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Asthma Care Training (ACT) for Kids

act Ribbon ACT is an asthma education and self-management program designed for children ages 7 to 12 and their parents.  The program is divided into three, 1.5-hour sessions in which the parents and children are taught in separate classrooms and then brought together at the end of each session to share their new knowledge. ACT teaches children to work in cooperation with their parents and health care professionals to improve their decision-making skills and self-management behaviors. This occurs through a series of interactive games and activities that teach children how to identify asthma-related symptoms, ways to communicate with adults, ways to avoid triggers, how to take preventive measures, and the appropriate use of medications.

Program Goals

The overall goal of the program is to reduce the frequency and severity of asthmatic episodes. Additional goals are to:

  • Increase the children’s and parent’s knowledge of symptoms, causes, and treatment regimens
  • Explore their attitudes and feelings about asthma and its treatment
  • Improve their decision-making skills in preventing asthma episodes
  • Encourage parents to permit and reinforce their children’s self-care behaviors

Program Outline

Session One: Warning Signals

  • What asthma is and how it affects the body
  • Recognizing and gauging the severity of symptoms
  • Use of peak flow meters
  • Decision-making about asthma-related issues

Session Two: Roadblocks

  • Why asthma develops and what triggers it
  • Asthma facts and fallacies
  • Identifying personal asthma triggers and what to do to avoid them
  • Peak flow practice

Session Three: Tune-Ups

  • Medications
  • Breathing exercises and relaxation techniques
  • Program review

Program Materials

The ACT program kit includes:

  • Three instructor manuals (one for the children's instructor, one for the parent's instructor and one for the physician/pharmacist to discuss asthma medications)
  • Two instructor kits (reusable trigger and environmental picture panels, relaxation tape, etc.)
  • Master copy of reproducible handouts for the parents and children
  • One set of supplementary items for educating 10 families

Preparation of Instructors

Instructors for this program should be health professionals such as nurses, respiratory therapists, physicians and pharmacists familiar with pediatric asthma management. A team of 2 - 3 instructors is needed to implement ACT (1 child instructor, 1 parent instructor, and 1 medication concepts instructor).

Program Development

ACT was developed by a group of physicians, nurses and educators at UCLA School of Nursing in 1983 to teach children and their families asthma self-management skills to reduce the frequency and severity of asthma episodes.  The program is designed to complement appropriate medical care and to encourage families to work in concert with their physicians to control children’s asthma.

Program Validation

The results of the original research validating the effectiveness of this program demonstrated a 43% reduction in hospitalizations, a 60% reduction in emergency department visits and significant cost reductions.

For more details on the formal research validating the ACT program as an effective patient education program, reference the following two articles:

Lewis CE, Rachelefsky G, Lewis MA, de la Sota A, Kaplan M. A randomized trial of A.C.T. (Asthma Care Training) for Kids. Pediatrics October 1984;74(4):478-486.

Rachelefsky GS, Lewis CE, de la Sota, A, Lewis MA. ACT (Asthma Care Training) for Kids. A childhood asthma self-management program. Chest January 1985;(suppl to no.1):98S-100S.

In addition, visit the following CDC Web site  http://www.cdc.gov/asthma/interventions/children.htm and scroll down to Asthma Care Training (ACT) for Kids for more information, including a link to a case study on how one site successfully replicated the program.

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