By: Facilitating completion of medication forms for school nurses to be able to administer asthma medications/children to carry asthma medications during school hours. Referring parents to clinic for treatment and follow- up. Stressing the importance of keeping appointments and communicating with the doctor. Increasing communication between children, parents, school administrators and teachers to better manage and control asthma. Using the “Family Asthma Guide” as an educational tool both in workshops and in the clinical setting.

Asthma Guide in English and Spanish Can be downloaded from website: Cultural sensitivity, literacy levels, and visual impact are all considered in the development of the guide.

Important Considerations for each presentation Make sure the presentations are clear Use simple vocabulary to increase understanding Explain thoroughly Make it as interactive as possible Use graphics and life examples that they can relate to Be sensitive of cultural beliefs and culture Encourage participation by asking questions Leave time for questions and answers Provide them with additional resource information when possible. Do not answer medical questions unless you have the qualifications to do so. Refer them to their medical providers.

Contact Information To receive a hard copy of the asthma guide or to learn more about our program, contact: Dr. Betty Perez-Rivera Program Director, Childhood Asthma Initiative Telephone: ext. 289 Fax: