Kids with asthma can...
The pool of the Roxbury Family YMCA echoed with shouts of surprise
and pure delight as more than 60 children and teenagers—some
of whom had never before been in a swimming pool—splashed,
chased each other and played games on the first Saturday in June.
Outside, an equally enthusiastic crowd played soccer and football,
explored an emergency medical vehicle and learned how to best
manage their asthma. The goal of the morning's events was to remind
children with asthma that they too can enjoy sports, outdoor activities
and especially swimming, which most clinicians believe is the
most asthma-friendly exercise there is. Co-sponsored by Children's
Hospital Boston, the Boston Asthma Games are just one of a series
of events that also includes a day camp and swimming programs
geared to children ages 8 to 12 with moderate asthma.
"A number of factors tend to inhibit people with asthma from
being as physically active as they could," says Amy Burack, RN,
MA, a key organizer of the games and Community Asthma Program
manager at Children's. Children, their parents or teachers may
fear an asthma attack and hope to head it off by avoiding sports.
But what Burack and her colleagues try to teach is that when asthma
is well managed, children should be able to participate freely
in athletics. In fact, regular physical activity builds lung capacity
and stamina, making children better able to handle an attack if
it happens. "Nothing is worse for a child than being made to feel
different," says Burack, who is an asthmatic herself, "and the
games remind them that they don't have to be."
Devon Aulmond has had asthma since he was 2, but after winning
a summer-long pass to the YMCA at last year's asthma games, the
8-year old is now an avid swimmer who also enjoys football and
basketball. Before attending Boston Asthma Camp, says his mother
Lucille, he "would try to act like his asthma didn't exist. He
would just play until he couldn't continue." Now he knows to ask
for help sooner. "He feels safer, so he enjoys his sports more."
Medical staff at asthma camp listened to Devon and taught him
to recognize the difference between his allergies and his asthma,
how to use his medication, and how to recognize and address his
early symptoms. "When he visits his doctor," says Lucille, "they
might ask how he feels, but they don't have the time to ask how
he feels when he thinks something's happening."
Partnering with the community
| Asthma is the #
1 chronic disease affecting children in the U.S. 185,000
children in Massachusetts have asthma, an estimated
7,000 in Boston public schools
alone. |
Started in 2002 by the Boston
Urban Asthma Coalition (BUAC), the Boston Asthma Games are now
part of the Asthma Health Project, a joint venture of Children's
and the Boston Public
Health Commission (BPHC). Hosted by the Roxbury Family YMCA,
other games participants include the American Lung Association,
Boston Public Schools, Boston Medical Center and Northeastern University's
Center for Sport in Society. GlaxoSmithKline pharmaceutical company
and Blue Cross Blue Shield also contributed to this year's event,
which drew over 130 residents of Boston neighborhoods. The broad-based
collaboration illustrates the approach taken by the hospital, as
it aims to find a role that encourages and supports partnership
with community-based organizations while making the best use of
the hospital's special resources.
The key, says Toby Donenfeld, director of Community
Health Ventures in Children's
Office of Child Advocacy (OCA), is to "try and bring the hospital's
expertise to the community and the community's expertise to the
hospital." Medical staff only see children for a short period
of time, while parents, teachers and coaches provide continuing
care and information about health.
One example is the way the hospital has approached partnering
with the Roxbury Boys and Girls Club. Listening to what staff
felt they needed, Burack designed a training on how to recognize
signs and symptoms of asthma and when to take action. The presentation
provided "simple, down to earth information," says Greg Stoddard,
a social worker at the club. Stoddard said they followed up with
a "fabulous" roundtable discussion where parents were able to
talk with representatives of Boston's Inspectional Services Department,
the BUAC and other asthma-related community groups. Children's
is in the process of making similar training available to other
Boys and Girls Clubs, as well as community centers, daycare providers
and Head Start programs through a partnership with WGBH, Boston's
public broadcasting station.
Leveraging resources
Physical activity is only one small piece of the asthma puzzle.
Statewide, Massachusetts has an average of four asthma hospitalizations
per 1000 people. In Roxbury, the average is 19 per 1000 people.
The baseline asthma rate nationally is under 10 percent, while
at one Boston public housing development, 40 percent of adults
and 56 percent of children surveyed reported having asthma. Environmental
factors, poor housing stock, school maintenance, school staffing
problems, and access to healthcare all play a role in causing
and exacerbating asthma in cities.
| Asthma accounts for 14
million lost school days in the U.S. annually and is
the leading cause of hospitalization
at Children's. |
There may be little that Children's can do to address some of those
problems directly, but the hospital puts its credibility, staff
and other resources behind initiatives that show promise for change.
By supporting community-based organizations such as the BUAC and
the Asthma Regional Council, and working with public agencies such
as the BPHC, Children's has helped advocate for improved construction
standards in public housing, better data collection, and changes
in how insurers cover asthma education and medication.
Of course, asthma is only one of the many community health problems
Children's takes on. Injury prevention, mental health, access
to health care, fitness, and nutrition are also central to the
hospital's mission to improve the lives of children and their
families. In all cases, Children's strives to respect the culture,
experience and wisdom of the communities they serve, asking first
what is needed, and then working with the community to make a
real difference.
