April 2014 / Good Health Starts at Home
Lesson Guide
Asthma and Allergies
Segment Time / 30 minutes to 1.5 hours
Purpose / To provide general knowledge of the disease of asthma and provide awareness of identification and prevention of asthma and allergy triggers in the home environment.
Audience / General consumer audience
Learning Objectives / Participants will accomplish the following:
Knowledge: Describe symptoms and causes of asthma and allergies.
Comprehension: Identify asthma/allergy triggers in the home environment.
Application:
· List examples of low-cost actions en to reduce asthma/allergy triggers in the home, including: dust mites, pests, pets, mold, second-hand smoke, nitrogen dioxide (byproduct of burning fuel) and other irritants (chemicals, cleaners, air fresheners, perfumes, hair spray, pesticides, scented or unscented products, cold air, and outdoor pollution).
· Identify resources for more help and information.
Instructor Lesson Materials / · Asthma and Allergies Lesson Guide
· PowerPoint with speaker notes
· Help Yourself to a Healthy Home booklet
· Healthy Homes: Assessing Your Indoor Environment (strongly recommended)
· Publications/Handouts of choice (optional—see below for suggestions)
· Name tags/tent cards for each student
· Pre/Post Tests and Evaluation form for each student
· Sign-in sheet, pens/pencils for participant
· Selected materials and supplies for demonstration activities (see below)
Participant Materials / · Asthma and Allergies PrePosttest/Evaluation
· Pens/pencils/paper
· Help Yourself to a Healthy Home book
· Copy of PowerPoint slides (optional)
· Other selected student publications/resource materials (optional)
Equipment / · Laptop
· LCD Projector
· Speakers for computer (if showing videos)
· Extension cord and power strip (plus tape to tape down cords)
· Microphone (if you are inviting a guest speaker or have a large group)
· White board or flip chart and markers
· Internet connection to show videos
Helpful websites / · US Department of Housing and Urban Development (HUD) Healthy homes and lead hazard control: www.healthyhomes.hud.gov
· US Environmental Protection Agency (EPA) http://www.epa.gov/asthma
· American Lung Association http://www.lung.org/lung-disease/asthma/
· National Heart, Lung and Blood Institute http://www.nhlbi.nih.gov/health/public/lung/index.htm
Publications/
Resource Materials (select most appropriate materials for your audience)
(Optional) / · Help Yourself to a Healthy Home http://www.aces.edu/pubs/docs/H/HE-0883/HE-0883.pdf focus on chapter on Asthma & Allergies (required)
· Healthy Homes: Assessing Your Indoor Environment (with DVD)
mms://wms.aces.edu/media/satellite/booth/eng_hh.wmv (strongly recommended) 24 minute video
Scenes 1-4 introduces a county agent going to a house to assess healthy homes issues.
For asthma, show scenes 5, 6 (child’s asthma triggers), 12 (pest problems in kitchen), 16,17,18 and 19 (these show dust mites, mold, pet dander and secondhand smoke).
HUD Publications: www.healthyhomes.hud.gov
· Seven Tips for Keeping a Healthy Home
http://portal.hud.gov/hudportal/documents/huddoc?id=DOC_11882.pdf
· Asthma Factsheet (download 1 page) http://portal.hud.gov/hudportal/documents/huddoc?id=OHHLHCflyerAsthma.pdf (download—2 pages)
· Allergy Factsheet http://portal.hud.gov/hudportal/documents/huddoc?id=OHHLHCflyerAllergy.pdf (download—2 pages)
EPA Publications: http://www.epa.gov/ncepihom/ordering.html
To order hard copy publications from EPA: National Service Center for Environmental Publications (NSCEP)
Asthma EPA Publications: http://www.epa.gov/asthma/publications.html
(Download or order several weeks in advance)
· Asthma Home Environment Checklist http://www.epa.gov/asthma/pdfs/home_environment_checklist.pdf
· Help Your Child Gain Control Over Asthma (also in Spanish) (for parents and caregivers) http://www.epa.gov/asthma/pdfs/ll_asthma_brochure.pdf
· Asthma Facts http://www.epa.gov/asthma/pdfs/asthma_fact_sheet_en.pdf
Asthma Action Plan (pick one and download)
· NHLBI/NIH http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_actplan.pdf
· American Lung Association http://www.lung.org/lung-disease/asthma/living-with-asthma/take-control-of-your-asthma/AsthmaActionPlan-JUL2008-high-res.pdf
Asthma medications: factsheets on types of inhalers, spacers, nebulizers, etc. http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_tipsheets.pdf
Additional Resources
· National Environmental Education Foundation—Environmental Management of Pediatric Asthma—Dust Mites, Cockroaches, Pets, Mold, Cigarette Smoke, and Air Pollution, handouts for interventions and patient guidelines (also in Spanish) http://www.neefusa.org/health/asthma/asthmaguidelines.htm
