The Challenge of asthma in adolescence

Benedictis, Diletta de; Bush, Andrew

doi:10.1002/ppul.20650

Cited by 70 publications

(64 citation statements)

References 102 publications

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“…This sense of belonging is particularly important for adolescents with asthma, who perceive themselves as different from peers and therefore try to "fit in" with a peer group, even to the extent of adopting risky behaviours [37] . Despite the effects smoking may have on exacerbating asthma [10,38] , it seems that having asthma was not a strong motivation for students in Jordan to quit smoking [39] .…”

Section: Discussionmentioning

confidence: 99%

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Cigarette smoking in adolescents with asthma in Jordan: Impact of peer-led education in high schools

Al-Sheyab

Gallagher²,

Gallagher³

et al. 2013

JNEP

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Background: Peer-led smoking prevention programs focus on teaching adolescents-especially those with asthma-who are affected most by cigarettes, refusal skills to lower their intention to smoke. The purpose of this study was to determine the impact of a peer-led asthma education program on students who were smokers in terms of self-efficacy to resist smoking, asthma knowledge and asthma-related quality of life. Methods:This study is a secondary analysis of a cluster-randomized controlled trial of students with asthma (n = 259) in 4 randomly-selected high schools, stratified for gender in Northern Jordan, using a closed-envelope technique. Trained bilingual health workers facilitated the implementation of the peer-led program, which uses a three-step cascade process to train peers from year 11 and 10 over a three week period to deliver asthma education for the school community, with the aid of well-established resources. Students with asthma (n = 261) in grades 8, 9 and 10 were surveyed at baseline in December 2006 and three months post-intervention on the main outcomes, which were asthma-related quality of life, knowledge of asthma management, and self-efficacy to resist smoking. For the purpose of this paper, we assessed the impact on the intervention only on students who were smokers (n = 72). Results:The prevalence of smoking among students with asthma was 29%. Male students (44%) were more likely to smoke than females (6%) (p<0.001). Compared to the control group, the peer-led intervention improved self-efficacy to resist smoking, understand asthma and asthma-related quality of life. Smokers within the intervention schools improved their self-efficacy to resist smoking by 83% (p=0.001), asthma knowledge by 60% (p=0.001) and demonstrated benefits within all the sub-domains of asthma related quality of life when compared to controls (p=0.001). Conclusion:The prevalence of smoking among high school Jordanian students with asthma, especially males, is alarmingly high, highlighting the need for early intervention. A school-based peer-led asthma and smoking education approach can be effective in motivating students to not smoke. Therefore, nurse educators worldwide, especially who work in youth centers, community, and school health fields, need to be aware of the effectiveness, availability, and possible adoption of such innovative interventions in order to improve overall well-being for adolescents in general and for smokers in specific.

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Section: Discussionmentioning

confidence: 99%

“…Smoking is particularly problematic for adolescents who have asthma because this subgroup is more likely to have more severe asthma [6][7][8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Cigarette smoking in adolescents with asthma in Jordan: Impact of peer-led education in high schools

Al-Sheyab

Gallagher²,

Gallagher³

et al. 2013

JNEP

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2008

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Asthma is a leading cause of hospitalizations, acute care utilization, health care costs, and school absences in children. Asthma morbidity is disproportionately high in inner city populations. In general, community-based public health interventions to reduce asthma morbidity have had modest success due in part to their limited reach and low participation by the targeted population. Adolescents have been especially difficult to reach. A coalition of community organizations developed a school-based, population-level system to identify, prioritize, and provide interventions for middle school children with asthma in a large urban school district in Oakland, CA. Nearly 92% (n = 8,326) of students in the targeted schools took an asthma case identification survey. Of those students who took the survey, 17.5% (n = 1,458) had active asthma and were eligible for services. Among those identified with active asthma, 83% (n = 1,217) voluntarily attended asthma self-management classes at school. The 4-week curriculum previously has been shown to significantly improve several indicators of asthma control in this population. Retention was high-72% of students who enrolled attended at least three of the four curriculum sessions. Many higher-risk students were subsequently referred to and enrolled in off-site asthma services. Large school districts with incomplete or inadequate health records, high asthma prevalence, and internal or external services available for students with asthma may benefit from a similar model. A system such as the one described may be an effective public health strategy for school districts, health departments, and community coalitions addressing asthma or other conditions with high childhood prevalence.

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“…Furthermore, psychosocial factors become increasingly important associations of severe disease [44][45][46].…”

Section: Problematic Severe Asthma: Phenotypes and Agementioning

confidence: 99%

Problematic severe asthma in children, not one problem but many: a GA2LEN initiative

Hedlin

Bush²,

Carlsen³

et al. 2010

European Respiratory Journal

146

130

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Although most children with asthma are easy to treat with low doses of safe medications, many remain symptomatic despite every therapeutic effort. The nomenclature regarding this group is confusing, and studies are difficult to compare due to the proliferation of terms describing poorly defined clinical entities.In this review of severe asthma in children, the term problematic severe asthma is used to describe children with any combination of chronic symptoms, acute severe exacerbations and persistent airflow limitation despite the prescription of multiple therapies.The approach to problematic severe asthma may vary with the age of the child, but, in general, three steps need to be taken in order to separate difficult-to-treat from severe therapy-resistant asthma. First, confirmation that the problem is really due to asthma requires a complete diagnostic re-evaluation. Secondly, the paediatrician needs to systematically exclude comorbidity, as well as personal or family psychosocial disorders. The third step is to re-evaluate medication adherence, inhaler technique and the child's environment.There is a clear need for a common international approach, since there is currently no uniform agreement regarding how best to approach children with problematic severe asthma. An essential first step is proper attention to basic care.

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The Challenge of asthma in adolescence

Cited by 70 publications

References 102 publications

Cigarette smoking in adolescents with asthma in Jordan: Impact of peer-led education in high schools

Cigarette smoking in adolescents with asthma in Jordan: Impact of peer-led education in high schools

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

Problematic severe asthma in children, not one problem but many: a GA2LEN initiative

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