Asthma in Children in Philadelphia


For this course, I chose to work with children with asthma in Philadelphia. This condition is more severe for children than for adults due to their smaller airways that make symptoms have stronger effects. According to the data provided by Healthy People 2020 (“Respiratory Diseases”, n.d.), 130 in 10000 children visit emergency departments due to asthma. This shows that although there are preventative measures such as nebulizers, the disease is still not addressed sufficiently well.

The Healthy People 2020 website (“Respiratory Diseases”, n.d.) displays a number of objectives related to combating asthma. They do not intend to implement any programs that specifically target children, instead focusing on the general improvement of the system. The programs proposed are mostly related to increasing awareness of asthma and the proper means of treating it, including instruction in the use of inhalers and handling of asthma attacks, as well as the implementation of a comprehensive asthma surveillance system in states where one is not yet present.

The U.S. Preventive Services Task Force primarily attempts to address asthma in children by reducing drug and tobacco usage among adolescents. It also tries to prevent the surfacing of the disease altogether by convincing pregnant women to avoid smoking tobacco. Due to the preventive nature of the Task Force, combined with the fact that asthma in children is thought to be primarily caused by environmental pollution, they do not engage in other significant activity related to the topic.

Lastly, a Doctor of Nursing Practice (“DNP Essentials”, 2016) should be capable of implementing all initiatives and Task Force recommendations proposed in her daily work. A nurse may provide recommendations about avoiding drugs and smoking to a pregnant woman and stress the importance of doing the same during educational meetings with children. A DNP prepared practitioner would also be able to make valuable contributions to the creation and maintenance of a surveillance system.

Health Promotion Theories

The social theory by Decker (n.d.) that I find the most appropriate for the situation is the social learning theory. It states that individuals learn by imitating their environment and reciprocate the sentiment expressed at them, which can be used to foster desirable behaviors. In this particular case, the application of the theory concerns preventive measures, expressed as spreading awareness that smoking and alcohol consumption, especially while pregnant, encourages the development of asthma in children. As such behavior becomes less socially acceptable, fewer people will engage in it.

From a nursing approach, the theory used should concern the personal level, as actions of individuals often cause asthma attacks. As such, the theory I found most relevant is the theory of planned behavior described by the U.S. Department of Health and Human Services (2005). The theory states that the most influential determinant of behavior is the intention, which is affected by the attitude of the person and people important to them, as well as their perceived self-control. If a person is made aware that their actions cause potential harm to the children surrounding them, they will be inclined to stop the harmful behavior.

I chose the social learning theory because, unlike the attachment theory, it does not necessarily concern the interior of an organization. Its drawback is that the prevention is aimed at children who may not yet have developed a social mindset, sometimes doing things because they are frowned upon. The theory of planned behavior was chosen because, unlike the others, it does not require direct action, which is suitable for asthma control because the primary way of addressing the disease is prevention. The drawback of this theory is that people who do not have children but still have them present in their surroundings might not be as concerned for the safety of the children from asthma until an attack happens in the person’s vicinity.

Inspection of an Engagement Agency

The agency chosen for the review is the Asthma Program of the Children’s Hospital of Philadelphia (2018). Described as one of the best in the nation, the program provides various health services such as testing, diagnosis, treatment, and follow-up care. Its website also contains educational materials on managing asthma, using inhalers, and replacing inhalers and medication. The organization’s official status as part of a hospital ensures a high standard of service and correct management of information for the treatment of a child’s other conditions as well as observation of their state.

Being part of a children’s hospital, the program has children as its primary focus. However, it offers a variety of non-health services to parents, mostly of an informational nature. The program also performs a variety of activities such as home visits and researches asthma and its causes as well as symptoms. This policy of focusing on treatment and management of the condition serves to enhance the quality of services provided, earning the section high acclaim. There is, however, a significant gap in the section’s methodology concerning the spreading of awareness of the information.

The program is concerned with the treatment and management of asthma in children, but it does not seek to prevent asthma attacks. As such, it does not spread information about the common triggers of asthma attacks in children. I decided to choose this gap for my grant proposal because effective prevention is the best way to deal with asthma. While the condition is present at birth and cannot be prevented, its adverse effects can be negated with correct management, letting the child grow up healthy and possibly never suffer from respiratory issues.

Particulars of the Project

The project will involve spreading awareness about asthma among the groups primarily responsible for causing the attacks, namely pregnant women, parents of young children and the children themselves. Following the principles of CBCAR described by Pavlish and Pharris (2011), the nurses will collect input from the community to determine the knowledge gaps that need to be addressed and spread the corresponding information. The people thus educated will then relay the information to their acquaintances who they believe to be at risk.

The information will be spread via communication with clients in the hospital, particularly those with respiratory issues, as well as advertisements on various media. Following the policy influencing guidelines set by Zaccagnini and White (2010), potential policy changes will be proposed to minimize the number of possible asthma triggers near children. The result should be a reduction in the incidence of asthma attacks in children, expressed as a decrease in hospitalizations and emergency department visits related to the issue.

As the project is not a large one, it should require an affordable amount of funding. Therefore, it should be possible to fund it from the existing state medical budget without searching for additional sources of income. If it succeeds, it can be used in the future as a reference for information campaigns concerning other common issues that have avoidable triggers. It would also serve as a display of the effectivity of the DNP program, encouraging its further development.

References

Children’s Hospital of Philadelphia (2018). Asthma program. Web.

Decker, R. (n.d.). Theoretical change models. Web.

DNP Essentials. (2016). Web.

Pavlish, C. P., & Pharris, M. D. (2011). Community-based collaborative action research. Sudbury, MA: Jones and Bartlett Publishers.

Respiratory Diseases. (n.d.). Web.

U.S. Department of Health and Human Services. (2005). Theory at a glance: A guide for health promotion practice. Web.

Zaccagnini, M., & White, K. (2010). The doctor of nursing practice essentials: A new model for advanced practice nursing. Sudbury, MA: Jones and Bartlett Publishers.