Question 1: What evidence do you have from your community to specify the health issue and focus population for this program? (What data tells you there is a problem here? Who is at risk?) |
Majority of Australian children are healthy, but it depends on the environment the child is raised, family circumstance, and school. Research carried in Wyndham community shows since 2007, asthma cases have been increasing among children aged 0-8 majority being boys 12% compared to girls 7.9% (Zahran et al., 2018, p. 149). However, asthma prevalence was higher among the children living in the lowest socioeconomic and rural areas, which is 15% compared to these residing in the highest socioeconomic, which is 8%. This is influenced by poor lifestyle due to low income. Control measures are put in place to improve the situation among the vulnerable population by creating awareness and availing medication at a reduced cost (Zahran et al., 2018, p. 149). |
Question 2: What social, environmental, and behavioral determinants of health are contributing to this health issue? How? (What is CAUSING this issue? Why?) |
According to the study, children with poor nutrition are likely to have asthma symptoms due to weak lungs as a result of insufficient vitamin C, E, and omega-3 fatty acids. People suffering from respiratory disease are most likely to have asthma if they are exposed to cold or excess humidity. Children being the most vulnerable (Jartti, 2017, p.895-906). Poverty triggers the spread of asthma as the low-income earners end up in substandard housing and sensitization, thus exposing children to an unhealthy environment and little maternal education. Also, the quality of the social relationship, for instance, in schools and religious groups, determines the health situation (Fitzpatrick 2016, p.11-19). |
Question 3: Are there any existing programs/policies, etc., already addressing this issue in this community? If so, what are they, and are they effective? (What is already being done? What gaps are there?) |
Health strategies have been put in place in Wyndham to prevent asthma. The Australian government support research on the best way to manage the disease. They are creating awareness and education on asthma care in schools and other social gathering places. Advocating for asthma children to ensure policies are in place to help them achieve optimal health and ensure their parents or guardians receive information. However, there is a need to come up with better ways of information to reach as many people as possible, even in rural areas. Fund is needed to support children living with this condition (Loojimans et al., 2016, p.152-157). |
Question 4: What resources, assets or strengths does your community have? (What can you use from WITHIN YOUR COMMUNITY to help support your program?) |
Education resources such as campaigns for creating awareness to the public about asthma and offering education tools and materials with vital information about the management of the disease. These materials are given to the parents having children with asthma. Use of social, cultural, and organization that is health-related and health behavior, for example, support of physical activities in children (Bush et al., 2017, p.886-898). Use of physical environments such as the construction of buildings and natural environments to aid in the prevention of asthma. Practise a healthy diet such as using fresh fruits and vegetables that is very crucial in children. Since salons and barbershop with broad reach population, they are used for screening (Knibbs et al., 2018, p.299-302). |
Question 1: What is the SMART goal of your program? This is the broad overall aim (long term changes) and who is your target population? – relates to outcome evaluation (What do you want to achieve? Who do you want to achieve it?) |
The goal of this program is to prevent asthma mortality in children aged 0-8. Encouraging parents to take children for some frequent check-ups for allies to help the doctor to make the right diagnoses before it is too late. And reminding parents to take their children for vaccination. Focus on maintaining normal activities by hiring a physical exercise expert to train children to achieve a healthy lifestyle, even for those living in the lowest-economic areas. Aim to maintain control of asthma symptoms and to limit asthma exacerbations in children Living below standard life (Ramratnam et al., 2017, p. 889-898). |
Question 2: What are the objectives that relate to your goal? What strategies will you use to realise these? – relates to impact evaluation (What changes do you need to make to achieve the goal?) |
Asthma objectives include suggesting a management plan for patients to control asthma exacerbations. Educating parents and family members about the pathophysiology of asthma in connection with acute and mechanism of action. Insist on compliance with the prescription of the medication and safe delivery methods. Develop a diagnosis of asthma by physical exam and history; for example, where a close family member has ever been diagnosed, and the child shows asthmatic signs, there is a high probability of diagnosis. Evaluation of non-asthma causes of wheezing and other symptoms is done to avoid the wrong diagnosis (Fitzpatrick 2016, p.11-19). |
Question 3: What are the actions or activities related to the objectives? What things will take place on the ground? – relates to Process evaluation (What will you DO to make the changes?) |
Implementation will be done by ensuring patient self -assessment. Nursing staff requests parents of the affected child to fill the self-assessment form to ensure they play a role in the chronic care model to keep patients active on personal care and to aid in identifying the gap. For instance, nurses recognize any need for intervention, such as providing education to the patient and filling of prescriptions. Use of register that contains the names and details of all identified asthma patient and ensuring every patient are provided a flu shot during winter. Nurses will be given additional training to ensure their engagement in the care of patients with asthma (Abrams et al., 2020, p. 287-312). |
Question 4: What is your timeline? What challenges might occur in meeting your targets? (How long do you need to make things happen?) |
The plan is to achieve the set goals within one year. The integration is to take the minimum time possible of less than a year, but due to challenges, it may not be possible. Some of the constrain that are affecting the timeline include lack of asthma management tools such as spirometers and peak flow meters. Lack of specific satisfactory diagnostic tests for asthma makes the process take a long time as medics use various criteria to diagnose. So quality time is required to bring all resources together to ensure no misdiagnosis or overdiagnosis (Keet et al., 2018, p. 737-746) |
Question 1: What health promotion model or models is the program going to utilise and why? (Eg: Health Belief Model, Stages of Change, Ottawa Charter, etc.?) |
