BREATHING SPACE
Respiratory Disease Newsletter
Health Promotion & Chronic Disease Division
Chronic Disease & Environmental Epidemiology Section
Volume 3, Number 3
Please welcome Sally Smaida
as the new Metro Minnesota
Asthma Coalition Coordinator. Sally has her MPH in
public health administration
from the University of Minnesota School of Public Health.
Sally comes to the Minnesota
Asthma Coalition with a
variety of public health
experience in non-profit,
academic, corporate, and
government settings where
she worked on policy, planning, and advocacy. Most
recently, she was the Director
of Public Policy at the Minnesota Association of Community Health Centers. Sally can
be reached at 651-222-2477 or
[email protected]
During the fall, especially September, the number of hospitalizations due to asthma
peaks in Minnesota. This pattern has been consistent since 1998, the earliest year
for which MDH has data on asthma hospitalization trends. Other states, including
Michigan, Vermont, New Hampshire, and Nebraska, have reported similar patterns.
The most distinct peaks in September occur in children, with pre-school children
having the highest rates of asthma hospitalizations. School-age children, including
young teenagers, have the second highest rates in September, while older age groups
exhibit less seasonal variation. Though there is no single, proven reason for this
peak, it is believed to be influenced by respiratory infections and increased pollen
and mold counts.
Seasonal variations in asthma-related hospitalizations,
Minnesota, 2003
0-4 yrs
rate per 10,000 population
Welcome to our New
Metro Minnesota Asthma
Coalition Coordinator!
September 2005
Child Hospitalizations for Asthma Peak in September
5-14 yrs
15-34 yrs
35-64 yrs
4.0
3.5
3.0
2.5
2.0
1.5
1.0
0.5
0.0
Jan Feb Mar Apr May Jun
Jul Aug Sep Oct Nov Dec
Data source: Minnesota Hospital Association
What’s Inside?
• Asthma Training Schedule
• Free posters
• Asthma Screening
• Super Asthma Saturday
• IAAP in Action
• EPA Intervention Grant
Breathing Space
Parents of children with asthma can do many things to prevent hospitalizations:
· Schedule a “well-asthma” visit with their child’s health care provider to
review their asthma management plan.
· Obtain an up-to-date Asthma Action Plan from the child’s health care
provider and give copies to the school nurse and/or day care provider.
· Make sure the child has asthma rescue medications, holding chambers, and
peak flow meters for home and school.
· Make sure the child has access to his/her asthma medications and knows
how to use them.
· Minimize the child’s exposure to things that trigger asthma, such as dust
mites, secondhand smoke, mold, and pet dander.
· Schedule a flu-shot appointment with the child’s health care provider when
the vaccine is available.
(Child continued on page 2)
1
September 2005
FREE “Tobacco-Free Sports” Posters Available!
Tobacco-Free Youth Recreation (TFYR), the Minnesota Department of
Health, and the Minnesota Prevention Resource Center (MPRC) have
partnered to make tobacco-free sports posters available to Minnesota residents
for FREE! All you pay for is the shipping cost. Quantities are limited! Download the order form at: http://www.ansrmn.org/TFYR03Home.htm.
Super Asthma Saturday in
Alexandria
Join us for Super Asthma Saturday!
This fun-filled educational event is for
anyone and everyone who has asthma.
Dr. Amy Ellingson will give an asthma
presentation. There will be educational games for children and three
different asthma education stations:
Inhaler/Nebulizer use, Peak flow use/
Asthma control, and Environmental
triggers.
Sponsored by the West Central
Regional Asthma Coalition (WCRAC)
in association with local public health
providers.
Date: September 17, 2005
Time: 10:00 a.m. until 12 noon
Location: Discovery Middle School
510 North McKay
Alexandria, MN 56308
Contact Person: Doreen Hanson,
WCRAC Coordinator @
320-763-6018 or
[email protected]
(Child continued from page 1)
The Minnesota Department of Health
is working with health care providers
across the state to support good
asthma management year round. By
working together, families and health
care providers can help minimize the
possibility that children will need to
be hospitalized for asthma attacks.
For more information, call the
Minnesota Department of Health
Asthma Program at 612-676-5226.
Visit our Web site at
http://www.health.state.mn.us/divs/
hpcd/cdee/asthma/Documents.html
for the news release, fact sheets,
educational materials, Asthma Action
Plans, and other resources.
