DUN PP
Asthma Management and Environmental Triggers 1
Asthma Management and Environmental Triggers
Student’s name: Dunia Barrueta
Instructor: Nora Hernandez Pupo
Institution: Florida National University
Course: Health Promotion & Role Development in Adv. Nursing Practice-DAX-DL02
Date: June 15, 2026
Proposed Health Promotion Program
The health promotion program will include an asthma management intervention that is grounded in an evidence-based home-based environmental trigger reduction and school-based asthma self-management education and community health promotion. Evidence-based interventions suggest that involving multiple settings in an integrated approach improves asthma outcomes (Spray & Hunleth, 2022). The children with asthma, less privileged families, and those residing in high-density urban areas, which are heavily burdened with environmental risk factors, including mold, pests, dust, and secondhand smoke and air pollution, will be the focus of the program. The purpose of the intervention is improving the environment, increasing adherence to the asthma action plan, and thirdly, by increasing their knowledge of how to avoid triggers and know what to do if they have asthma.
This will be achieved by an interdisciplinary team through coordinated home visits and a school-based education program. Assessors will consist of respiratory educators, advanced practice registered nurses (APRNs), community health workers, school/environmental health specialists, educational materials (asthma action plans, inhaler technique guides), peak flow meters, and mobile assessment tools for home environmental evaluation. In the home visits, community health workers and nurses will book in environmental triggers and offer customized advice on issues including mold remediation methods, pest control training, ventilation enhancing suggestions, and smoking cessation referrals. A key aspect of this asthma self-management education will be mastering inhaler technique, symptom recognition, and how to plan for emergencies in school (Elliott et al., 2022). The APRN will be responsible for the program coordinator for clinical oversight, staff training, data monitoring, and coordination with schools and community agencies. The APN's function in chronic disease management, patient education, and care coordination spanning health care systems and community settings could support the feasibility of this program for the APN.
The timeline will go over a 12-month period. Program planning will take place in months 1-2, which will involve the identification of stakeholders, recruitment and training of staff, creation of educational materials, and assessment tools. Active implementation 3-10 months will include monthly home visits, continuous school-based education classes, and activities to raise awareness about asthma triggers and prevention within the community. Data collection will take place on an ongoing basis during this period to track the frequency of symptoms, if changed, and visits to the emergency room and adherence to an asthma action plan. During months 11–12, program evaluation, outcome analysis, stakeholder feedback, and suggestions for program sustainability and expansion at other schools and community sites will be conducted.
Objective (SMART Goal)
This program aims at decreasing the number of emergency rooms visited due to asthma, increasing the uptake of asthma action plans, and enhancing the knowledge of the students and/or parents/carers of how to manage the asthma triggers and the use of medications (Kabir et al., 2026). Other anticipated outcomes include better maintenance of the environment in the child's home, decreased exposure to asthma triggers, and better self-care behaviors for children and families.
Specific target of the SMART Goal Statement: Asthma-related ED visits should decrease by 25 % by 12 months of the implementation of the integrated home- and school-based asthma management program, while the knowledge scores for children's asthma self-management should increase by at least 25 % from baseline, and adherence with asthma action plans should improve by 30 % by 12 months.
Evaluation Plan
Program effectiveness will be determined by using both process and outcome measures. Process evaluation will monitor the number of home visits, the number of school education sessions conducted, the number of participants attending sessions, and the number of home visits for environmental triggers. These data will allow for accuracy that the program is being delivered as intended, and gaps in service delivery can be identified. The outcomes to be evaluated will be the asthma-related health outcomes: number of emergency department visits, hospitalizations, number of symptoms, and medication adherence. Data at baseline will be compared to data from the 6- and 12-month follow-up to see if there was improvement.
