Overview
In 2014, the Asthma Society, in partnership with Pavee Point, the Roma Centre and the HSE National Social Inclusion Office, piloted an asthma education programme for travellers. The pilot was positively evaluated by Trinity College Dublin.
This evaluation found, inter alia, that
- There was an overwhelmingly positive response to the programme and the stakeholders, facilitators and the participants generally found it difficult to fault the programme.
- The participants reported that their knowledge levels with regard to all aspects of asthma and its management had increased tremendously since attending the programme.
- Generally, the participants felt confident in their ability to teach other health care workers about what they had learned during the programme.
- Many of the participants had already started to educate other health care workers and they spoke enthusiastically and positively about this process.
- The teaching aids such as the pack, the leaflet and the poster which were specifically designed for use by the Travellers were well evaluated and positively received.
- This ‘Train the Trainer’ approach has been shown to be an effective, transferable and cost effective strategy to building capacity to outreach specialist asthma education to a wider population and is particularly suitable for use with disadvantaged and hard to reach groups such as the Traveller Community.
- This approach is suitable for use with other marginalised groups subject to local commitment and cultural adaptation.
The evaluation made a number of recommendations, including, inter alia, the need to ensure its long term sustainability and provide periodic refresher training for participants. These recommendations were taken on board before the programme was rolled out to Traveller Healthcare Workers across Ireland in 2015 and 2016.
The Society also provided refresher training for the 2015 groups in 2016 so they could reflect on their experience of delivering the messages they learned previously and get extra support in areas of identified need. Refresher training for the 2016 groups will take place in 2017.
The funding received from the HSE National Social Inclusion Office for the programme was as follows:
2013-2014 / 2015 / 2016Traveller health programme funding / €40,000 / €69,765 / €66,361
This report provides an overview of the programme and its achievements to date.
Participant Profile
30 people received certification for their participation in the pilot training in 2014. A further 146people participated in the five week training programme between May 2015 and April 2016. 113 of these were Traveller Healthcare Workers, 7 were Public Health Nurses for Travellers, 22 were Traveller Health Project Coordinators and 4 were Community Men’s Health Workers.The reported reach of certified participants is 2,768 families. This translates to each participant engaging with 16 families.
2016 Activities – Initial 5 Week Training
In 2016, the Asthma Society provided five-week initial training to 73 people in 4 areas as follows:
- Castlebar area – January & February 2016: 11 Traveller Healthcare Workers (THWs) and 2 Traveller Health Coordinators participated in the training. Two THWs joined to be certified from Tuam as they had missed the last day of the Tuam training in December 2015. The reported reach of these trained workers is 370 families.
- Roscommon area – February & March 2016: 15 Traveller Healthcare Workers (13 certified), 3 Traveller Health Coordinators, 1 Community Development Worker and 1 designated public health nurse participated in the training. The participants came from the Loughrea, Roscommon & Longford areas and have a reported reach of 170 families.
- Limerick area – April 2016: 16 Traveller Healthcare Workers (12 certified), 2 Traveller Health Coordinators, and 2 designated public health nurses participated in the training. The reported reach of these trained workers is 418 families.
- North West area (Donegal) – May 2016: 16 Traveller Healthcare Workers (12 certified), 2 Traveller Health Coordinators (nil certified), and 2 Community Development Workers participated in the training. The participants came from the Donegal, Leitrim & Sligoareas and have a reported reach of 810 families.
Prior to the delivery of the initial training in each Traveller Health Unit, a needs assessment was conducted to determine the specific learning needs of the group. Evaluations were also carried out after the training which found that the participants’ knowledge of asthma and confidence in their ability to educate families about asthma management hasd improved significantly.
2016 Activities - Refresher Training
In 2016, the Asthma Society delivered half day refresher training to 59 Traveller Healthcare Workers from five Traveller Health Units as below.
Traveller Health Unit / Date of Refresher / No. of ParticipantsSouth East / June 2016 / 15
Midlands / July 2016 / 13
Cork/Kerry / October 2016 / 13
Clare/Tipperary / October 2016 / 9
Galway / December 2016 / 9
Prior to the delivery of the refresher training in each Traveller Health Unit, a needs assessment was conducted to determine the specific learning needs of the group. The needs assessments provided positive feedback on the initial training and specific feedback in relation to learner needs one year on.
In general, participants were interested in a general refresher with an overview of asthma management messages and updates on developments since they completed the training.
Evaluations conducted at the end of the refresher training highlighted an increased confidence among Traveller healthcare workers in their ability to talk to families about asthma. Comments from the evaluations also suggest that refresher training every 12 months would be beneficial.
2017 Plans
We will deliver refresher training to the Traveller Health Units in Castlebar, Roscommon, Limerick and Donegal in late 2017.
Follow-Up Support Provided By The Society
Significant follow-up support is offered to all participants in the programme by the Asthma Society. Participants are given packs of materials to use with families and invited to contact the Society if they need more. They are also encouraged to use the Society’s online resources, such as its instruction videos on the correct use of different types of inhalers and devices.
The Society’s health promotion team offers ongoing phone and email support, including advice on how to deliver key asthma management messages to families and communities. Participants are also encouraged to speak with one of the asthma specialist nurses on the Asthma Society’s Adviceline if they, or one of the families they work with, need further information or advice.
Key LearningFrom The Programme
The overall feedback from this programme has been overwhelmingly positive from Traveller Healthcare Workers, ASI nursing and health promotion staff and Traveller Health Project staff.
Traveller Healthcare Workers have reported that it significantly improved their knowledge of asthma management and made them more confident in supporting people with asthma in their areas. They also stated that the provision of resource packs by the Asthma Society helps them provide information to families in a practical manner, particularly regarding the correct use of inhalers and devices.
Having an established HSE structure through which to organise this training was crucial to its success. The addition of Traveller Health Unit Coordinators in the training hasalso been imperative in ensuring sustainability of the programme and offering a further level of support to the healthcare workers.
Conclusion
Asthma is the most common reported chronic health condition in Traveller children. Research carried out by the Department of Health & Children (2010) found that asthma rates are higher among members of the traveller and Roma communities and asthma control is significantly lower. With the kind support of the HSE, the Asthma Society is helping to improve asthma management among this vulnerable group by helping Traveller Healthcare Workers educate and support travellerswith asthma in their area.