Breathing Space
Available posters include:
1. Minnesota Twins “Be Tobacco Free: Choose Not to Chew” featuring
centerfielder Torii Hunter
2. Minnesota Thunder “Fast, Fearless, Strong, and Tobacco Free”
featuring players Johnny Menyongar, Joe Warren, & Freddy Juarez
3. Minnesota Wild “Our Only Addiction is the Game” featuring players
Brad Bombardir and Wes Walz
4. University of Minnesota Gophers “Tobacco-Free is the Way to Be”
poster featuring 10 athletes. (The Gophers poster must be ordered
separately from TFYR at [email protected] or 651-646-3005. Please
indicate quantity of posters requested and shipping address.)
Sports-related tobacco prevention posters can be placed in school classrooms,
locker rooms, gymnasiums, community centers, ice arenas, and other community venues.
FREE Asthma Health Fair and Screening!
Adults and children who experience breathing problems, such as coughing,
wheezing and shortness of breath, can find out if asthma is “taking their
breath away” through the Nationwide Asthma Screening program. The
screenings will be conducted by doctors, nurses and respiratory therapists
from the Twin Cities specializing in asthma. Those who already know they
have asthma can talk with a specialist about their asthma and how to keep
symptoms under control.
Date: Saturday, October 29, 2005
Time: 9:00 - 2:00 p.m.
Location: Minneapolis Urban League, 2100 Plymouth Avenue North,
Minneapolis
Contact Person: Sally Smaida 651-222-2477 @ [email protected] or
Makeda Norris 612-302-3164 @ [email protected]
This is brought to you locally by the Metro Minnesota Asthma Coalition and
the Minneapolis Urban League
How it Works?
During the screening, adults and children who are experiencing breathing
problems will answer some questions about their breathing problems. Another version of the questions is available for parents of children up to age 8
to complete on their child’s behalf. In addition to the questions, participants
take a special lung function test that involves blowing into a tube and then
meet with a physician to determine if they should seek further examination
and diagnosis.
The Nationwide Asthma Screening Program has been developed in cooperation with two patient support organizations: the Asthma and Allergy Foundation of America and the Allergy and Asthma Network/Mothers of Asthmatics.
2
September 2005
Upcoming Health Professional Trainings
Managing Asthma in Minnesota Schools
Created especially for school staff, this day long seminar provides school personnel with information about asthma
basics, policies/procedures, steps toward helping students manage their asthma, and useful resources. The training
and manual are free. There is a nominal fee for lunch and refreshments. Participants are eligible to receive 7.2
contact hours. Audience: School health office staff, School Nurses, Health Assistants, and Teachers.
Date:
Time:
Location:
To Register Contact:
November 28, 2005
8:00 a.m. - 4:00 p.m.
Heritage Center - Stearns County History Museum, St. Cloud, MN
Sally Sabathier @ 612-676-5226 or [email protected]
Date:
Time:
Location:
To Register Contact:
November 29, 2005 (tentative)
8:00 a.m. - 4:00 p.m.
Willmar, MN
Sally Sabathier @ 612-676-5226 or [email protected]
Caring for Kids with Asthma
This 2-hour program, developed by Controlling Asthma in American Cities Project, is designed to build knowledge
and skills of childcare providers to support appropriate care for a child with asthma. Audience: Childcare providers,
Head Start teachers.
Date:
Time:
Location:
Contact Person:
September 19, 2005
7:00 p.m. - 9:00 p.m.
Rochester Public Library, Rochester, MN
Judy Wothke @ 507-453-0714 or [email protected]
The Asthma Educator Certificate Course
The American Lung Association of Minnesota (ALAMN) Asthma Educator Certificate Course is a two-day workshop for individuals wanting to improve their ability to provide asthma education for patients and families with
asthma. After completing the course, many attendees go on to take the certified asthma educator exam offered by the
National Asthma Education Certification Board (NAECB) to become certified asthma educators.
Date:
Time:
Location:
October 12-13, 2005
Oct. 12 - 8:00 a.m. to 3:45 p.m. & Oct. 13 - 8:00 a.m. to 4:00 p.m.
Grand Rios Water Park Resort & Conference Center,
6900 Lakeland Avenue North, Brooklyn Park, MN
To Register Contact: Glory Dennison @ 651-227-8014 or [email protected]
Cost:
Early Bird Special (Before September 28) - $275.00;
After September 28 - $300.00
Cost includes course materials, patient instructional toolkit, continental breakfast, lunch and
refreshments each day.
