Reducing Environmental Asthma Triggers Anne Kelsey Lamb, MPH, - - PowerPoint PPT Presentation

▶
reducing environmental asthma triggers
SMART_READER_LITE
LIVE PREVIEW

Reducing Environmental Asthma Triggers Anne Kelsey Lamb, MPH, - - PowerPoint PPT Presentation

Mar 07, 2023 473 likes •995 views

When Clinical Management Isnt Enough: School-Based Health Centers as Leaders in Reducing Environmental Asthma Triggers Anne Kelsey Lamb, MPH, Director Regional Asthma Management & Prevention (RAMP) Asthma in children 7 million

slide-1
SLIDE 1

When Clinical Management Isn’t Enough: School-Based Health Centers as Leaders in Reducing Environmental Asthma Triggers

Anne Kelsey Lamb, MPH, Director Regional Asthma Management & Prevention (RAMP)

slide-2
SLIDE 2

Asthma in children

  • 7 million children under the age of 18 in the U.S.

have asthma

  • Most common cause of disability among children in

the U.S.

  • Leading cause of school absences due to chronic

disease.

slide-3
SLIDE 3

Asthma disparities

Current Asthma Prevalence by Age Group, Race and Ethnicity, and Poverty Status (2013)

8.3 7.0 7.7 11.2 9.4 5.9 10.9 7.0 6.2 6.6 14.6 4.7 2 4 6 8 10 12 14 16 18 20 Children Adults White Non-Hispanic Black Non-Hispanic Other Non-Hispanic Total Hispanic Puerto Rican Mexican <100% poverty 100-<250% poverty 250-<450% poverty ≥ 450% poverty Percent

slide-4
SLIDE 4

The important role of SBHCs

SBHC users are:

  • Less likely to go to the ED or be hospitalized

for asthma

  • Less likely to have asthma-related restricted

activity days

  • Less likely to miss school as a result of their

asthma

slide-5
SLIDE 5

Underlying premise of our project:

SBHCs provide an ideal setting in which to incorporate environmental components into chronic disease management programs, leveraging their role as a strong link between the student, school, and home.

slide-6
SLIDE 6
slide-7
SLIDE 7
slide-8
SLIDE 8

Environmental asthma triggers

  • Two categories: allergens and irritants
  • Difference between exacerbation and causation
  • Asthma triggers vary from one person to the next
slide-9
SLIDE 9

Allergens

mold

dust mites

slide-10
SLIDE 10

Allergens

cockroaches rodents

slide-11
SLIDE 11

Allergens

pets pollen

slide-12
SLIDE 12

Irritants/ pollutants

environmental tobacco smoke chemical irritants from personal products

slide-13
SLIDE 13

Irritants/ pollutants

cleaning products pesticides

slide-14
SLIDE 14

Irritants/ pollutants

gas stoves and space heaters wood smoke

slide-15
SLIDE 15

Irritants/ pollutants

  • utdoor air pollution
slide-16
SLIDE 16

Irritants/ pollutants

  • utdoor air pollution
slide-17
SLIDE 17
slide-18
SLIDE 18

Conduct one-on-one education about environmental asthma triggers during patient visits. Conduct, organize, or support school-based group education for students. Provide education for school staff. Print/order and distribute materials, tools and curricula for educating students, families and school staff.

Strategy 1: Education

slide-19
SLIDE 19

Conduct one-on-one education

  • During patient visits

– Teach how environmental asthma triggers can make asthma worse as well as how to recognize immediate and delayed reaction. – Teach patients strategies for reducing exposure to things that make their asthma worse. – Use an Asthma Action Plan that includes trigger information

slide-20
SLIDE 20

Conduct, organize, or support school-based group education for students

Elementary schools

  • Asthma Awareness Curriculum for

the Elementary Classroom

  • Fight Asthma Now for Youth
  • Open Airways for Schools
  • Roaring Adventures of Puff
  • You Can Control Asthma

Middle and high schools

  • Adolescent Asthma Action
  • Fight Asthma Now for Teens
  • Kickin’ Asthma
  • Power Breathing
slide-21
SLIDE 21

Provide education for school staff

slide-22
SLIDE 22

The West Oakland Middle School SBHC used the results of trigger assessments to shape education

  • Students completed at start of education program
  • Triggers incorporated into asthma action plan, group

health education and one-on-one education with the provider.

slide-23
SLIDE 23

Incorporate strategies to reduce exposure to environmental asthma triggers into your case management approach to students with asthma. Facilitate connections to resources that exist, communicate with and educate other partners critical to effective asthma management (parents, school staff, etc.) and identify when direct advocacy is needed.

