Teaching Sessions for African American Children: Addressing the Asthma Issue

Introduction

When dealing with a particular clinical issue, patient education is a crucial step that healthcare providers have to take in order to help individuals become successful in controlling their health. This has been shown to be important for patients diagnosed with asthma due to the variability of symptoms associated with different environmental factors. While the target population of African-American children has high risks of getting asthma, patient education as a tool has not been explored in regards to this group.

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Spirit of Inquiry Ignited

Asthma is a persistent issue that is often overlooked by researchers. There is a disproportionate number of African Americans that have asthma (Todoric, Bangdiwala, Vadlamudi, Alarcon, & Hernandez, 2015). Moreover, the burdens of the condition fall more heavily on Black children, regardless of their social status and family income. The illness can manifest due to a variety of factors such as environmental pollution, nutritional patterns, and exposure to different triggers (for example, mold, dust, pets). The problem persists as Black children are two times more likely to suffer from asthma than other racial groups (the United States Environmental Protection Agency, 2014). This means that immediate actions are needed to manage the illness by providing ample educational resources to avoid asthma triggers and live a healthy and fulfilling life.

The PICOT Question Formulated

In African American children with asthma (P), will the use of teaching sessions (30 minutes per week) (I) compared with the traditional teaching tools for managing the problem (C) have better effects on the management of the disease (O) over a year (T)?

Search Strategy Conducted

CINAHL, PubMed, Cochrane, National Guidelines Clearinghouse, and TRIP databases were searched in order to find relevant literature on the topic of asthma teaching strategies in African-American children. Several studies were found to supplement the research on the topic. The majority of searched studies focused on the hereditary or environmental predictors of asthma within the target population of African-American children, which presented a significant research challenge.

Critical Appraisal of the Evidence Performed

Several important conclusions can be made from the literature search. For instance, the prospective study by Agusala, Vij, Agusala, Dasari, and Kola (2018) found that asthma in children is characterized by a series of social and personal challenges, which enables healthcare providers to focus on pediatric patients in rural areas where healthcare is not readily available. Also, Everhart, Greenlee, Winter, and Fiese (2018) determined that asthma in children is strongly linked to the quality of life provided by their caregivers. Ding, Wathen, Altaye, and Mersha (2018) discovered a link between asthma and African ancestry, while Archibald, Hartling, Ali, Caine, and Scott (2018) found that emotionally sensitive information was useful in asthma education. These findings provided significant support for the project.

Evidence Integrated with Clinical Expertise and Patient Preferences to Implement the Best Practice

The plan for this project relies on translating the evidence found during the literature search into thirty-minute teaching sessions conducted weekly and assessing their effectiveness. The results will be compared to traditional training methods in reducing the burden of asthma among African-American children over a year. When children are seen in clinical health practice settings and are diagnosed with asthma, the usual treatment is the use of long- and short-term medications. While medications such as inhaled corticosteroids or quick-relief bronchodilators are effective, the lack of patient education prevents children from understanding their condition and having the ability to manage asthma. However, when medication-based treatment is supplemented by patient education, it is expected that children get a quicker relief of their long-term condition.

Weekly teaching lessons will only be possible through the collaboration between children’s parents or caretakers and their healthcare providers. An advanced practice nurse or a registered nurse with knowledge in pharmacology, cultural competence, and child psychology can provide effective training to African-American children and encourage them to be active in preventing asthma attacks as well as be diligent in following the treatment that has been prescribed to them.

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Outcomes of Practice Change Evaluated

All twenty children enrolled in the project completed their course of weekly 30-minute lessons. Their parents and caretakers reported an improved self-efficacy in avoiding factors that trigger asthma as well as an increased awareness associated with taking medication within several months. If the teaching sessions were beneficial, it is expected that children’s awareness and the ability to effectively manage their condition. The intervention can be used by nurses when working with all pediatric patients with asthma within shorter timeframes.

Project Outcomes Disseminated

The project was presented in an educational setting to encourage future nurses to use education as a tool for managing asthma as well as other health conditions (e.g., obesity) that prevail in minority populations. It is important to mention that the outcomes of the project were disseminated against all participants’ parents and caretakers to encourage them to share the new information with their friends and family for facilitating a discussion on overcoming the challenge of asthma among African-American children.

Conclusion

The research showed that patient education is as important as medication-based treatment, especially among patients that have fewer opportunities to contact their healthcare providers. It is expected that the positive outcomes of the project will yield improved efforts of nurses to educate their patients and not to overlook the importance of information. Also, the project offered an insight into the issue of African-American children overlooking their health, which is a problem that needs further resolving.

Evaluation Plan and Methods

  1. Purpose: to determine whether educating patients from a vulnerable population could improve their diagnosis and facilitate a better understanding of asthma.
  2. Clinical question: can asthma symptoms decrease or disappear completely with the help of patient education?
  3. Time: final results will be evaluated after one year; short-term improvements are expected to be seen within two to three months.
  4. Stakeholders: nurses, project participants, and their parents (or caretakers) are the key parties involved in research.
  5. Theoretical Framework: it has been theorized that asthma in children is predetermined by the quality of their lives as well as hereditary factors that increase the likelihood of the condition (Everhart et al., 2018; Ding et al., 2018). Emotionally-sensitive information such as the use of illustrations and images is an effective method for teaching children about useful methods of asthma management.
  6. Design: a cohort study that examined a specific population (African-American children aged between seven and twelve years) with a particular trait (asthma diagnosis) over a period of one year.
  7. Confidentiality: all personal information remained confidential. Participants’ parents or caretakers were asked to sign a consent form, thus agreeing that their children would participate in the project.
  8. Sample/Setting/Procedure: pre-and post-intervention outcomes were evaluated. Altogether, twenty African-American patients aged between seven and twelve years were enrolled in the project. The intervention took place in an educational setting – a classroom at a local school was used to host the lessons. Each lesson took thirty minutes and included the presentation of new information through different sources (images, graphs, movies) and a discussion section.
  9. Instrument: thirty-minute lessons that were held once a week in the course of three months were the key instrument used in improving patient outcomes. The effectiveness of these lessons was to be examined within a one-year period; however, it was expected that children would show significant improvements compared to their initial knowledge much sooner.

References

Agusala, V., Vij, P., Agusala, V., Dasari, V., & Kola, B. (2018). Can interactive parental education impact health care utilization in pediatric asthma: A study in rural Texas. Journal of International Medical Research. 1-12. Web.

Archibald, M. M., Hartling, L., Ali, S., Caine, V., & Scott, S. D. (2018). Developing “my asthma diary”: A process exemplar of a patient-driven arts-based knowledge translation tool. BMC Pediatrics, 18(1), 186-196.

Ding, L., Li, D., Wathen, M., Altaye, M., & Mersha, T. B. (2018). African ancestry is associated with cluster-based childhood asthma subphenotypes. BMC Medical Genomics, 11(1), 51-62.

United States Environmental Protection Agency. (2014). Children’s environmental health disparities: Black and African American children and asthma. Web.

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Everhart, R. S., Greenlee, J. L., Winter, M. A., & Fiese, B. H. (2018). Primary and secondary caregiver reports of quality of life in pediatric asthma: Are they comparable? Applied Research in Quality of Life, 13(2), 371-383.

Todoric, K., Bangdiwala, S., Vadlamudi, A., Alarcon, L., & Hernandez, M. (2015). Assessing asthma in African American children using the asthma control test (ACT) and childhood ACT. Annals of Allergy, Asthma & Immunology: Official Publication of the American College of Allergy, Asthma, & Immunology, 114(4), 342-344.

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