in West Virginia
1-800-LUNG-USA
June 13, 2012
www.lung.org
Who We Are
The American Lung Association® (ALA) is the oldest voluntary health
organization in the United States, with nearly 200 affiliate associations
around the country. Founded in 1904 to fight tuberculosis, the American
Lung Association® today fights lung disease in all its forms, with special
emphasis on asthma, tobacco control and environmental health. We
are funded by contributions from the public, along with gifts and grants
from corporations, foundations and government agencies.
www.lung.org
American Lung Association in West Virginia
Established in 1954, the West Virginia chapter of the ALA sponsors
various programs that promote lung health.
Tobacco Education and Prevention: Did you know that…
More than 4,000 West Virginians die each year -- 12 every day -from smoking-related diseases.
West Virginians pay $897 million a year for the direct health care
costs of smoking.
Smoking costs West Virginian’s $2 billion a year.
www.lung.org
American Lung Association in West Virginia
Tobacco Prevention Programs:
N-O-T on Tobacco- N-O-T is the American Lung Association's schoolbased voluntary program designed to help high school students stop
smoking, reduce the number of cigarettes smoked, increase healthy
lifestyle behaviors, and improve life management skills
Teens Against Tobacco Use (TATU)- is a peer-teaching tobacco
control program aimed at deterring youngsters from taking up smoking.
Teenagers are trained to act as instructors for prevention meetings with
younger children.
www.lung.org
American Lung Association in West Virginia
Tobacco Prevention Programs (cont.):
Freedom From Smoking (FFS)- The program takes a positive behavior
modification approach to adult smoking cessation. It offers a systematic
approach to quitting smoking and is designed to provide a built in
support system to help participants develop a lifelong plan to quit
smoking and stay quit!
RAZE – A youth-led movement in West Virginia to inform teens of Big
Tobacco lies and to educate on the dangers of tobacco. These groups
practice peaceful demonstrations called “commotions” and are located
in schools and community organizations throughout the state.
www.lung.org
American Lung Association in West Virginia
Asthma Program:
The West Virginia Asthma Coalition (WVAC) is a group of professionals including physicians, respiratory therapists and school nurses asthmatics and parents of asthmatics who are dedicated to improving
the quality of care for asthma patients in the state and increasing public
awareness about asthma. Activities include advocacy for West
Virginians with asthma, providing programs such as “Open Airways For
Schools,” and implementing the WV Department of Health’s Asthma
Prevention Strategic Plan.
www.lung.org
American Lung Association in West Virginia
Camp Catch Your Breath is a weeklong, summer camp that provides a
fun and educational experience for
children with asthma. In addition
to the asthma educational
components, children will
participate in games, sports,
swimming, and crafts.
www.lung.org
OAS History
Open Airways For Schools (OAS) program
is an adaptation of Open Airways, a successful clinic-based education
program developed by Columbia University’s College of Physicians and
Surgeons.
OAS was adapted for use in schools in order to reach children with
limited access to health care services and children whose asthma has
gone undetected and therefore untreated. It was adopted and
implemented in 1991 by the American Lung Association.
www.lung.org
OAS History
OAS was originally tested among 200 children. The children who
completed the program:
were more confident in their ability to manage their asthma;
improved their school performance;
had fewer episodes of asthma that were of shorter duration;
took more steps to manage their asthma.
The program is approved and recommended by the National
Association of School Nurses.
www.lung.org
Overview
The Open Airways For Schools (OAS) curriculum was created for
children in grades 3-6, aged 8-11.
OAC consists of six 40-minute group lessons for children that are usually
held during the day, with take home assignments for the kids to
complete with their parents.
www.lung.org
Objectives
The program is intended to increase children’s ability to take care of
their asthma on a daily basis. Specifically, OAS will teach them to:
Take steps to prevent asthma episodes
Recognize symptoms when they first occur, and carry out
proper management steps
Discuss and solve problems related to asthma with parents,
doctors, teachers, and friends
Feel more confident about taking care of their
asthma
Curriculum
OAS incorporates an interactive teaching approach to promote children’s
active involvement in the learning process. Teaching activities include:
Group discussion
Modeling of new skills and verbal reinforcement from
Instructor
Role-playing, stories, and games
Relaxation exercises
Health Messages
There are five major health messages in the OAS program:
Asthma is treatable.
Asthma episodes do not have to be a crisis.
Prescribed medicine should be taken at the first sign of
symptoms or at the first sign of a cold.
