Alberta Asthma Centre

THE "ROARING ADVENTURES OF PUFF" (RAP) PROGRAM OVERVIEW

Studies have shown RAP to be effective. See the following publications:

Goal

School-aged children with asthma who participated in the Roaring Adventures of Puff (RAP) program will exhibit:

Settings

School
- We feel that school are the ideal setting to teach the RAP program for the following reasons
- Encourages teacher/parent participation
- Easy access to children
- Enhances attendance
- Encourages ongoing peer support
- Supports attention to asthma issues at school (ie school asthma guidelines)
- Community-based
Other settings

Guiding Principles
Asthma Management
- Based on Canadian Asthma Consensus Guidelines, 1999
  - Asthma is controllable
  - Education is essential component to asthma care
  - Prevention should be emphasized through trigger avoidance, healthy lifestyle, & preventative therapies
  - Home management supported by teaching self- monitoring and the use of action plans
  - Health professional partnership is important
Program Delivery

Assessment - provides tools and suggestions for:
- Health climate
- School setting
- Child's asthma/perceptions
- Physician directions
Goal setting - tools for determining goals
Planning - facilitates organization and preparation
Intervention - outlines possible activities and dialogue
Evaluation
- Overall program
- Process of teaching
- Satisfaction of child and parent
- Outcome measurements in child

Collaboration
- Link with local asthma or school health related groups/individuals
- Talk with teachers & parents for individual child concerns
- Support teachers and principals to develop practical school guidelines for asthma
- Communicate with child's physician to notify of participation, obtain action plan, & flag concerns
Behaviour Change
- Combine knowledge of all model/theories and evidence into teaching approaches
- Models/theories provide rational
- Consider how is this learning activity incorporating principles of behaviour change
- Following summary of models, think of a memorable learning experience and what principles would apply
- Considers environmental, personal (physiological and cognitive), and behavioral factors. (Social Cognitive Theory)
- Opportunity to practice self-regulation - self-observation (monitoring), self-judgment, and self-reaction
- Incorporates observation of new behaviors and consequences from peers, role models or other models (ie puppets)
- Uses positive reinforcement that moves from external to internal motivators
- Influences environmental factors such as peers, family, and friends, as well as school and home surroundings
- Promoting optimal self-efficacy with a variety of mock and real practice opportunities and highlighting performance attainments (Excellent resource - Lorgig,K. 1996. Patient Education: A Practical Approach. Sage Publications: London.)

Examples of Teaching Strategies in RAP
- Games - encourages fun problem solving, team work, reinforces knowledge, evaluates comprehension
- Role play - simulated practice of situations and behaviors, stimulates discussion
- Model building - helping abstract concepts become more concrete
- Asthma diary recording (symptoms, peak flow, medication, & triggers) - facilitating self-awareness and internal reinforcement
- Puppetry - Depending on group and age, the puppet can be used to:
  - Role model
    - Puff has ups and down with his asthma and tells a short story relating to session topic
    - Demonstrates how to use devices
    - Shows how to play the game
  - Role play tool for children
    - Child uses puppet in shows, songs or self-expression
  - Behaviour management tool
    - Child talking during discussion has Puff
    - Puff sits by child to remind him of RAP rules
RAP Sessions
Parent Teacher Asthma Awareness Event