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Marisela Robles, MS
Katrina Kubicek, MA
Michele D. Kipke, PhD
SC Clinical and Translational Science Institute and
Children’s Hospital Los Angeles
Neal Richman, PhD
Saba Firoozi, MPH
BREATHE California of Los Angeles County
Charlene Chen, MHS
Hannah Valino, MPH
COPE Health Solutions
AFTER-SCHOOL SETTINGS AS A METHOD OF
ADDRESSING ASTHMA MANAGEMENT AND
PREVENTION: A COMMUNITY-BASED RESEARCH
PERSPECTIVE
PRESENTER DISCLOSURES
(1) The following personal financial relationships with
commercial interests relevant to this presentation
existed during the past 12 months:
Marisela Robles
“No relationships to disclose”
PARTNERSHIPS
This project is a unique partnership with:
•University of Southern California
•Children’s Hospital Los Angeles
•BREATHE California of Los Angeles County
•COPE Health Solutions
•Boys and Girls Club of Long Beach
•Community and Clinical Partners
BACKGROUND
• Asthma is the most common chronic childhood disease in
the US.
• It accounts for three times more lost school days than any
other chronic disease
• Higher rates of asthma among children living along
congested freeways and ports and other industrial areas
• Long Beach is particularly burdened with higher rates of
childhood asthma, where asthma affects 21.9% of children
ages 5-17, compared with 15.6%, 18%, and 14.2% in LA
County, CA and the US respectively.
BACKGROUND CONTINUED
• Providing parents and children with the tools needed to
effectively control asthma is an essential component of
pediatric care for children with asthma.
• School-based programs were found to be effective in
increasing knowledge about asthma.
• No identified after-school program based on asthma education
and management.
METHODS
• Community-Based Participatory Research (CBPR) approach
o Healthcare Community Advisory Board
o Parent Advisory Board
• Photovoice method
Study Participants:
• 124 total participants,16 focus groups
• 9 children (8-12 yrs. old) focus groups, 74 child participants
36 male and 38 female
• 6 parent focus groups, 41 parent participants
4 male and 36 female
• 1 staff focus group, 9 participants
ANALYSIS AND CONCEPTUAL MODEL
BASED ON EMPOWERMENT THEORY AND SOCIAL SUPPORT
RESULTS
LIMITATIONS
“If other people challenge you and
you want to take the challenge,
and you know you can’t but you
are competitive so at the end,
you’re out of breath and might
have an asthma attack.”
“…how can you explain to a
little child, you can’t play like
everyone else?”
“If they [children] have asthma they
can’t touch them [pets] or pet them…
or get near them… they get asthma.”
RESULTS CONTINUED
SOCIAL SUPPORT
“My friend said let’s go racing,
and I said, ‘no you can’t
because you have asthma,’ and
then he started running and he
had to stop and use his inhaler.”
RESULTS CONTINUED
ADVOCACY
“My neighbors are smokers they
just moved in so I don’t know
what I am going to do. A least we
have more laws. People can’t
smoke in restaurants, But what
about where you live?”
“I have a picture of the refineries.
I work close to it in the childcare.
There are kids there who already
come with asthma, but they have
to withdraw because the smoke
from the refineries aggravates
their asthma.
CURRICULUM ADAPTATION
• New emphasis on how children with asthma can safely
engage in physical activity
• Incorporated a buddy system
• New section on advocacy
• Added to the asthma myths activity
• Included photographs and examples provided by study
participants
DISSEMINATION
• Parent Asthma Booklet
• Photo Gallery
• SC CTSI Website
• Manuscript
• Community Presentations
CONCLUSIONS
• This study provides guidelines for how to conduct a CBPR
project with the goal of creating a community-driven and
scientifically-grounded asthma curriculum.
• The first asthma curriculum identified that integrates social
support as a way to mediate positive health outcomes.
Next Step:
• Take the newly adapted curriculum into an efficacy trial to
identify whether the desired outcomes are met.