Solutions to problems can be found.
A child with asthma should live as normal as
possible.
Understanding Asthma
Asthma is a chronic inflammatory disorder of the airways that cause
three primary changes in the lungs:
Inflammation (swelling) of the lining of the airways
Bronchoconstriction (spasms of the bands of smooth muscles lining
airways) which reduces the diameter of the airways
Excess mucus production that can narrow the lumen of the airways
and form clogs
www.lung.org
Understanding Asthma
www.lung.org
Understanding Asthma
Characteristics
Intermittent reoccurring episodes of:
Inflammation (swelling) of the lining of the airways
Shortness of breath
Chest tightness
Wheezing
www.lung.org
Understanding Asthma
Incidence of Asthma
It is estimated that more than 25 million Americans have asthma.
Asthma affects nearly 7 million children under the age of 18 in the
United States.
Asthma is the third leading cause of hospitalization among children under the age of
15.
Asthma claimed the lives of 3,345 Americans in 2009, or more than 9 people everyday.
Asthma is a leading cause of school absences from chronic disease – accounting for
over 10.5 million lost school days in 2008.
American Lung Association Fact Sheet, Funding for the National Asthma
Control Program at the Centers for Disease Control and Prevention
www.lung.org
Understanding Asthma
West Virginia-Specific Incidence
In four out of the past seven years, the prevalence of adult asthma was
significantly higher in WV than the United States.
Nearly 33,000 children in WV were diagnosed with asthma (6.5%).
There are 68,980 adults in WV diagnosed with asthma (7.3%).
Total charges for asthma hospitalizations increased from $10.3 million in
1996 to $23.2 million in 2006.
The Burden of Asthma in West Virginia, August 2007
American Lung Association Fact Sheet, Funding for the National Asthma
Control Program at the Centers for Disease Control and Prevention
www.lung.org
Asthma Triggers
There are many common substances that can initiate or aggravate an
asthma attack. These substances, along with environmental conditions,
are often referred to as triggers.
Not all people with asthma have the same triggers that will cause an
asthma attack.
Those with asthma should learn and remember what their triggers are
and protect themselves from exposure whenever possible.
If they cannot remove themselves from exposure, they should keep
their medication readily available.
www.lung.org
Asthma Triggers
Common Triggers
A cold, sinus infection or similar illness
Exercise, especially in cold weather
Irritants, like air pollution, perfume, paint, etc.
Tobacco smoke
Strong emotions
Things that the person is allergic to like pets, dust mites,
cockroaches, molds, weeds, and pollens
www.lung.org
Asthma Management
– Quick-relief or “reliever” medications used to treat asthma
attacks and acute symptoms
– Long-term “controller” medications reduce the airway
inflammation that causes these symptoms
– Other elements of long-term management include:
• reducing exposure to allergens and other asthma triggers
• regular monitoring of asthma symptoms and peak flow
• development of an action plan for use during attacks
• regular doctor visits and assessment of the therapy's
success
www.lung.org
Asthma Management
• Preventing chronic asthma symptoms and asthma attacks
during the day and night
– no sleep disruption due to asthma
– no missed school or work because of asthma
– no or minimal need for emergency care or hospitalizations
• Maintaining normal activity levels, including exercise and other
daily activities
• Having normal or near-normal lung function
www.lung.org
Asthma Management Plan
Pulmonary Function Testing:
• Key to the diagnosis and management of asthma
• Peak flow rate and spirometry are the two
pulmonary function tests most often diagnostic
of asthma
• Baseline value is obtained when the student is
asymptomatic which is between 80 and 100% of
the patient’s personal best (normal PEFR range)
www.lung.org
Peak Flow Rate
Significance of Peak Flow:
• Green (80-100% of personal best) signals all clear (student
is advised to adhere to regular maintenance regimen)
• Yellow (50 to 80% of personal best) signals caution, since
airways are somewhat obstructed
• Red (below 50% of personal best) signals medical alert.
Bronchodilator therapy should be started immediately and
clinician should be contacted if PEFR measures do not
return immediately to yellow or green zones
www.lung.org
Peak Flow Rate
People with moderate or severe asthma
should take readings:
• Every morning and
night
• After an attack
• Before inhaling certain
medications
www.lung.org
Sample Open Airways for Schools
The American Lung Association in West Virginia is pleased to provide
sample information of Open Airways For Schools. We hope that this
background information on our organization and the burden of asthma
in West Virginia has helped prepare you for Open Airways for Schools.