Strategy 2: Case Management

slide-24
SLIDE 24

Incorporate strategies to reduce exposure to environmental asthma triggers into case management approach

  • Communicate/ Educate
  • Identify / Facilitate Services
  • Advocate
slide-25
SLIDE 25
slide-26
SLIDE 26

Increase awareness. Conduct or facilitate an assessment. Support or lead a comprehensive approach to improving indoor air quality. Support or lead an intervention to address specific triggers or other factors (such as mold and moisture, chemical irritants from schools and personal products, and ventilation.)

Strategy 3: Improving Indoor Air Quality in Schools

slide-27
SLIDE 27

Increase awareness

slide-28
SLIDE 28

A SBHC in Cincinnati will assess classroom triggers and educate teachers about simple ways to reduce triggers

slide-29
SLIDE 29

Support or lead a comprehensive intervention

slide-30
SLIDE 30

Implement interventions targeting specific environmental asthma triggers

  • Cockroaches and rodents
slide-31
SLIDE 31

Implement interventions targeting specific environmental asthma triggers

  • Cleaning products
slide-32
SLIDE 32

Strategy 4: Improving the Students’ Home Environments

Establish referral systems for in-home asthma education and environmental remediation programs in the community. Educate students and families. Provide supplies to students and families. Utilize case management strategies to connect families with resources.

slide-33
SLIDE 33

Establish referral systems for in-home asthma education and environmental remediation programs

slide-34
SLIDE 34

SBHC staff provide home visits themselves

slide-35
SLIDE 35

Educate students and families

slide-36
SLIDE 36

Provide supplies to students and families

slide-37
SLIDE 37

A SBHC in Hempstead, NY is working with high school students to identify triggers in their homes

  • The program empowers youth to

engage in their own health

  • The program provides students with

supplies (pillow cases, asthma-friendly cleaning supplies, IPM supplies) to address the triggers they identify.

slide-38
SLIDE 38

Strategy 5: Improving Outdoor Air Quality around the School and Community

Conduct an assessment of local air quality. Partner with the school to implement programs and policies to reduce exposure to outdoor triggers near the school. Increase awareness and protect students on high pollution days. Develop anti-idling education and policies. Develop approaches to reduce pollen exposure. Partner with others in the community on clean air advocacy.

slide-39
SLIDE 39

Conduct an assessment of local air quality

slide-40
SLIDE 40

Partner with the school to implement programs and policies

slide-41
SLIDE 41

The Carson Wellness Center chose to address bus idling

  • Staff in the clinic reported smell
  • f exhaust fumes
  • Mostly in the afternoon
  • Some days stronger than
  • thers
  • Patterns included really hot

days and really cold days

  • Realized the smell was coming

from the school buses parked

  • utside our clinic – right next to

the“fresh air vent”

slide-42
SLIDE 42

Conducted trigger assessment with students

slide-43
SLIDE 43

Their project

  • Created survey for bus drivers

to understand behavior

  • Conducted a presentation,

based on survey results, about idling effects on people with asthma

  • Found an informal leader

among bus drivers, who helped increase attendance

  • Bus drivers attended training

and were very engaged

“All the women were very pleasant, the information was very helpful and something I can use everyday not just at work as a bus driver”

slide-44
SLIDE 44

The SBHC at Fremont High School chose to implement the EPA’s Flag Program

slide-45
SLIDE 45

The Flag Program at the Fremont SBHC

slide-46
SLIDE 46

Partner with others in the community

  • n clean air advocacy
slide-47
SLIDE 47
slide-48
SLIDE 48

Q & A

slide-49
SLIDE 49

What can your SBHC do to reduce environmental asthma triggers?

Take out your worksheet Team up with a neighbor Address the questions Share your selected activity and your first step

slide-50
SLIDE 50

Apply for your SBHC to receive a stipend to conduct one of these interventions

Applications due October 14th

slide-51
SLIDE 51

Contact information

Anne Kelsey Lamb anne@rampasthma.org (510) 285-5712