ASK : ASTHMA SAFE KIDS. A Program to Educate, Treat, and Prevent Asthma in Kids

Asthma is one of the most common chronic diseases for children in Philadelphia and throughout the United States. There is no cure for asthma, but it can be managed with proper education. According to the Asthma and Allergy Foundation of America, Philadelphia is ranked in their 2007 “Asthma Capital” survey as the second worst asthmatic city in the United States. Twenty percent of children living in Philadelphia under five years of age have asthma. Children who live in inner city environments are exposed to both outdoor and indoor asthma triggers, such as smog, pollen, tobacco smoke, pet allergens, cock roaches and dust. Asthma is the inflammation of air passages from the mouth and nose to the lungs when exposed to these triggers, making it difficult to breathe. Symptoms of asthma include coughing and wheezing, and in severe cases asthma can lead to death.

Asthma Safe Kids:

Asthma Safe Kids (ASK) is an in-home asthma education program for caregivers of children under 18 years of age with asthma. The program is designed to increase education and awareness of asthma triggers in the home environment in order to eliminate them. As a result, the asthmatic children will have fewer asthma attacks and fewer Emergency Department visits and hospitalizations.

The ASK education and assessment materials are based upon the American Lung Association’s Attack Asthma curriculum, and the Environmental Protection Agency’s Home Environmental Assessment. The ASK materials have been adapted to teach parents about how to address asthma triggers in their own home. Caregivers receive two home visits, during which the outreach worker conducts an environmental assessment and educates them on how to reduce asthma triggers in the home. Cleaning supplies are given to the caregivers and they are shown how to properly clean problematic areas. The supplies include: plastic mattress and pillow covers, laundry detergent, roach bait, rodent traps, dusting wipes and other incentives.

Clients receive instruction on how to limit dust levels and to limit exposure to perennial allergens, such as dust mites, cockroach antigens, and molds, as well as environmental tobacco smoke. Trigger-management strategies suggested to the clients include: not allowing smoking within the home; vacuuming and washing throw rugs and upholstered slip covers, draperies, etc. at least every two weeks; using air-tight mattress and pillow covers; washing bed linens at least every two weeks in hot water; and placing roach and rodent traps in the home appropriately.  In the second visit the outreach worker conducts another environmental assessment and reinforces asthma information with the client.

The ASK program helps to improve the living conditions of asthmatic children by eliminating asthma triggers in the child’s home environment. The program not only helps to improve the living conditions of the asthmatic child, but decreases the risks for other children in the household of developing asthma as well. 

Asthma Safe Kids began in 2000 and was administered by nurses within NNCC nurse-managed health centers located within the Philadelphia region. Temple Health Connection in North Philadelphia, and the Health Annex in West Philadelphia currently facilitate the program in those areas of the city with funding from Steps to a Healthier Philadelphia and the Environmental Protection Agency, Region III.

Because of the success of the program in Philadelphia, the NNCC was funded in 2002 by the EPA, Region III, to administer an expansion of the ASK program to the Greene County area of Southwestern Pennsylvania, and Mon County, West Virginia through an NNCC-member center, the Primary Care Center of Mt. Morris, in partnership with the Pennsylvania State Rural Connection, Rural Nursing Centers of Pennsylvania State University.

Merck Childhood Asthma Network (MCAN) Project:

The Philadelphia Merck Childhood Asthma Network (MCAN) Project is a four-year community-based asthma intervention program that is implemented in different areas of Philadelphia each year. The NNCC works in collaboration with the Community Asthma Prevention Program (CAPP) of the Children’s Hospital of Philadelphia, the Health Promotion Council, the Philadelphia Health Management Corporation and other key partners to reduce disparities in access to asthma-related services and improve health outcomes of asthmatic children in the targeted communities.

Outreach staff from the NNCC and CAPP conduct door-to-door surveys to identify children in the targeted neighborhood who have unknown or untreated asthma and refer these cases to asthma-related services in the city. The outreach staff will then conduct home visits to the homes of the caregivers reached by the door-to-door screenings who have children with untreated asthma.