Scholarships:
A limited number of $150 scholarships are available. Scholarship forms are available on
ALAMN’s website (www.alamn.org/prof/asthmaeducators.asp) and are due by
September 28, 2005.
Continuing Education Credits: 15.5 CEU credits
3
Setting the PACE for Asthma in Minnesota
This five-hour training course for primary care providers is designed to improve asthma care and outcomes for
children with asthma. The course covers asthma management, the NIH guidelines, spirometry, asthma medications,
patient education, and documentation and coding for asthma. Audience: Pediatricians and Primary Care Physicians
Date:
Time:
Location:
To Register Contact:
September 17, 2005
8:00 a.m. – 2:00 p.m.
American Lung Association of MN, St. Paul, MN
Leslie King Schultz @ 651-223-9567 or [email protected]
Date:
Time:
Location:
To Register Contact:
September 23 - 24, 2005
September 23, 5:00 p.m. - 8:00 p.m. & September 24, 8:00 a.m. - 12:00 p.m.
Riverwood HealthCare, Aikin, MN
Debra Breuer @ 218-927-5532 or [email protected]
Asthma Management: Guidelines & Medications
This two-hour program was developed to improve physician awareness, attitudes, ability, and application of therapeutic skills for asthma. Program content includes the NIH guidelines and asthma medications. Audience: Pediatricians and Primary Care Physicians
Date:
Time:
Location:
To Register Contact:
September 22, 2005
6:00 p.m. Social; 6:30 p.m. - 8:30 p.m. Dinner/Presentation
Holiday Inn, Fairmont, MN
Erin Simmons @ 507-381-8257 or [email protected]
Date:
Time:
Location:
To Register Contact:
October 13, 2005
6:00 p.m. Dinner; 6:30 - 8:30.p.m. Presentation
Douglas County Hospital, Alexandria, MN
Doreen Hanson @ 320-763-6018 or [email protected]
Improving the Lives of Our Patients with Asthma: Asthma Interventions for Busy Pharmacists
This course is an opportunity for pharmacists to become more familiar with asthma as a chronic inflammatory
condition and be able to demonstrate and discuss with patients the various asthma medications, how to administer
and manage their medications and the roles these medications play in managing their asthma. Audience: Pharmacy
Providers
Date:
September 21, 2005
Time:
6:00pm Registration/Dinner; 6:30 p.m. - 8:30 p.m. Presentation
Location:
Michael’s Restaurant, Rochester, MN
To Register Contact: Judy Wothke @ 507-453-0714 or [email protected]
Minnesota Asthma Coalition Regional Coordinators
Metro Area - Sally Smaida
651-222-2477, [email protected]
South Central MN - Erin Simmons
507-381-8257, 1-800-586-4872, [email protected]
East Central MN - Lori Swanson
320-679-6316, [email protected]
Northeast MN - Erin Simmons
507-381-8257, [email protected]
Northwest MN - Michelle Moncrieffe Foreman
218-751-0755, [email protected]
West Central MN - Doreen Hanson
320-763-6018, [email protected]
Central MN - Kathleen Milligan
320-253-6011 or 320-492-6206, [email protected]
Southwest MN - Amy Roggenbuck
320-568-2471, [email protected]
Southeast MN - Judy Wothke
507-453-0714, [email protected]
Statewide MAC - Erin Simmons
651-340-6106, 1-800-586-4872, [email protected],
or visit www.mnasthma.org
4
The Interactive Asthma Action Plan (IAAP) in Action!
by Kathy Thielen, RN, Duluth Family Practice Center
Have you ever worked with an asthma patient who keeps going to the ER? An asthma child who has frequent hospital
admissions? How about the asthma patients who use their inhalers upside down?
When our facility began using the IAAP in December 2003, it forced us to look at all aspects of asthma care. Our
family practice residency program consists of 32 resident physicians and five faculty physicians. After the initial IAAP
inservice and live demonstration of the IAAP and Spirometry to all providers, we focused on our main goals:
· create and provide an asthma action plan (AAP) to our pediatric population ages 5-18
· broaden this goal to provide AAPs to all of our asthma patients
· create a one to one patient to resident/RN asthma teaching ratio (so we can find those patients who use their
inhalers upside down!)
