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Children With Asthma: ETS reduction intervention

Children With Asthma: ETS reduction interventionAn intervention of this nature might have greater acceptance in a clinical (ie, nonresearch) setting, where meetings with the nurse could be approached as a normal component of the care of children with asthma. A research setting poses special challenges due to the burdens of data collection and to the detail and formality of the consent procedures. The extent of advance disclosure in ETS reduction intervention studies has varied. Notwithstanding the differences in the criteria of investigators and IRBs for informed consent that are implicit in these variations, full disclosure most likely decreases the willingness to participate on the part of some caregivers. Published reports of ETS reduction interventions should carefully describe the recruitment and disclosure procedures and should document participation rates in order to define the limitations of generalization of the results. www.mycanadianpharmacy.com

Appendix: Outline of the Behaviorally Based Counseling and Cotinine-Feedback Intervention
Session 1
I. Introduction
a. Overview of the program
b. Identify problems that the parent has in managing the child’s asthma
II. Asthma pathophysiology
a. Explain how the lungs and breathing system work
b. Explain how this system is affected during and after an acute asthma episode
c. Explain inflammation and how to prevent and control it
d. Explain the effects of irritants/allergens on the lungs
e. Explain what it means to control asthma: environmental control and medications
f. Parental practice in explaining asthma to someone else
III. Understand the cumulative effects of asthma triggers
a. Water pitcher demonstration to explain the cumulative effects of asthma triggers
b. Explain how to prevent symptoms
IV. Eliminate the child’s exposure to ETS
a. Complete a 4-day ETS exposure recall: recognizing how and where the child is being exposed to tobacco smoke
b. Explain the cotinine test as a measure of tobacco smoke exposure
c. Review cotinine test results collected at enrollment and provide a copy of the result to parents to take home
d. Explain the relationship between the initial cotinine result and the 4-day ETS exposure prior to that (initial) test
e. Identify smokers and locations that have the highest priority in reducing the child’s ETS exposure
f. Role play situations if the parent seems to lack effective negotiation strategies and if negotiation is required with another person
g. Provide parent with “no smoke exposure” prescription and “smoke free zone” stickers, and discuss how they might be used
h. Complete a “behavioral contract” with the parent to reduce the child’s exposure to ETS in the next 2 weeks
V. Offer to answer medication questions in the next visit or a follow-up phone call VI. Wrap up
a. Plan follow-up phone call in about a week
b. Give card with name and phone number for questions or problems