The social-ecological model will be applied during the management and prevention of asthma programs. These will include the evaluation and identification of asthma children in Wyndham community by reaching out to them in schools and religious gatherings. This method will focus on training, implementing asthma policies in schools, and improving the environment based on indoor air, general hygiene of the school, and restrictions on medication (Devries et al., 2017, p. 534-542). The program will use this type of model because it is cost-effective in terms of prevention of the disease rather than curing, which can take a lifetime to enhance becoming expensive. It educates individuals on how to have a healthier lifestyle (Movi et al., 2017, p. 460-465). |
Question 2: What is the setting/supportive environment where your program will take place? Is this the most appropriate given your target population? Why? (What venue/location will you use? How will it be accessed? What facilities are required, etc?) |
The program will take place in the Wyndham community because it has the highest asthma percentage of children compared to other communities. Asthma center may be used due to the availability of resources to use during the exercise, such as peak flow meter. People especially parents with babies aged 0-8 years, will be informed about the venue via various ways of communication, for example, through the media, posters, and announcing in public gatherings (Do et al., 2019, p. 186). |
Question 3: What individual health education (or personal skills) need to be considered? What knowledge deficits do you need to address? (What education is needed or gap in knowledge recognised? For Whom? Why?) |
Self-management education in asthma patients is necessary to help them to optimize how to manage their condition. In this case, it will be conducted to the parents with a child having asthma. Self- management help to improve quality of life by reducing asthma exacerbations and asthma control. This is achieved by practicing a healthy lifestyle that involves engaging in physical activities and the use of a healthy diet (Harris et al., 2019, p. 1). Self-management education can be in written form for a personalized asthma management plan for an individual based on strategies to identify health deterioration and what should be done about. However, for success to be achieved, healthcare professionals also need an adequate train to offer the best knowledge to patients (Tan et al., 2019, p. 1-12). |
Question 4: What other stakeholders need to be involved in your program? And why? (Who else could be involved? How might they contribute?) |
This program will include several stakeholders who include clinic networks and health plans. The study has proved that the combination of these two results to effective interventions to improve the quality of life for asthma people. Health plan helps the health care workers to provide the patient with both health and social needs that they require. Through the help of the information technology department, health workers are educated on how to use paper documents and electronic health records to share factors of the asthma care plan. Insurers can also be brought on board to medical provide cover for the patient (Alherbish et al., 2018, p.36). |
Question 1: Outcome Evaluation How will you know that you have reached your SMART goal? (What tells you your intended outcome has been achieved?) |
The achievements of SMART goals are realized when there is evidence of accomplishments. For instance, in this case, the reduction of mortality rates within the Wyndham community shows improvement in self-management. Reduced rates of asthma in the community is an implication of improved health standards and other control measures that were put in place. If asthma symptoms are maintained, and the numbers are not going high, it a positive response towards the program. If the patient can continue with physical activities without difficulty, no emergency rooms visit for asthma patients, and less requirement for quick-relief medicine is an excellent sign of improvement (Cassim et al., 2018, p.219). |
Question 2: Impact Evaluation How will you know when you have reached your objectives? Have your strategies been effective? (What is telling you that changes have occurred?) |
Evaluation is done through the data collection form. This is to record each objective, and its impact, including general information about asthma, what causes, psychological aspects of disease and self-management of asthma symptoms. Integration is done to tell whether education has had any impact. The analysis is done based on the percentage of learning objectives, objectives in terms of the health of the patient, to improve self-management and social behavior. From details of the data, it possible to tell whether any change occurred and to what extent (Dharmage et al., 2019, p. 246). |
Question 3: Process Evaluation How will you assess that the actions or activities used have been effective? (How will you know if what you are DOING in your program is effective?) |
The characteristics of asthma programs should be reflected. The program covers education, health plan, clinical, environment, demographic, and in general, community-centered. According to research, this kind of approach toward asthma programs has always been successful (Campbell & Carson 2017, p.56). Collaboration with other organizations and departments help to bring resources together for a better outcome. Healthcare professionals and other program providers being on the ground of the most vulnerable population. It easy to understand their social needs that trigger asthma and find effective measures to control the situation. Being present during the program, you can identify immediate changes through interacting and interrogating the patient present (Knibbs et al., 2018, p. 299-302) |
Question 4: Tools What formal/informal tools will you use to evaluate your program in terms of success or the effect on your target population? (What resources will provide data or information regarding your program’s success?) |
Several tools can be used to evaluate asthma programs. Some of these tools include self-administered asthma control assessment tools. These tools are used to influence an objective assessment of asthma management, involving the capability to reflect the overall status of asthma control (Murray et al., 2018, p. 129). This includes the Asthma Control Test (ACT); this is focused on patient asthma symptoms, its daily effect, and the use of medication. That we will use to assess asthma control in patients with asthma aged above 5years, Asthma Control Questionnaire (ACQ), this will be used to differentiate the controlled and uncontrolled asthma by quantifying asthma control as a continuous variable (Galant et al., 2017, p. 664-671). |
References
Abrams, E. M., Hoch, H. E., Becker, A. B., & Szefler, S. J. (2020). Potential Therapeutic Options for Severe Asthma in Children: Lessons from Adult Trials. In Severe Asthma in Children and Adolescents (pp. 287-312). Springer, Cham.
