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Community Engagement /Focus Groups

Community Engagement /Focus Groups. Identify perceived needs and potential barriers related to each Beacon project initiative (i.e. the wide spread use of asthma action plans for school children.). Groups of interest: Parents of school aged children

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Community Engagement /Focus Groups

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  1. Community Engagement /Focus Groups Identify perceived needs and potential barriers related to each Beacon project initiative (i.e. the wide spread use of asthma action plans for school children.) • Groups of interest: • Parents of school aged children • Public health, School nurses & population care managers • Physicians / nurses who provide health care • Community leaders • Settings • Convened where the groups of interest are located • Professional moderators • Relaxed atmosphere with a constructive dialogue Focused discussions: Participants have privileged seats at the table 1

  2. Asthma Focus Groups Participants 14 Focus Groups 7 School Staff and Parent Focus Groups 103 stakeholders participated 1) School Personnel 2) Parents of children with asthma 3) Healthcare Professionals

  3. Methods From February 3 to March 24, 2011, fourteen (14) focus group discussions were held throughout SE Minnesota to gather an understanding of current beliefs, behaviors, and attitudes about asthma action plans (AAP) from: school professionals, parents of children with asthma, and health care professionals, n=103. Trained facilitators used a pre-formulated questioning route developed by asthma experts in sessions that lasted approximately 60 minutes. All discussions were audio-recorded and transcribed.

  4. Analysis All transcripts were independently hand coded and software coded (NVivo 9, QSR International, 2010) by qualitative analysts. Coders then met to discuss themes and arrive at consensus and categorical semantic agreement on multiple occasions. Electronic codes were then reconciled to reflect the agreed-open framework and overarching themes. Summary reports were used to inform stakeholders and to develop “use cases,” – potential ways AAP were likely to be used and flow through a system where a school is the focus of action.

  5. Focus Groups-School Sites(School Nurse, Health office, Teachers & Coaches) “Teaching for 8 years, my biggest concern with asthma is who actually has it and who is just tired and flat out breathing heavy. It is important that I know and get that information from the nurse, who has (asthma), and who doesn’t have it.” - Phy Ed Teacher/Coach • Want to know what they are “allowed” to do. • Asthma Action Plans are useful to Health Office staff • Coaches rely on 1st Aid Training to know what to do • Issues • Inhalers are kept in Health Office • Communication of Changes in med order or plan • Suggestions • Access to electronic information would help

  6. Parent Input “Coaches don’t always have a plan if something goes wrong. At a basketball game, a player was having an asthma attack and she didn’t have her inhaler on the bench, so one of her teammates had to go rummage through her belongings in the locker room to find her inhalers.” - Parent of Asthma Child • Supportive of Improved Communication • Want Paperwork Process simplified • Asthma Action Plans are useful tools • Not concerned about confidentiality • Want to be kept in the loop

  7. Health Professionals’ Survey • In March of 2011, an online survey was sent via email link to 249 asthma care professional at Mayo Clinic Rochester; 106 responded (response rate=42.6%). • Most endorsed* asthma action plans (AAP) as evidence-based and leading to improved outcomes (74.3%) • Almost all supported* evaluation and measurement of school-based outcomes, e.g. fewer missed days (89.1%) • Most want to hear from the school** when a child is missing class because of his/her asthma (93.2%) • Almost all*** are willing to review and sign an AAP, with over a quarter willing to spend as much time as it takes to make an AAP (83.1%, 27.4%)

  8. Focus Group Summary There were four overarching themes that emerged from the 14 focus groups among various stakeholders: Communication: There are various communication dyads (eg, parent<->school, physician<->school) and modes (eg, email, fax) where information can be lost or misconstrued. A shared portal and/or assurance that the right people have information and proper documentation is crucial. Asthma Control Continuum: Each child is different and changing. The AAP should reflect each child’s triggers and current status as clearly as possible and that information should be disseminated to everyone who comes in contact with the child. Policies and Protocol: There is a fair amount of confusion on the part of most stakeholders about “who is allowed to do what, when” and “who is in charge of what, when.” Few wanted to violate privacy or carry out an AAP not approved by parents and physicians. Self-Reliance: By the time children reach adolescence, it was felt they should be trained and approved for self-administer, self-carry of asthma medication. Back-up inhalers and other support measures should still be in place, however, particularly as adolescents participate in after-hours co-curricular programs like sports

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