Shawna McGhan

Evaluation of an Education Program for Elementary School Children with Asthma

To evaluate the effectiveness of a comprehensive asthma management education program for 7- to 12-year-old children with asthma, entitled Roaring Adventures of Puff (RAP), 18 elementary schools in Edmonton were randomized to intervention and control groups. Participating in the program were 76 students with asthma in the intervention schools and 86 in the control schools. Children in the intervention schools had statistically significant improvements in unscheduled doctor visits, missed school days, moderate-to-severe parent rating of severity, severity of shortness of breath, limitations in the kind of play, and correct use of medications. Unscheduled doctor visits and missed school days were the only significant improvements in the control group; however, improvements were about half that of the intervention group. The results showed that a comprehensive, school-based asthma education program is feasible and improves outcomes.

Impact of Online Support for Youth With Asthma and Allergies: Pilot Study

Youth with asthma and allergies often feel isolated and different from their peers. The objective of this study was to test the impact of online social support for these youth. Three months of support was provided using weekly synchronous chat sessions. Online sessions were facilitated by trained peer mentors (older youth with asthma and/or allergies) and health professionals. Youth could also e-mail one another between chat sessions and post messages on an electronic community bulletin board. Twenty-eight adolescents across Canada participated. Social isolation and loneliness were significantly reduced. Youth reported gaining confidence and a sense of normality.

“I Want to Meet Other Kids Like Me”: Support Needs of Children with Asthma and Allergies

Context: Asthma is the most common chronic illness of childhood and the leading cause of hospitalization in young children. Asthma negatively impacts physical health, psychosocial wellbeing, and quality of life for affected children but the psychosocial support needs of children with asthma and severe have not been studied from their point of view. Objective: The objective of this study was to assess the support and education needs and preferred interventions of allergic children with asthma and/or severe allergies. Methods: Qualitative constant comparative content analysis was used to identify major themes from semi-structured individual interviews with 20 children with asthma and allergies and 35 parents. Findings: Children expressed frustration with the limitations imposed by asthma and allergies on their regular activities and normal lives. Parents believed that peer support someone to whom their child could relate as a role model that support could improve both their children’s and their own coping. Conclusions: Parents and children preferred a combination of in-person meetings and internet support to enhance the capacity of children, reduce children’s anxiety, increase their self-care skills, and self-confidence. In addition they believed a support intervention was a stepping stone to developing a community of support for children with asthma, allergies, and anaphylaxis.

Factors associated with poor asthma control in children aged five to 13 years

BACKGROUND Most children with asthma should be able to achieve acceptable control. However, are there differences between those with acceptable and poor control, and if so, how can health care approaches be modified accordingly? OBJECTIVE To examine the characteristics of elementary school children aged five to 13 years with acceptable and poor levels of asthma control. METHODS The present cross-sectional study of children with asthma used five indicators of control, as outlined by the Canadian Asthma Consensus Report, to categorize acceptable and poor asthma control. RESULTS Of 153 children, 115 (75%) were rated as having poorly controlled asthma. Of those with poor control, 65 (64%) children were currently using inhaled corticosteroids, and 65% of those reported using inhaled corticosteroids daily versus as needed. Fifty-one per cent of the children with poorly controlled asthma had exposure to tobacco smoke, whereas 79% of the children with asthma under acceptable control were from households with no smokers (P=0.002). The poor control group also had significantly worse parental perceptions of the psychosocial impact of asthma on their child. No significant difference was found in the percentage of those who had written action plans in the poor control group (28%) compared with the acceptable control group (26%), and similar percentages in each group stated that they used the plans. CONCLUSIONS Despite the high use of inhaled corticosteroids, the majority of children had poorly controlled asthma. The poor control group had more exposure to tobacco smoke and a worse psychosocial impact due to asthma. Few children had past asthma education and action plans, suggesting that there is a need to improve access to and tools for education.

Online Solutions to Support Needs and Preferences of Parents of Children With Asthma and Allergies

Many families of children with asthma and allergies experience support deficits and isolation. However, support interventions have not been designed to meet their needs. Consequently, parents’ intervention preferences were elicited, and an online peer support group intervention was designed based on these preferences and piloted in the study described. In-depth interviews with 44 parents elicited preferences for support interventions for both children and parents. Many said they felt alone and wanted support from others in similar situations. Based on the parents’ preferences for accessible online peer support groups, a pilot online intervention was designed and implemented. Parents received information and reassurance from other parents in peer support sessions. Parents appreciated the accessibility and anonymity of the online support group. This innovative online peer support intervention, informed by parents’ preferences, could be adapted and tested in intervention trials and guide programs and practice for families affected by asthma, allergies, and other chronic conditions.