ACKNOWLEDGEMENTS
National Institutes of Health
Grant number UL1RR031986
Boys and Girls Club of Long Beach Staff
Healthcare Community Advisory Board Members
Parent Advisory Board Members

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The Most Powerful Weapon Against Asthma Is Education

  • 1. Marisela Robles, MS Katrina Kubicek, MA Michele D. Kipke, PhD SC Clinical and Translational Science Institute and Children’s Hospital Los Angeles Neal Richman, PhD Saba Firoozi, MPH BREATHE California of Los Angeles County Charlene Chen, MHS Hannah Valino, MPH COPE Health Solutions AFTER-SCHOOL SETTINGS AS A METHOD OF ADDRESSING ASTHMA MANAGEMENT AND PREVENTION: A COMMUNITY-BASED RESEARCH PERSPECTIVE
  • 2. PRESENTER DISCLOSURES (1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: Marisela Robles “No relationships to disclose”
  • 3. PARTNERSHIPS This project is a unique partnership with: •University of Southern California •Children’s Hospital Los Angeles •BREATHE California of Los Angeles County •COPE Health Solutions •Boys and Girls Club of Long Beach •Community and Clinical Partners
  • 4. BACKGROUND • Asthma is the most common chronic childhood disease in the US. • It accounts for three times more lost school days than any other chronic disease • Higher rates of asthma among children living along congested freeways and ports and other industrial areas • Long Beach is particularly burdened with higher rates of childhood asthma, where asthma affects 21.9% of children ages 5-17, compared with 15.6%, 18%, and 14.2% in LA County, CA and the US respectively.
  • 5. BACKGROUND CONTINUED • Providing parents and children with the tools needed to effectively control asthma is an essential component of pediatric care for children with asthma. • School-based programs were found to be effective in increasing knowledge about asthma. • No identified after-school program based on asthma education and management.
  • 6. METHODS • Community-Based Participatory Research (CBPR) approach o Healthcare Community Advisory Board o Parent Advisory Board • Photovoice method Study Participants: • 124 total participants,16 focus groups • 9 children (8-12 yrs. old) focus groups, 74 child participants 36 male and 38 female • 6 parent focus groups, 41 parent participants 4 male and 36 female • 1 staff focus group, 9 participants
  • 7. ANALYSIS AND CONCEPTUAL MODEL BASED ON EMPOWERMENT THEORY AND SOCIAL SUPPORT
  • 8. RESULTS LIMITATIONS “If other people challenge you and you want to take the challenge, and you know you can’t but you are competitive so at the end, you’re out of breath and might have an asthma attack.” “…how can you explain to a little child, you can’t play like everyone else?” “If they [children] have asthma they can’t touch them [pets] or pet them… or get near them… they get asthma.”
  • 9. RESULTS CONTINUED SOCIAL SUPPORT “My friend said let’s go racing, and I said, ‘no you can’t because you have asthma,’ and then he started running and he had to stop and use his inhaler.”
  • 10. RESULTS CONTINUED ADVOCACY “My neighbors are smokers they just moved in so I don’t know what I am going to do. A least we have more laws. People can’t smoke in restaurants, But what about where you live?” “I have a picture of the refineries. I work close to it in the childcare. There are kids there who already come with asthma, but they have to withdraw because the smoke from the refineries aggravates their asthma.
  • 11. CURRICULUM ADAPTATION • New emphasis on how children with asthma can safely engage in physical activity • Incorporated a buddy system • New section on advocacy • Added to the asthma myths activity • Included photographs and examples provided by study participants
  • 12. DISSEMINATION • Parent Asthma Booklet • Photo Gallery • SC CTSI Website • Manuscript • Community Presentations
  • 13. CONCLUSIONS • This study provides guidelines for how to conduct a CBPR project with the goal of creating a community-driven and scientifically-grounded asthma curriculum. • The first asthma curriculum identified that integrates social support as a way to mediate positive health outcomes. Next Step: • Take the newly adapted curriculum into an efficacy trial to identify whether the desired outcomes are met.
  • 14. ACKNOWLEDGEMENTS National Institutes of Health Grant number UL1RR031986 Boys and Girls Club of Long Beach Staff Healthcare Community Advisory Board Members Parent Advisory Board Members