Questions?
www.lung.org
Working With Children
 The Distracted Child – May be dealing with problems or fears that make it
hard for them to progress. May need a little extra attention. Often just
validating feelings can calm the child and redirect his/her attention.
 The Shy Child – May take a while to warm up to the group dynamic. Share
experiences with them that are similar to theirs. Open ended questions
often help this child to formulate answers. You may find it more
comfortable for the child not to call on them. Extra ‘classroom’ helper
assignments may help.
 The Overexcited Child – May talk over the other children or raise hand
even though she/he does not know the answer. Assure them that everyone
will get called on to answer questions and participate. It may be a good
idea to allow this child to help you distribute materials.
Working With Children
 Stick to the curriculum. It offers tips on asking questions,




giving encouragement and praising children.
Respond to incorrect answers with “Doctor’s say…” or
“Experts say…”
Don’t scold, put down or make fun of a child.
Don’t forget about non-verbal communication.
Always redirect discussions back to asthma.
Overview of Materials
 Curriculum Guide with handout disk
 Instructor’s Guide
 Posters
Curriculum Guide
 Introduction
 How to use the curriculum
 How to prepare to facilitate the classes
 Six sessions
Posters
 Thirteen posters that are to be used with the curriculum
guide.
 Colorful and kid friendly
 Available in English and Spanish
Instructor’s Guide
 Asthma Basics
 Asthma management basics including triggers and
medications
 History of the program and most commonly asked
questions
 An overview of the materials
 Role of the instructor
Teaching Methods and Activities
 Information about asthma given by the instructor
 Use of art materials to express and share feelings about
asthma
 Modeling by the instructor
 Role-play to rehearse new skills in life-like situations
Teaching Methods and Activities
 Use of stories to stimulate problem solving
 Use of games to practice decision-making
 Relaxation exercises to help children stay calm and
controlled when asthma symptoms occur
 Strong verbal reinforcement of children’s attempts to use
new skills
Format of Lessons
 Learning Objectives
 Activities, Materials Needed, Estimated Time
 Instructions (what to do)
 Methods to Generate Discussion (what to say)
 Health Messages (what the kids should understand)
 Materials (what to use)
Format of Sessions
 Take Home Assignment
 Preview of the Next Session
 Review and Success Stories
 Tips for Instructors
 Information for Parents/Guardians
Lesson One:
Basic Info and Feelings About Asthma
 Discussion of what is asthma
 Sharing feelings about symptoms
 Belly breathing for relaxation exercises
 Parent Letter #1: Information about asthma and the OAS
program
Lesson Two:
Recognizing and Managing Symptoms
 Describe their warning signs for asthma symptoms
 List steps they take presently to manage asthma
 Practice the four steps to manage asthma using role-play
activities
 Parent Letter #2A - Peak Flow Meter, Asthma
Medications and Asthma Action Plan
 Parent Letter #2B - Asthma Medications for Child
Lesson Three:
Medications and Symptoms
 Discussions about solving problems with medications
 Story/discussion about deciding how bad your symptoms
are
 Game – deciding how bad your symptoms are
 Parent Letter # 3 – The Five Emergency Signs of an
Asthma Attack
Lesson Four:
Finding and Controlling Triggers
 Discussion of locating triggers at home and at school and
controlling them
 Role Play – Talking to parents and others about triggers
and solutions
 Parent Letter #4 – Common Asthma Triggers
Lesson Five:
How to Get Enough Exercise
 Discussion and Role Play of how to remain active
 Playing “Simon Says” as an example of how to be active
 Tensing and Relaxing Exercise
 Parent Letter #5A – Six Ways to Stay Active
 Parent Letter #5B – Graduation Invitation
Lesson Six:
Doing Well at School
 Discussion of how to decide when to go to school and
when to stay home
 Discussion of ways to make up missed school work
 Activity – How I feel about myself
 Graduation Ceremony
Does it Work?
A 1987 study of OAS found that children who completed
the program:
 Have fewer and less severe asthma attacks
 Improve their academic performance
 Have more confidence in their ability to take steps to
manage their asthma
 Exert greater influence on their parents’ asthma
management decisions
Questions & Discussion
 An OAS Class will be offered on Saturday, August 25th
at the American Legion located at 415 Dickinson
Street Charleston, WV
 For more information or to sign up for the class,
please contact:
Lindsay M. Elkins, BA, MS
lelkins@lunginfo.org
304-342-6600