Asthma in Middle Schools: What Students Have to Say About Their Asthma

Abstract

Preadolescence involves cognitive, social, and physiological changes along with changes in the child's environment. During this developmental stage, young adolescents are transitioning into middle school, forming a larger social network, and managing parental expectations for assuming more responsibility for self-care. The impact of these developmental changes on asthma management is not well understood. The purpose of this study was to better understand asthma and asthma management from the perspective of middle school students. A partnership was formed between the university researcher, several school nurses, and a representative of the health department, through the Orange County Asthma Coalition. Funds were secured from the American Lung Association. School nurses helped to identify and recruit 50 middle school students with asthma to participate in focus groups. The focus-group discussions centered on asthma management with implications for intervention development. Analyses sought to identify developmental issues that affect management. Results indicated that the transition to middle school represents a challenge to managing asthma. As compared with the elementary school environment, support structures are broader and more diffuse, physical education is more demanding, and peer pressure is greater. Nevertheless, the desire for greater autonomy and independence in self-care was strong, particularly among eighth graders. Most interventions are designed for either children or adults, without recognizing the important developmental changes that are occurring in preadolescents with implications for asthma management. A school-based intervention in middle school may help students with asthma transition to greater autonomy of care, while easing transition in other domains of life.

Identification and Education of Adolescents with Asthma in an Urban School District: Results from a Large-scale Asthma Intervention

“…37 Likewise, few studies have focused on the identification of students with asthma in the secondary schools, an age group with whom many perceive to be more difficult to work compared to elementary school-aged children. 17,38 Factors that likely contributed to the success in Oakland include the allowance of flexibility for the schools in the survey completion process, minimization of the burden on teachers, and identification of volunteer school liaisons to help with all facets of the process. Scheduling of classes during nonacademic times facilitated support from school staff.…”

“…Older children are generally less adherent with medications than are younger children and are at an important developmental age to learn disease self-management skills. [17][18][19] The Coalition determined that the best strategy to reach a large proportion of the age group was through the public schools. A process was needed that could identify the children with asthma, prioritize those most in need of asthma-related services, and refer and enroll these students into these services in a timely manner.…”

Parent-Child Agreement in Report of Nighttime Respiratory Symptoms and Sleep Disruptions and Quality

“…The school age child's ability to contribute to the management of their chronic condition is influenced by their cognitive, psychosocial and motor capabilities (Anderson, Ho, Brackett, Finkelstein, & Laffel, 1997;Ayala et al, 2006;McQuaid, 2001;Miller-Johnson et al, 1994;Schilling, Knafl, & Grey, 2006;Wade, Islam, Holden, KruszonMoran, & Mitchell, 1999). Children's abilities to perceive internal body states and communicate these accurately to parents and health care providers are important so that a mutual understanding of the illness experience can form the basis of effective treatment.…”

Using Tailored Videos to Teach Inhaler Technique to Children With Asthma: Results From a School Nurse-Led Pilot Study

“…Videos are a preferred intervention mode for children with asthma (Ayala et al, 2006), and nurses noted that children liked the brevity of the video as well as being able to choose the character they wanted to watch. Even though children were given six main characters to choose from, 96% chose a character who was gender concordant and 70% chose a character that was racially concordant.…”

“…Given that school-based asthma education programs have successfully improved children's outcomes (Bartholomew et al, 2006;Evans et al, 1987;Joseph et al, 2007;Levy et al, 2006;Tinkelman & Schwartz, 2004) and that children prefer multimedia interventions, like videos (Ayala et al, 2006;Baptist et al, 2011;Lee & Le, 2013), a school-based tailored video intervention may offer a simple and effective way to teach children with asthma how to use their inhalers correctly. The purpose of this mixed methods pilot study was to test whether a tailored inhaler technique video intervention: (1) could be feasibly implemented by school nurses and (2) improve the inhaler technique of children with asthma.…”