Asthma Care Training (ACT) for Kids

A program of the Asthma and Allergy Foundation of America, implemented in Providence 'Alaska' Medical Center, Anchorage, Alaska.

Asthma Care Training for Kids: Strengths/Challenges

Among the many factors that contribute to the ACT for Kids’ success at Providence, the primary one is the dedication and commitment of Dr. Demain and his staff. All of the doctors who teach the ACT for Kids sessions donate their time and often stay after the sessions to answer questions. The program coordinator goes above and beyond the call of duty to reach and locate patients, attain and secure money for scholarships, and network with pharmaceutical companies for supplies. Furthermore, all staff members make themselves available to families who may have questions after the classes have ended. Some additional strengths and challenges are discussed in the following sections.

Strengths

Pre-packaged ACT for Kids kit: The ACT for Kids kit allows session leaders to follow a previously evaluated format for teaching asthma self-management. This is especially beneficial for session leaders who do not have a teaching background.

Structure of the sessions: The separate group meetings for the children and parents enable more concentrated and age-specific learning of the materials. This structure also permits parallel learning between parent and child. The hands-on, interactive play creates a more substantive learning environment for both children and parents..

Physician-led program: The involvement of three pediatric asthma specialists lends credibility to ACT for Kids. Parents, sometimes for the first time, have access to experts who can give them advice on how to cope with their specific situation. The doctors allow time during and after the class for questions and discussion on topics of interest to each parent.

Educational materials: The sessions use multimedia teaching materials that are user friendly. Lessons are taught not in lecture style but interactively and in an open manner that helps to empower and increase self-efficacy for both children and parents.

Administrative support: The hospital administration supports ACT for Kids and allows the program to be part of Pulmonary Rehabilitation. The administration is committed to the program despite the costs it imposes. Both the ACT for Kids staff and the hospital administration hope that the decrease in emergency room visits and hospitalization offset the cost of the program.

Challenges

Lack of Funding Support: Third-party payers are often reluctant or refuse to reimburse for education programs, including asthma self-management programs. As a result, the cost of the program is often not reimbursable. Patients must either pay for their portion of the program costs themselves or apply for a scholarship. In the latter case, this forces the full cost of the program to be borne by the hospital. This cost may be difficult to absorb for financially strapped institutions or for those with a lack of administrative support for asthma education.

Physician cooperation: The staff tries hard to increase the visibility of ACT for Kids through advertisements, brochures, and word-of-mouth. However, many physicians still do not refer patients to the program; territorial or turf issues may be the cause. Other physicians may be cautious about referring their patients to other doctors’ programs or might prefer to educate patients about asthma themselves. Alternatively, some physicians may not be convinced of the benefits of asthma education. ACT for Kids staff continue to reach out to physicians to allay some of these concerns.