1. ASTHMA EDUCATION IN PRESCHOOLS Kristin Kalina, CPN, MS May 1, 2006 Pediatric Pulmonary Center University of Arizona

2. OBJECTIVES  Highlight National and Local Statistics regarding Children Attending Preschool  Discuss Prevalence of Asthma among Preschoolers  Outline Needs Assessment findings from Tucson Preschools  Present Teaching Tools Developed for Local Preschools  Provide Future Recommendations to Further the Success of this Project

3. Children in Preschool  Over 130 “Center-based Early Childhood Care and Education Centers” in the Tucson Area  8.7 Million Children in a Child Care Arrangement Percentage of U. S. Children Enrolled in Center-Based Care by Age 199119931995199619992001 Children ages 3-552.8%52.7%55.1%55.0%59.7%56.4% Enrollment by Age (percent distribution) 3 year olds42.3%40.4%40.7%42.1%45.7%43.0% 4 year olds60.4%62.2%64.7%63.2%69.6%66.2% 5 year olds63.9%65.7%74.5%72.8%76.5%72.8% U.S Department of Education, 2002 Quest/DEX Tucson Area Phonebook, 2005

4. Children in Preschool (cont.)  1999 – 73% of children <5 yrs with employed parents in a care arrangement other than care by a parent Primary Child Care Arrangements for Children with an Employed Parent in 1999: All Income Levels (Percent Distribution) Children Under Age 5Children Age 5Children Ages 6-12 Center-Based Care28%Center-Based Care40% Before/After School Program 15% Family Child Care Provider 14% Before/After School Program 8% Family Child Care Provider 7% Relative Care27% Family Child Care Provider 11%Relative Care23% Nanny/Babysitter4%Relative Care19%Nanny/Babysitter4% Parent Care27%Nanny/Babysitter3%Parent Care/Other Care41% Parent Care/Other Care19%Self-Care10% U.S Department of Education, 2002

5. Preschool Children with Asthma  2003 – 4 million children < 18 yrs had an asthma attack in the past 12 months One of the most common chronic diseases of childhood #1 cause of school absenteeism due to chronic disease  8.6% of Children <5 years have Asthma 1,177,472 with asthma = 59.3 per 1,000 children 838,226 with an asthma attack or episode = 42.2 per 1,000 children  Children 0-5 Years Make up 27% of Children with Asthma American Lung Association, 2004 National Center for Health, 2005 & Aging Society Organization, n.d.

6. Asthma Among Arizona’s Preschoolers  Hospital Discharge Data 2000 – 39% of Asthma Discharges were Patients 14 Years or Younger 2001 – Decreased to 35%  1.4 Million Children in Arizona – 27% of the Total Population 49.3% of the Population Categorized as Minority Over 170,000 (18%) of Children Live Below the National Poverty Level Arizona Department of Health Services, 2005 National Bureau of Statistics, 2000

7. Asthma Among Arizona’s Preschoolers  8 Facilities Surveyed All Licensed 6 Linked to National Organizations  470 children, 60 using “Asthma” medications = 13%

8. Needs Assessment Findings  Teachers Lacking any Formal Education on Asthma and Medication Administration  No Asthma Action Plans in Place, “Standard” Medication Administration Consent Form Used  Directors Very Interested in Receiving Information, Specifically asked for materials on: Disease Process  Symptoms  Triggers and Ways to Prevent “Attacks” Medication Administration  Nebulizers  Inhalers & Spacers  Use of Asthma Action Plan

9. Educational Materials Developed  Asthma Information Sheet What It Is and what causes it Signs and Symptoms Triggers  Symptoms of Asthma Common Symptoms During an Attack or Exacerbation Symptoms that Require Immediate Medical Attention  Medication Administration Plan Administration Sheet specifically for Inhaled Medications When Parents Should be contacted  Using a Metered Dose Inhaler and Spacer What Medication is Usually Given What a Spacer is and why it Should be Used How to Properly use a Spacer with an Inhaler

10. Educational Materials Developed (cont.)  Using a Nebulizer Machine What a nebulizer Machine is Why it Should be used How to use and clean the machine  Make your Facility Asthma-Friendly Checklist by the National Heart, Lung, and Blood Institute Examines Asthma Friendliness of a Child-Care Facility  Want more Information on Asthma? Try One of These Resources Outline of Web-Based Resources Listing of Age Appropriate Books on Asthma for Children Directory of Local Resources

11. Recommendations for the Future  Have Program “SUCCEEDS” Certified Developed Specifically for Preschool and Childcare Providers Contact: Child & Family Resources, 2800 E. Broadway  Provide Educational Materials in Spanish  Offer Hands-On Training for Administration of Medications  Make Materials Available On-Line for Broader Distribution – to Include Home Based Systems

12. QUESTIONS?