· Allergy & Asthma Network: Mothers of Asthmatics. Indoor AIRepair at Home. Room-by-room tips, nontoxic cleaning recipes, checklist for action steps http://www.aanma.org/pdf/AIRRepairHomeNL.pdf
· Statistics on asthma prevalence in the U.S. (CDC)—compare states: http://ephtracking.cdc.gov/showAsthma.action (click on Search Data)
For children:
· Dusty the Asthma Goldfish and His Triggers (also in Spanish) (EPA educational activity book for children) http://www.epa.gov/asthma/pdfs/dustythegoldfish_en.pdf
· Is Your Home A Healthy Home (Coloring and Activity Book) http://www.aces.edu/pubs/docs/H/HE-0937/HE-0937.pdf
For athletes and coaches:
· The Coach’s Asthma Clipboard Program http://www.health.state.mn.us/asthma/coachclipboard.htm
For Native American populations:
· Native AIR, Native Asthma (16 minute video) http://www.nativeasthma.org/Materials.htm
Mold:
A Brief Guide to Mold, Moisture and Your Home (EPA) http://www.epa.gov/mold/pdfs/moldguide.pdf
Secondhand Smoke:
· EPA Smoke-free Homes http://www.epa.gov/smokefree/
Selected videos / Order DVDs in advance or provide internet connection for link.
· Healthy Homes: Assessing Your Indoor Environment video: (23:45) mms://wms.aces.edu/media/satellite/booth/eng_hh.wmv
Produced by Cornell Cooperative Extension, shows health and safety inside actual homes with tips to control these hazards. (See selected scenes for different topics).
(this is a recording of the DVD that accompanies the booklet: http://www.aces.edu/pubs/docs/H/HE-0923/HE-0923.pdf
· EPA: Breathing Freely: Controlling Asthma Triggers Video (also available in Spanish) (10 minutes) http://www.epa.gov/asthma/publications.html
· American Lung Association and EPA Video: Asthma Awareness Message (1:38 minutes)
http://www.lung.org/associations/charters/midland-states/program-information/asthma/
· American Lung Association: What is Asthma? animation that shows three primary changes in the airways during an asthma attack (inflammation, bronchoconstriction, increase in mucus):
http://www.lung.org/lung-disease/asthma/learning-more-about-asthma/asthma-basics.html (2 minutes)
YouTube videos (connection to Internet required or download in advance)
· http://www.youtube.com/watch?v=mmQeKUEfnBc Asthma symptoms (4 minutes)
· http://www.youtube.com/watch?v=AqBTKE_PStY types of asthma medications (7 minutes)
· http://www.youtube.com/watch?feature=player_embedded&v=NUob1sfL3Ig (American Lung Association: Quick Relief Medicines) (30 seconds)
Extended Activity / Asthma Awareness Month: Promotional Activity for May
Download event planning kit from: http://www.epa.gov/asthma/awareness.html
Children’s Health Month (October)
http://yosemite.epa.gov/ochp/ochpweb.nsf/content/chm-home.htm
Suggested Materials and Supplies for Demonstrations and Activities
(select most appropriate materials for your audience) / · Coffee stirring straws (one for each participant) for the How Asthma Feels activity
· Model of airways—asthmatic airways vs. normal airways (asthma easel display available from 3B Scientific http://www.a3bs.com/Asthma-Allergies-Education,pg_1208_346_1094.html
· Asthma inhaler (try to borrow used one from asthma patient—or have pharmacist guest speaker demonstrate—see Guest Speaker form)
· Peak flow meter (try to borrow used one from asthma patient—or have pharmacist guest speaker demonstrate—see Guest Speaker form)
· Asthma spacer (try to borrow used one from asthma patient—or have pharmacist guest speaker demonstrate—see Guest Speaker form)
· Integrated Pest Management tools: sticky traps, baits, copper scrubber, mouse/rat traps, caulking, boric acid, garbage bag, sealed storage container—available at hardware stores
· Dust/Allergen-Proof pillow/mattress covers—available at Walmart/Target/department stores
· Microfiber cleaning cloths—cheapest available at auto parts stores
· N-95 mask (for cleaning mold/dust—available at hardware stores)
· Pleated and fiberglass air filters (get small sizes to demonstrate)
· Fragrance-free hypoallergenic detergent and soap—grocery stores
· HEPA filter for a vacuum cleaner—Walmart/Target/hardware stores (or demonstrate a HEPA vacuum if available)
Preparing for this Lesson
Asthma and Allergies
Preparing for this Session / This lesson assumes that an Extension educator will be the speaker for the session. If an alternate speaker or co-speaker is used, be certain they have reviewed the material and are clear that Extension is tasked with presenting non-biased material.