· provide peak flow meters to all asthma patients (provided free by a drug rep/grant)
· provide American Academy of Family Physicians (AAFP) asthma brochure and patient education materials on
peak flow instructions/calendar, use of metered dose inhalers (MDI’s), and use of dry powder inhalers (DPI’s)
· use “Spirocard” spirometry testing via a software program on a designated laptop
· have RN work one to one with each physician the first time using the IAAP to walk them through the process
The IAAP is accessed through an icon on a computer by the physician. The IAAP is printed in color and given to the
patient. A copy is made to be scanned into the patient’s electronic medical record (EMR). Parents have the option of
checking boxes on the IAAP for daycare or school so they may have a copy.
The IAAP is a wonderful teaching tool and works well in our residency program. If physicians are not sure how to
classify the severity of a patient’s asthma, the IAAP helps them choose the classification based on the patient’s symptoms. Once classified, the medication choices follow the recommendations for the severity classification chosen. We
have found that if a physician wants to choose an unlisted medication, then the national asthma guidelines are not being
followed!
MDH was very helpful the few times we needed to call/email them with questions during the initial set-up. Using email
for questions has worked well.
While we continually work on our asthma goals, we feel the IAAP has been a great asset. If you need a tool to help with
your asthma patients, consider the IAAP! The IAAP can be found online at http://www.health.state.mn.us/divs/hpcd/
cdee/asthma/ActionPlan.html or https://www.mnasthma.org/aap/ .
EPA Intervention Grant
The MDH Asthma Program and Pediatric Home Service are collaborating to implement environmental interventions for
asthma triggers such as secondhand smoke, house dust mites, mold, and animal dander. Funding is provided by a U.S.
Environmental Protection Agency (EPA) grant.
Fifty children have been recruited into the study as of June 30, 2005. The most common product interventions have
been air cleaners, bed and pillow encasements, and vacuum cleaners; the average cost for these interventions was $225.
Preliminary results from the initial 50 interviews include: 38 children have written asthma action plans; 27 missed three
or more school days during the previous 90 days. Forty six percent of the children live in a home where smoking is
permitted. See the table below for some of the common triggers and allergies reported.
Follow-up interviews are planned for 3, 6, 9 and 12 months after the environmental interventions. For additional information on the EPA grant, contact Laura Oatman at 612-676-5049 or [email protected].
Common Environmental Asthma Triggers
Trigger
Viral Infections
Weather
Secondhand Smoke
Exercise
Allergies
Irritants
Breathing Space
Number of Children
50
40
36
33
30
17
Common Allergies
Allergy
House Dust Mites
Mold
Cats
Dogs
Mice
Cockroaches
5
Number of Children
48
23
18
13
2
1
September 2005
BREATHING SPACE
For more information, or to request
this material in another format
contact: Steve Golat at 612-676-5244
or [email protected]
MN Relay Service TDD: 1-800-6273528
To receive this newsletter electronically, go to:
http://www.health.state.mn.us/divs/
hpcd/cdee/asthma/Newsletter.html,
and click on Subscribe to Breathing
Space.
If you no longer want to receive a
paper copy of Breathing Space, please
call 612-676-5244 or 1-877-925-4189
and ask to be removed from our
mailing list.
Editor
Subha Chandar, MPH
Production
Steve Golat
Commissioner of Health
Dianne Mandernach
Printed on Recycled Paper
BREATHING SPACE, a quarterly respiratory disease newsletter, is produced by
the Minnesota Department of Health Asthma Program. The purpose of this
newsletter is to provide health professionals, school nurses, and community
members with current research, information, and resources on respiratory disease.
This newsletter is supported by Grant/Cooperative Agreement
#U59/CCU522470 from the Centers for Disease Control and Prevention (CDC).
Its contents are solely the responsibility of the authors and do not necessarily
represent the official views of the CDC.
Questions about lung health?
Call 1-800-548-8252
American Lung Association Call Center
MDH Asthma Staff Contact Information
Asthma Program Telephone Number: 612-676-5226
Toll Free Number: 1-877-925-4189
Asthma Web Site: http://www.health.state.mn.us/divs/hpcd/cdee/asthma/
Wendy Brunner, 612-676-5541, email: [email protected]
Subha Chandar, 612-676-5545, email: [email protected]
Erica Fishman, 612-676-5213, email: [email protected]
Janet Keysser, 612-676-5691, email: [email protected]
Jessica Lundin, 612-676-5769, email: [email protected]
Laura Oatman, 612-676-5049, email: [email protected]
Susan Ross, 612-676-5629, email: [email protected]
Health Promotion and Chronic Disease Division
Chronic Disease and Environmental Epidemiology
717 Delaware Street S.E.
P.O. Box 9441
Minneapolis, MN 55440-9441
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8549
September 2005