Dr Smita Shah

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Initiatives and Community Approaches

• Dr Smita Shah
• Director
• Primary Health Care Education Research Unit
• Sydney West Area Health Service
• Senior Clinical Lecturer
• University of Sydney
• Australia
• Smita_shah_at_wsahs.nsw.gov.au

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Asthma in a Small World
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Adolescent Asthma

• 1 in 6 adolescents
• 43 had asthma attacks
• 22 had severe limitation
• 22 smoked
• 78 missed school

PG Gibson et al, 1998
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Triple A Program

• Peer-led
• Entrusts young people to take the health messages
• Based on psycho-social theory
• Structured program
• Triple A Program Resource kit
• Asthma Friendly Schools Program

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Medical Students Train as AAA Educators
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Step 1 Training Asthma Peer Leaders
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Step 2 Peer-led lessons
Take your medication before exercise
Take that cancer stick away
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Step 3 Asthma Skits
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Does it work?

• Program tested in a large randomised controlled
  trial ( n 1379)
• Improvements in
• Quality of Life
• School absenteeism
• Asthma attacks at school
• Participant satisfaction
• Shah et al., BMJ 2001, Boulet et al., Evidence
  Based Medicine 2001

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Comments from Peer Leaders

• Gained leadership skills and felt proud that I
  got the message across
• Knowing what to do if an asthma attack occurs
• How to help people with asthma
• Dont smoke if you have asthma
• Organisational skills and the confidence to teach

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Parents School Staff

• Parents
• Its great to see teenagers taking
  responsibility for their health
• . has become better at managing her asthma
• Should be a regular program in the school

Teachers Students are no longer embarrassed to
take their medications at school We no longer
have emergencies at school Benefits for the
peer leaders were enormous Reduction in
smoking
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Summary

• Triple A Program
• Improves QoL
• Reduces asthma attacks and school absenteeism
• Seen as beneficial by young people themselves
• Sustainable
• Currently being trialed in USA (and Jordan)
• Resources soon available on Asthma Foundation of
  Victoria website (www.asthma.org)
• Funding thanks to the Australian Government
  Department of Health and Ageing

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Triple A and Aboriginal Children

• Hard to reach population
• Can reache large numbers
• Empowering
• Beneficial for all involved
• Promotes local leadership
• Better communication skills

We got so much out of this program - and now my
daughter plays netball and athletics and state
championships and won a bronze medal for 700
meters
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Works for us works for you
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Sydney Opera House Harbor Bridge

• Questions