Before the Training:
1. Several weeks in advance:
a. Determine appropriate training location and time.
b. Contact an Extension educator or other guest speaker(s) at least a month in advance (optional)—if using, use Guest Speaker Confirmation form. For this subject area, consider asking a pharmacist or IPM Extension Specialist.
c. Send out notices for the training.
d. Order handouts/reference materials/videos (especially those from EPA) if not making copies.
2. At least one week before training:
a. Read the lesson guide and PowerPoint materials carefully and thoroughly. Review speaker notes and add notes if necessary.
b. Review the Help Yourself to a Healthy Home book and Healthy Homes: Assessing Your Indoor Environment booklet. Watch the DVD for the Assessing booklet and select the scenes applicable to subject areas if you choose to show the DVD.
c. Review handouts/reference materials and supplemental material carefully. Select handouts that may be useful for your audience.
d. Make copies of handouts for this session.
e. Review the optional activities and choose show and tell activity/demonstration tools. Visit a retail store and purchase demonstration supplies as needed or bring examples from home. See Suggested Materials and Supplies for Demonstrations and Activities.
f. Download any videos on your computer if you don’t have the DVD.
g. Download suggested YouTube videos.
3. Day before Training:
a. Assemble snacks/beverages: water, sodas, crackers, fruit, plates, napkins, etc.
b. Load course materials on computer/thumb drive.
4. Day of Training
a. Arrive at least 45 minutes in advance
b. Set up computer/LCD projector/check speakers. Tape down cords.
c. Set out references/publications, course materials. Either place on participants’ tables or place near registration table for students to pick up. Set out registration sign-in list.
d. Set up demonstration tools on table or have in container for easy access.
e. Set up whiteboard/large flipchart.
Presenting the Program
Asthma and Allergies
Important Instructor
Notes / 1. Remember to use activities, demonstration of materials, and videos for a variety of teaching tools and to not be too dependent on the PowerPoint slides.
2. Encourage participation and questions by the participants throughout the presentation. Be interactive with your learners.
3. Provide personal stories when possible. People sometimes remember better when personal stories are shared either by you or by the participants.
4. Good visuals will provide guided practice for the learning objectives of the lesson. Activities and demonstration materials can reinforce learning.
5. The adult learner brings a background of learning and experience that contributes to learning. Many will have experienced some of these home hazards in their own homes.
6. The purpose of this information is to empower people with knowledge so they will adopt healthy behaviors and to offer practical, low-cost action steps to solve problems.
7. Emphasize the vulnerability of children for environmental health concerns. These are important concepts to remember:
a. Children are not just little adults. Their organs (especially the brain) and immune systems are still developing, especially until about age 6. Their metabolic rates are faster. Pound-per-pound children drink, eat and breathe more than adults.
b. Children’s behaviors keep them closer to the floor—where pollutants may collect.
Training Agenda
Asthma and Allergies
Segment / Time / Activity / Materials/Notes
Sign-in and Introductions / 10 minutes / · Make sure everyone has signed the sign-in sheet. If participants didn’t sign in upon entering, pass around the sign-in sheet.
· Introductions (including yourself) or get-acquainted activity of your choice. / Sign-in sheet
Introduction and Objectives / 5 / Ask: Have you ever had---
· Stinging or watery eyes?
· Burning throat?
· Wheezing or trouble breathing?
· Where? Home? Store? Outside?
· What do you think caused it?
· Does anyone here have asthma or allergies or know someone who does?
Review Learning Objectives
Review Publications
Help Yourself to a Healthy Home
HUD Healthy Home website resources: www.healthyhomes.hud.gov / PowerPoint slides 1-4
Publications: Help Yourself to a Healthy Home
HUD publications:
· Seven Tips for Keeping a Healthy Home
· Asthma Factsheet
· Allergy Factsheet
EPA publications
(optional—listed above)
What is asthma? / 5 / Discuss asthma facts and prevalence.