Furthermore, knowledge and behavioural outcomes will be assessed with asthma pre- and post-test questionnaires to evaluate the survey scores of asthma knowledge and inhaler technique, and avoidance of asthma triggers. The clinical improvement will also be assessed using peak flow monitoring and self-assessed symptom diaries. Structured interviews and questionnaires will be used for qualitative feedback from parents, children, school nurses, and health care providers to evaluate how well the program is working, how helpful the program is to them, and the challenges they faced in implementation. Data will be used to review if program objectives are met and will be used to inform future improvements.
Barriers, Challenges, and Strategies
One key challenge is that families face housing instability, which can affect their ability to support their environment and the ecological niches every family needs. Another difficulty is inconsistent participation by the caregivers related to work schedules, transportation, or poor health literacy, which can affect participation in the home visits and health education sessions.
The following measures will be put into place to meet these needs: Environmental remediation resources and referrals will be provided through the pairing of the program with community, housing authority, and public health resources and partners. Teaching materials will be developed in plain language and appropriately in various formats to address a range of literacy levels. Community health workers of similar cultural backgrounds will be used to enhance rapport building and engagement. Scheduling flexibility, evening and weekend visits, and reinforcement within the schools will also boost participation rates and program accessibility.
Sustaining long-term behavior change and program funding is another potential challenge. Families often initially learn how to manage asthma, but maintaining asthma management behaviors is difficult without ongoing support (McTague et al., 2022). Furthermore, due to funding limitations, mobile equipment, crew, and environmental assessment resources may be limited in the long run. These are all potential constraints if not properly managed, which can diminish the sustainability of the intervention over time.
The program will tackle these challenges by creating sustainable funding at the public health Ryan T. Napps grant, School District partner, and local healthcare funding mechanisms. Long-term follow-up will aid in the maintenance of behavior change with the use of school nurses and primary care providers. The adoption of EHRs and shared care coordination systems will help coordinate and monitor care for patients. Periodic, booster education sessions will also be held in education to maintain adherence and reinforce actions in managing asthma, as well as community awareness sessions, continuing long-term adherence, and reinforcing actions in asthma management.
Lastly, Asthma continues to be an important chronic health condition that disproportionately affects vulnerable groups, especially children who live in lower socio-economic status communities and urban areas. High rates of exacerbation morbidity are a consequence of limited access to health and care services and environmental triggers, as is a low number of unnecessary emergency visits. The suggested scheme of work is designed to address these identified discrepancies in a comprehensive and grounded program of intervention, which includes home, school, and community programs.
The program builds on the advanced practices nurses and the specific expertise they bring in the field of health care, along with interdisciplinary collaboration and the Health Belief Model approach, to promote better disease management, environmental awareness, and interaction with health care. The integrative approach of educational, environmental assessment, and community support components provides a sustainable solution that contributes to asthma health disparities and the success and sustainability of impacted communities.
References
Elliott, J. P., Morphew, T., Gentile, D., Williams, P., Barrett, C., & Sossong, N. (2022). Improved asthma outcomes among at-risk children in a pharmacist-led, interdisciplinary school-based health clinic: A pilot study of the CAReS program. Journal of the American Pharmacists Association, 62(2), 519-525.e1. https://doi.org/10.1016/j.japh.2021.11.008
Kabir, A., Islam, M. A., Joypaul, S., Gide, D., Arnolda, G., Zurynski, Y., Fisher, G., Kelly, C., Mullins, Y., Gould, B., Flynn, A., Burke, S., Chua, A.-V., Dealhoy, C., Rojas, C., Braithwaite, J., Jaffe, A., & Homaira, N. (2026). Integrating evidence-based paediatric asthma management in Australian primary care: phase I protocol for developing implementation bundles. Frontiers in Health Services, 6. https://doi.org/10.3389/frhs.2026.1723215
McTague, K., Prizeman, G., Shelly, S., Eustace‐Cook, J., & McCann, E. (2022). Youths with asthma and their experiences of self‐management education: A systematic review of qualitative evidence. Journal of Advanced Nursing, 78(12), 3987–4002. https://doi.org/10.1111/jan.15459