DUNIA HEALTH P 2

1

Health Promotion Proposal Part 1

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: May 27, 2026

Asthma Management and Environmental Triggers

Health Problem Overview

Asthma is a chronic inflammatory respiratory disease defined by the features of airway narrowing, ‘hyper-responsiveness,’ and frequent episodes of wheezing, coughing, chest tightness, and difficulty breathing. It is a considerable public health issue both worldwide and nationally. Global prevalence of asthma is estimated to be about 262 million with significant disability in healthcare utilization worldwide (Song et al., 2022) In the United States, 25 million persons – more than 4 million children – are already diagnosed with asthma, and emergency department attendance and work/school absences among people with asthma have been steadily increasing over the years (Song et al., 2022).

Environmental factors (such as air pollution, exposure to mold, occupational, and tobacco smoke) play important parts in asthma exacerbations and asthma control. Widespread exposure to air-borne pollutants and allergens has been increasing in recent years, and so too has worsening climate change and sprawl, all of which have resulted in more frequent and more virulent attacks of asthma. This proposed health promotion program will address asthma triggers and the management of asthma for those who are at high risk to decrease the occurrence of asthma exacerbation. The changes to be implemented in this program will result in a measurable outcome of a reduction of 25% in emergency visits for asthma within 12 months of the program's implementation, with 30% improvement in adherence with the asthma action plan.

Vulnerable Population

Asthma crises impact the most vulnerable, including children, low-income families, residents of high-density areas, and persons living in high air pollution or insufficient and hazardous housing. Children are regarded as the most vulnerable group, with exposure to a higher risk of the virus due to immature respiratory mechanisms in their bodies and higher exposure to the virus in their schools. Pediatric asthma prevalence is far higher in low-income communities in cities compared to rural, low-income communities due to community exposures to traffic-related air pollution and indoor allergens (Grant & Wood, 2022).

Limited access to health care, health care medications, and health care preventive education are key factors, and low socio-economic status is highly correlated with adverse outcomes of asthma. Overcrowding, lack of proper ventilation, secondhand smoke, mold and pests are all recognized poor triggers for asthma and are more likely to be found in overcrowded houses or poorly-ventilated houses. Environmental injustice and inequities in health care access, in addition, contribute to disparities among minorities in the United States with regard to asthma morbidity and asthma deaths (Grant & Wood, 2022). These are shared risk factors for these populations, and therefore are important factors to address when trying to prevent or manage asthma.

Evidence-Based Literature Review

Home-based environmental trigger reduction programs are an evidence-based treatment for asthma. Crocker et al. (2023) conducted a randomized controlled trial and found that the HEA associated with personalized trigger-reducing education was highly effective in decreasing asthma symptom severity and the number of emergency visits. This is a personalized intervention which directly modifies environmental risk factors, a strength of which is. However, some limitations are there, such as high requirements of resources and the need for patient participation in home assessment.

School-based asthma self-management education programs are other effective interventions. Spray & Hunleth (2022) found that structurally supported asthma education, in the school environment, increased students' understanding of their inhalers, triggers, and monitoring of their symptoms. What makes this an effective strategy is that it is easily replicable and available across different settings for children who are at risk, and can help to ensure that positive self-management practices are reinforced. One limitation, however, is that there is some variation with program implementation and no long-term follow-up information on sustained outcomes. The literature review indicated that interventions targeting more than one setting (home, school, and community) were shown to have the greatest impact on asthma outcomes.

Theoretical Framework

The Health Belief Model (HBM) is a model that fits well to guide this asthma health promotion proposal. The model hypothesizes that behavior with regard to health is based on people's attitude and awareness of threats (susceptibility and severity), advantages (benefits), and limiters (barriers) of action (Habtamu Endashaw Hareru et al., 2024). People do not always practice 'trigger avoidance' or take medicines as directed when their experience or understanding of asthma is not severe enough, or when they believe environmental exposures are harmful.

This program will use HBM by raising awareness on social media, spreading awareness of issues such as air pollution, smoke, allergens, etc. The risk of not managing your asthma properly will be reinforced by a discussion of the risks of uncontrolled asthma, such as being treated in hospital and being a poor tenant. Consistent inhaler use, avoidance of triggers, and environmental control will be discussed and promoted via educational sessions with patients and a community awareness campaign. Medication costs and awareness gaps will be mitigated by linking to community support and resources, with environmental factors being addressed through strong working with both parents and the board. Patients and patient-carers will learn to use an inhaler and their asthma action plan, which will enhance self-efficacy.

References

Grant, T. L., & Wood, R. A. (2022). The influence of urban exposures and residence on childhood asthma. Pediatric Allergy and Immunology, 33(5). https://doi.org/10.1111/pai.13784

Habtamu Endashaw Hareru, Tizalegn Tesfaye Mamo, Abebe, M., & Berhanu Gidisa Debela. (2024). Health-promoting behavior and its determinants toward non-communicable diseases among adult residents of the Gedeo zone, South Ethiopia: the application of the health belief model. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1453281

Picado, C., Mullol, J., & Roca-Ferrer, J. (2023). Mechanisms by which dupilumab normalizes eicosanoid metabolism and restores aspirin-tolerance in AERD: A hypothesis. Journal of Allergy and Clinical Immunology, 151(2), 310–313. https://doi.org/10.1016/j.jaci.2022.09.012

Song, P., Adeloye, D., Salim, H., Dos Santos, J. P., Campbell, H., Sheikh, A., & Rudan, I. (2022). Global, regional, and national prevalence of asthma in 2019: a systematic analysis and modelling study. Journal of Global Health, 12(12). https://doi.org/10.7189/jogh.12.04052

Spray, J., & Hunleth, J. (2022). Breathing Together: Children Co-constructing Asthma Self-Management in the United States. Culture, Medicine, and Psychiatry. https://doi.org/10.1007/s11013-022-09766-5