· Asthma is a chronic disease
· Asthma can be controlled, but it cannot be cured
· Most common chronic childhood disease
· 26 million adults/7 million children in U.S. have asthma
· Hereditary disposition, children at greater risk to environmental pollutants / PowerPoint Slides 5-7
HYHH book
Publication: Asthma Facts http://www.epa.gov/asthma/pdfs/asthma_fact_sheet_en.pdf
What happens during an asthma attack? / 10 / Discuss: 3 components
· Chronic Inflammation of tissues of airways—air passages become swollen
· Muscles in the airways contract and airways narrow
· Mucous produced clogs airways / PowerPoint slides 8-9
Demonstrate:
Asthma airways model (if available)
Show: YouTube video—describes asthma symptoms (4 minutes) http://www.youtube.com/watch?v=mmQeKUEfnBc
What does asthma feel like? / 5 / Say: Stand up and jog in place for 30 seconds. Now hold your nose and breathe only through the straw for one minute. How do you feel? / PowerPoint slide 10
Demonstration activity:
Pass out one stirring straw to each participant
Warning signs of asthma / 1 / Discuss:
Warning signs: coughing, wheezing, shortness of breath, etc. / PowerPoint slides 11-12
Asthma can be controlled / 10 / Discuss:
2 main ways to control asthma:
1. Proper use of medications
2. Controlling triggers
Asthma Action Plan: examples
2 Types of asthma medications:
1. Controller/everyday
2. Rescue/quick relief / PowerPoint slides 13-20
Publications: Asthma Action Plans (see examples above)
Demonstrate:
· Asthma inhaler
· Spacer
· Peak flow meter
Show: YouTube videos
· http://www.youtube.com/watch?v=AqBTKE_PStY types of asthma medications (7 minutes)
· http://www.youtube.com/watch?feature=player_embedded&v=NUob1sfL3Ig (American Lung Association: Quick Relief Medicines) (30 seconds)
Emergency treatment for asthma / 1 minutes / Discuss signs of a severe attack and what to do (medications or ER). Discuss allergens and symptoms. / PowerPoint slide 21
Indoor Air Pollution and asthma triggers / 5 / Discuss common asthma triggers: allergens, irritants, exercise, infections, emotions, weather
Discuss Indoor Air Pollution and common asthma triggers
Discuss each of the five major indoor environmental asthma triggers, including where each trigger is found and action steps that can reduce effects.
· Secondhand smoke
· Dust mites
· Pet dander
· Mold
· Pests / PowerPoint slides 24-28
Publication:
EPA Asthma Home Environment Checklist
Secondhand Smoke / 2 / Discuss dangers of particles in secondhand smoke
Quitline materials 1-800-QUIT-NOW / PowerPoint slides 29-32
Demonstrate:
State quitline materials
Dust mites / 5 / Discuss dust mites and where they are found
Demonstrate tools to control dust / PowerPoint slides 33-37
Demonstrate:
Pillow/mattress covers, HEPA vacuum/bag,
microfiber cloths
Mold / 5 / Discuss the key to mold control is moisture control / PowerPoint slides 38-42
Demonstrate:
N-95 face mask
Toilet paper test of ventilation
Publication:
EPA Mold, Moisture and Your Home
Pets / 2 / Discuss importance of keeping pets off furniture/beds and out of bedrooms of those with pet allergies / PowerPoint slides 43-45
Pests / 5 / Discuss IPM (Integrated Pest Management) as best way to control pests / PowerPoint slides 46-52
Demonstrate:
Baits, traps, low-toxic products (boric acid, etc.), caulk
Air Cleaners and Filters / 1 / Explain room air cleaners to be used only as a last resort. Clean/prevent triggers first. Do not use air cleaners that produce ozone. / PowerPoint slides 53-54
Demonstrate:
Pleated and fiberglass air filters
Other asthma triggers / 2 / Discuss other things that trigger asthma: infections, cold weather, exercise, strong fragrances, pollen / PowerPoint slide 55
Demonstrate:
fragrance-free hypoallergenic detergent and soap
Review / 10 / Show EPA video: Breathing Freely: Controlling Asthma Triggers (also available in Spanish)
Review 2 ways to control asthma, use of asthma action plans / PowerPoint slide 56
http://www.epa.gov/asthma/publications.html
Learn more / 10 / Cite additional sources of information—both federal and state/local resources / PowerPoint slide 57
Evaluation / 5-10 / Administer Pre/posttest/Evaluation.
Questions/comments / Pre/Posttest Evaluation form
Original version created by Bobbie Shaffett, Mississippi State University, 2012