Alherbish, M., Mobaireek, K. F., & Alangari, A. A. (2018). Admission predictability of children with acute asthma. Annals of thoracic medicine, 13(1), 36.
Bush, A., Fleming, L., & Saglani, S. (2017). Severe asthma in children. Respirology, 22(5), 886-897.
Campbell, R. F. K. P. J., & Carson, K. (2017). Experiences of parents and carers in managing asthma in children: a qualitative systematic review protocol.56
DeVries, A., Wlasiuk, G., Miller, S. J., Bosco, A., Stern, D. A., Lohman, I. C., … & Curtin, J. A. (2017). Epigenome-wide analysis links SMAD3 methylation at birth to asthma in children of asthmatic mothers. Journal of Allergy and Clinical Immunology, 140(2), 534-542.
Dharmage, S. C., Perret, J., & Custovic, A. (2019). Epidemiology of asthma in children and adults. Frontiers in pediatrics, 7, 246.
Do, A. N., Chun, Y. N., Andrade, J. T., Grishina, G. T., Grishin, A. V., Vicencio, A. T., … & Bunyavanich, S. (2019). Network analysis reveals causal key driver genes of severe asthma in children. Journal of Allergy and Clinical Immunology, 143(2), AB186.
Fitzpatrick, A. M. (2016). Severe asthma in children: lessons learned and future directions. The Journal of Allergy and Clinical Immunology: In Practice, 4(1), 11-19.
Galant, S. P., Komarow, H. D., Shin, H. W., Siddiqui, S., & Lipworth, B. J. (2017). The case for impulse oscillometry in the management of asthma in children and adults. Annals of Allergy, Asthma & Immunology, 118(6), 664-671.
Harris, K., Kneale, D., Lasserson, T. J., McDonald, V. M., Grigg, J., & Thomas, J. (2019). School?based self?management interventions for asthma in children and adolescents: a mixed methods systematic review. Cochrane Database of Systematic Reviews, (1).
Jartti, T., & Gern, J. E. (2017). Role of viral infections in the development and exacerbation of asthma in children. Journal of Allergy and Clinical Immunology, 140(4), 895-906.
Keet, C. A., Keller, J. P., & Peng, R. D. (2018). Long-term coarse particulate matter exposure is associated with asthma among children in Medicaid. American journal of respiratory and critical care medicine, 197(6), 737-746.
Knibbs, L. D., Woldeyohannes, S., Marks, G. B., & Cowie, C. T. (2018). Damp housing, gas stoves, and the burden of childhood asthma in Australia. Medical Journal of Australia, 208(7), 299-302. Cassim, R., Dharmage, S. C., Koplin, J. J., Milanzi, E., & Russell, M. A. (2018). Suspected asthma status and time spent in physical activity across multiple childhood age groups. Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology, 120(2), 219.
Looijmans-Van den Akker, I., van Luijn, K., & Verheij, T. (2016). Overdiagnosis of asthma in children in primary care: a retrospective analysis. Br J Gen Pract, 66(644), e152-e157.
Movin, M., Garden, F. L., Protudjer, J. L., Ullemar, V., Svensdotter, F., Andersson, D., … & Almqvist, C. (2017). Impact of childhood asthma on growth trajectories in early adolescence: F indings from the C hildhood A sthma P revention S tudy (CAPS). Respirology, 22(3), 460-465.
Murray, C., Drake, S., Foden, P., Lowe, L., Durrington, H., Custovic, A., & Simpson, A. (2018). P129 Diagnosing asthma in symptomatic children at age 11: evidence from a birth cohort study.
Ramratnam, S. K., Bacharier, L. B., & Guilbert, T. W. (2017). Severe asthma in children. The Journal of Allergy and Clinical Immunology: In Practice, 5(4), 889-898.
Tan, R., Cvetkovski, B., Kritikos, V., O’Hehir, R. E., Lourenço, O., Bousquet, J., & Bosnic-Anticevich, S. (2019). Identifying an effective mobile health application for the self-management of allergic rhinitis and asthma in Australia. Journal of Asthma, 1-12.
Zahran, H. S., Bailey, C. M., Damon, S. A., Garbe, P. L., & Breysse, P. N. (2018). Vital signs: asthma in children—United States, 2001–2016. Morbidity and Mortality Weekly Report, 67(5), 149
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