The epidemiology of childhood asthma in Red Deer and Medicine Hat, Alberta

OBJECTIVES To document the prevalence of asthma among school-aged children in two Alberta communities, to understand host and indoor environmental factors associated with asthma, and to compare these factors between the two communities. DESIGN A cross-sectional study with a nested, case-control follow-up. SETTING Red Deer and Medicine Hat, Alberta. PATIENTS AND METHODS Questionnaires were sent to families of children aged five to 19 years in Red Deer (n=5292) and Medicine Hat (n=5372) to identify children with current asthma. A random sample of 592 children with current asthma and 443 with no history of asthma constituted a case-control population; they were followed up by telephone to obtain responses to the European Respiratory Health Survey and, in children with current asthma, the Pediatric Quality of Life Questionnaire. RESULTS Cross-sectional response rates were 84% and 73% for Red Deer and Medicine Hat, respectively. The prevalence of asthma was higher in Medicine Hat (17.0%) than in Red Deer (12.8%). In the follow-up study, factors associated with the presence of asthma were parental asthma or allergies, number of siblings, presence of cats, serious respiratory illnesses before five years of age, sex, age, presence of mould and/or mildew and use of a gas cooking stove. The presence of mould and/or mildew was a significant risk factor in Red Deer but not in Medicine Hat. CONCLUSIONS Asthma prevalence among school children in Red Deer was consistent with recently published Canadian data; the prevalence in Medicine Hat was higher than expected, especially given the low relative humidity. Risk factor data are consistent with other studies in that parental asthma, especially maternal asthma, was a significant predictor of childhood asthma. Cats in the house (both communities) and environmental tobacco smoke (Medicine Hat only) were significantly less common among children with asthma, suggesting that preventive actions may have been taken in the homes of some children with asthma.

A child's asthma quality of life rating does not significantly influence management of their asthma.

Children of parents who perceive their children have increased asthma severity use more medical services and reliever medication.

Impacts of Online Peer Support for Children With Asthma and Allergies: “It Just Helps You Every Time You Can't Breathe Well”

Children with asthma and allergies experience social isolation and gaps in social support particularly from peers. The objective of this pilot study was to design and test an accessible online support intervention for these children. Support was delivered by peer mentors with asthma and allergies and a professional. Weekly support groups were conducted over 8 weeks using Go to Meeting and Club Penguin. Quantitative measures and a qualitative interview were administered. Significant increases in perceived support and support-seeking coping and trends in decreased loneliness emerged at post-test. Participants also reported increased self-confidence and satisfaction with the intervention.

Online Support Intervention for Adolescents With Asthma and Allergies Ingredients and Insights

Objectives. To determine appropriate components and contents of an online peer support intervention for young adolescents and to evaluate intervention processes, perceived benefits, and satisfaction with the intervention.Methods. Three months of support were provided through synchronous chat, e-mail exchange, instant messaging, and bulletin boards. Online support group sessions were facilitated by trained peer mentors (older youth/young adults with asthma and allergies) and health professionals. Participant use of online options was tracked (eg, log-ons, e-mails, chat minutes). Qualitative data were elicited from peer mentor reports, online support group chat transcripts, project coordinators’ field notes, peer mentor exit interviews, and adolescent telephone interviews.Results. Almost all adolescents were satisfied with this online support intervention. Topics discussed in the support groups were pertinent to their educational and support needs. Peer mentors provided emotional, affirmation, and informati...

Online Support for Children With Asthma and Allergies

Children with asthma and allergies experience social isolation and gaps in social support particularly from peers. The objective of this pilot study was to design and test an accessible online support intervention for these children. Children (n = 27) aged 7 to 11 from across Canada participated. GoToMeeting was employed for the support group sessions and Club Penguin for social connections during and between support group meetings. Content included: strategies for coping with asthma and allergies, role playing and games to help children deal with difficult situations, fun and enjoyment, and presentations by positive role models. Participation in the online peer support intervention was high, 86.3% on average over the 8-week intervention. By sharing their experiences, listening to peers’ experiences, and role playing, children were introduced to practical skills: problem solving, communicating, seeking support, and self-advocacy.