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Children With Asthma: Session 2

I. Review of progress
a. Discuss progress and problems
II. Use of metered-dose inhaler
a. Review written instructions on inhaler use
b. Demonstrate use of (placebo) inhaler with the child and have the parent use the “inhaler usage skills checklist” during the demonstration
c. Discuss inhaler-use techniques, and answer any questions
III. Review of asthma pathophysiology with the child (if possible) and the adult(s)
a. Review the “Picture of My Body and What Happens With Asthma” handout
b. If the patient is an older child, have the child practice explaining asthma to a friend
c. Demonstrate with a straw how difficult it is to breathe when the child gets asthma
d. Review “My Early Warning Signs” and “My Asthma Triggers” handout
e. Discuss what the child can do to avoid tobacco smoke (as appropriate) and explain the importance of indoor air problems affecting asthma
IV. Understand the role of tobacco smoke exposure in asthma symptoms
a. Determine whether there are any misconceptions and/or disagreements within the family about asthma
b. Show the “Poisoning Our Children” video, and then discuss the ideas and answer questions from the video
c. Discuss the severity of the child’s asthma canadian health mall

V. Progress in eliminating the child’s exposure to tobacco smoke
a. Review progress on the behavioral contract
b. If participants who were not at session 1 are present, explain what cotinine is and what it means. Review the cotinine test results collected before the last session, and provide a copy of the results to the parents to take home
c. Explain the relationship between the last cotinine result and the 4-day ETS exposure prior to the test, and compare them to the initial cotinine results and exposure
d. Complete a new 4-day ETS exposure recall
e. As appropriate to circumstances, reinforce the efforts of the family, discuss barriers, role play negotiation with (another) smoker, and/or offer to personally call other smokers to invite them to the next session
f. Establish one or two goals for the period between sessions 2 and 3, referring to the 4-day ETS exposure and complete behavioral contract
VI. Wrap up
a. Answer questions
b. Plan follow-up phone call in about a week
c. Encourage family to phone if questions or problems arise