Gaps in Asthma Care and Education

elder with Roxanne at asthma eventSpecific assessment activities to determine gaps in asthma care and education are ongoing and include:

1. As part of its National Lung Health Framework-funded (Phase 1) project entitled “Child-Friendly Asthma Education:  Building Capacity in Canadian Communities”, AAC hosted four meetings of a nationally representative panel of academics, asthma educators and policy/program directors. This group recommended the Roaring Adventures of Puff (RAP) curriculum, in particular the school-based small group format, as an optimal way to address barriers associated with rural and remote locations, including First Nations communities.

2. As part of two recent projects (called, respectively:  “A Shared Vision” and “A Shared Voice”), Asthma Society of Canada (ASC) collected feedback about the RAP curriculum and barriers relating to receiving asthma education in Aboriginal communities.  Their recommendations included:
  • To develop of culturally appropriate asthma educational materials and resources by modifying existing resources and/or designing new materials.
  • Implement asthma educational activities for children and their extended families as a priority with considerations to be given to adapting existing child-friendly educational programs (e.g. RAP “The Roaring Adventure of Puff”).
  • Ensure appropriate access to these resources in the communities.
  • Engage First Nations and Inuit community members in the development/adaption of new asthma educational materials and community-based programs.
3. In 2010, as part of its Growing Healthy Children Project, Ontario Lung Association delivered a condensed version of the RAP program to 78 students in Northern Ontario First Nations communities.  OLA reported that RAP demonstrated success in improving: 
  • asthma awareness through project reach
  • asthma self-management through understanding of medication and  introduction of an action plan
  • access to an asthma educator and other related respiratory information and materials, via Keewaytinook Okimakanak Tele Medicine, Ontario (KOTM) and OLA Helpline.

At the close of the project, OLA recommended (in relevant part) to:

  • Mobilize community partnerships
  • Build capacity for the Community Health Representatives (“CHRs”) on lung health
  • Enable aboriginal people to manage and deliver the services and support each community to deliver the health services that meet the needs of their own people.

4. The Alberta Asthma Centre is partnering with the University of Alberta, Social Support Network, on its new project: Building Continuity of Support for Children with Allergies and/or Asthma and their Families in Aboriginal and Non-Aboriginal Rural Communities.

The purpose of the proposed study is to develop a supportive community of peers for children with asthma and/or allergies and their parents. Participants will be recruited using existing clinical and community networks (e.g., pediatric asthma and allergy clinics, community organizations, Aboriginal service agencies), and information sessions with Aboriginal communities including Elders. The support-education intervention will include: a) peer and professional intervention agents; b) provision of information, affirmation, and emotional support; c) one-to-one and/or group format; d) online and/or telephone delivered support; and, e) an initial face-to-face support session. Quantitative standardized measures will be administered to children (e.g., Pediatric Asthma Quality of Life Questionnaire, Child Health Questionnaire, Loneliness and Social Dissatisfaction Scale, Self Report Coping Scale, Child Asthma Self-Efficacy scale, Children’s Inventory of Social Support) and their parents (e.g. Pediatric Asthma Caregiver’s Quality of Life Questionnaire, Coping Health Inventory, Perceived Stress Scale, UCLA Loneliness Scale, Parent Asthma Self-Efficacy scale, Arizona Social Support Interview Schedule) at pre- and post-test to assess health-related outcomes.