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Asthma in children is a very harmful respiratory disease that may even lead to death. Asthma has an influence on the children socially, physically as well as emotionally. Therefore, it is the responsibilities of the parents as well as the health experts to help in reducing Asthma in children as well as help those who are affected know how to deal with it. African American children and the low-income earners continue having underprivileged health positions and those earning high income as well as the white people (Keir et al, 2002). Attempts to lessen, if not to do away with, health discrepancies among children are an essential means of developing the existing status of children’s wellbeing as well as making sure that their constant health into maturity is safe. It is significant to enlighten the stakeholders, consisting of policy creators, health care experts, health tactics, health care buyers, as well as beneficiaries, in particular families as well as parents, concerning the causes of health disparities in addition to the current situation of health inconsistencies among children (Breysse et al, 2004).
The aim of Breath in Freely (BIF) program will be directed to some of the Asthmatic children in Gertrude hospital in South Bronx. This hospital has been selected since it is a children’s hospital with the most affordable health care therefore most parents take their children there. According to the health survey in 2008, about ninety-three percent of the low-income earners in South Bronx are registered to that hospital. During this program, there will be screening, education about asthma and its effects and the different ways of controlling it and counseling for the parents and their children who are suffering from asthma. BIF is geared towards improving the lives of those children suffering from asthma, assist them to feel welcomed, and wanted in the society. This program has its focus on the African American children in South Bronx as well as their guardians (Essen-Zandvliet & Hughes, 1992).
The parents will be meeting weekly for thirty minutes to get education and counseling from the health providers. The program targets children aged 0-4 years and it will run for nine months. Screening will be taking place after every two weeks and this will be during the weekends since most parents will be available to bring their children for the check-ups. Three clinical officers from the health department will conduct this program.
Literature on Causal Factors
Hulisz (2010), says that while the understanding of asthma has gone up in recent years, the mortality as well as morbidity associated with this chronic situation continues to include a major health quandary. Although fresh and better treatments for asthma become available each year, the latest facts on these new treatments often is not communicate efficiently to patients. Even when patients are given information on new treatments, they over and over again believe contact with their clinicians has been insufficient. These communication problems lead to ineffective management of the disease.
Sullivan et al (2002), says that asthma is the general chronic disease that affects the airways, which have the role of carrying air in and from the lungs by narrowing and inflaming those airways (Mason et al., 2005). The disease is characterized by recurring and variable symptoms including coughing, wheezing, breath shortness and chest tightness. The disease is classified as non-atopic or atopic; or according to (FEV1). Asthma is believed to be caused by a mixture of environmental and generic factors (Mason et al., 2005). The symptoms can be avoided by preventing triggers and they can be treated using various medications. Asthma has an effect on all types of people with all ages, but mostly starts at some point in childhood. In the United States of America, more than twenty five million people are said to have asthma and out of these about 7 million are children.
According to Brown et al (2005), the most unfortunate thing about asthma is that it has no cure but there are different ways in which it can be controlled. It is caused by genetic and environmental factors. These factors have an influence on how severe asthma is and how well it acts in response to medicine. The relations is complex and not completely understood. It is deemed that the latest increased levels of asthma are because of environmental or epigenetic changes. The highest risk factors that lead to asthma are a mixture of genetic disposition with ecological exposure to drawn in particles and substances that may rouse allergic responses or exasperate the airways (Carl, 2003). These are:
- Inside allergens (for instance, house dirt mites in carpets, bedding as well as stuffed furniture, contamination as well as pet dander)
-Outdoor allergens (for instance the moulds and pollens)
-Smoke from tobacco
- Chemical irritants in the place of work
Ralston et al (2005), emphasizes that additional triggers can comprise of intense emotional awakening such as fear or anger, cold air, as well as physical exercise. Even some medications can set off asthma like aspirin and supplementary non-steroid anti-inflammatory drugs, in addition to beta-blockers that are used in treating heart conditions, high blood pressure as well as migraine. Urbanization has also been connected with an increase in asthma (Stout et al, 1998).
Some various air pollutants trigger the asthma infections and they are as follows:
- Ground Level Ozone: A poisonous element of smog, ozone sets off asthma attacks and worsens the existing asthma. It may as well lead to the increase of asthma in children. Ozone is created at ground level at what time the tailpipe contamination from trucks and cars reacts with sunlight and oxygen. Ground level ozone is a major problem in towns with plenty of traffic, for instance New York City, Houston as well as Los Angeles. In the year 2004, according to the American Lung Association, one hundred and thirty six million people resided in regions that dishonored ozone air quality values.
-Sulfur Dioxide: A respiratory irritation linked with the start of asthma attacks, SO2 is created when crude oil and coal are burnt up. Power plants that are coal-fired, mainly those that burn coal with no SO2 contamination regulators, are the most horrible Sulfur dioxide polluters. One in five Americans lives within ten miles of a power plant that is fired by coal. Diesel engines and Oil refineries that burn high-sulfur gas also discharge large levels of sulfur dioxide into the air.
-Particulate Matter: This phrase defines a broad variety of toxins such as soot, dust, diesel exhaust particles, fly ash, wood smoke as well as sulfate aerosols that are suspended as small particles in the atmosphere. A number of these fine elements can be lodged in the lungs triggering asthma attacks. Mason et al. (2005) have indicated that the amount of hospital admissions for asthma goes up when heights of particulate substances in the atmosphere go up. Power plants that are coal-fired, factories as well as diesel cars are major causes of particulate contamination. Around eighty one million people reside in regions that do not meet public quality standards for regulating the air for particulate matter (Butz et al, 1994).
-Nitrogen oxide also known as NOx: A gas released from power plants and tailpipes, nitrogen oxide adds to the creation of ground-level ozone as well as smog. It as well reacts with extra air toxins to form tiny particles that are capable of causing breathing problems, particularly in asthmatic people.
Literature on Related Intervention
Evidence has shown that the only important way to reduce childhood asthma is by educating the parents and guardians about asthma to help them to know what to look out for in their children and give counseling to the children who have asthma. In the past there has been an indication that a number of programs have been carried out to promote education and counseling in various places (Schreck & Babin, 2005).
The Centers for Disease Control and Prevention (CDC) provide community guide recommendations concerning asthma control. These guides target very many people including children where they visits people homes and educate them. One of their programs is the ZAP Asthma project, which is a multipart public-private partnership that has its focus on reducing the occurrence of negative health effects related to pediatric asthma. Its aim is to show the efficiency of environmental control and health education approaches to reduce asthma mortality as well as morbidity.
Another example of an evidenced based program is the Home-Based Multi-Trigger, Multi-component Environmental Interventions. These programs aim to decrease exposure to several indoor asthma triggers (irritants and allergens). These interventions entail visiting homes, which is done by trained personnel to perform some various activities. The programs in this analysis carried out environmental activities that incorporated:
- Evaluation of the home setting
- Modifying the indoor home atmosphere to decrease contact with asthma causes
- Teaching in relation to the home atmosphere
Other programs also took in extra non-environmental activities for instance general asthma education, social services and maintenance, education and training on the different ways of developing asthma self- management as well as harmonized care for the asthma patient. Initiating for change program has also chipped in creating an Asthma-Friendly school. This site provides a toolkit to assist supporters in schools as well as school districts convince the community and other schools stakeholders of the importance of schools that are asthma-friendly.