Improving self efficacy in childcare settings for asthma chronic disease management

Background: Asthma is the most common chronic childhood disease nationwide, impacting the lives and families of 304,798 (12.2%) of Georgia’s children. Children ages 0 to 4 have the lowest prevalence of asthma among children 0-17, yet have the highest rate for asthma-related emergency room (ER) visits, approximately 2.5 times as much as other age groups.  Child care providers are in a unique position to contribute to the reduction in asthma morbidity by understanding asthma’s early warning signs, reducing asthma triggers and responding appropriatly to address asthma-related illness and emergencies.

Method: Training intervention was delivered to selected child care centers recruited through referrals, headstart, and recommendations from previously trained centers. Three training modules were designed to address 1) Asthma management foundations 2) Asthma Medications 3) Creating asthma friendly environments. Fourteen centers participated in training between March and July 2012. Pre / post-test and an effectiveness survey was assessed using a quasi-experimental design and analyzed using paired t-test in SAS 9.3 software.  

Results: Among the centers trained, the asthma prevalence ranged between 5%-35%. Participants mean post-test (91.7) on the foundation course was significantly higher than the pre-test score (80.7) [ p<0.001]. Similarly, the Asthma Medications post test score (80.3%)  was significantly higher than the pre-test score (74.3%) [p<0.001]. Eighty-five percent of participants reported increase in self-efficacy in managing asthma in the childcare setting.

Conclusion: Chronic disease management training in childcare settings is effective in increasing knowledge and can support early identification of children demonstrating asthma symptoms to ensure connection family to clinical and community resources.