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Asthma

Open the conversation

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If it’s ok with you, can we spend a few minutes focusing on what you and your parents think might be some help for you?

Insight

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Setting the scene for both the child and parent/guardian allows a constructive person-centred conversation around behaviour change. With younger children the emphasis needs to be around short-term goals. The more concrete and specific – the better!

Did you know?

Toddlers and pre-schoolers should spend at least 3 hours per day in a variety of physical activities spread throughout the day including active and outdoor play.

All physical activity counts towards moving more.

Children and young people should aim to minimise the time they spend sitting for extended periods of time, including watching TV, playing computer games and travelling by car when they could walk or cycle and should replace sedentary time with light intensity physical activity wherever possible.

Real impact

Physical activity is not just sports – have fun!

Make sure you speak to school and your teachers, make a plan about how you can participate!

Make sure you get enough inhalers and spacers from your doctor. Not having an inhaler with you could stop you being active.

Assess impact of the condition

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How does your condition affect your playtime?

Insight

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Living life with a long -term condition commonly affects physical activity beliefs and behaviours. Focusing on this can be a useful way to introduce the topic.

Young children lack experience and their goals are short term. Engaging with parents is key to establishing behaviour change in this age group.

Learning motivational interviewing can help you avoid common pitfalls that sometimes make conversations about behaviour change unrewarding and ineffective. Visit our education section to learn more.

Did you know?

Toddlers and pre-schoolers should spend at least 3 hours per day in a variety of physical activities spread throughout the day including active and outdoor play.

All physical activity counts towards moving more.

Children and young people should aim to minimise the time they spend sitting for extended periods of time, including watching TV, playing computer games and travelling by car when they could walk or cycle and should replace sedentary time with light intensity physical activity wherever possible.

Real impact

Physical activity is not just sports – have fun!

Make sure you speak to school and your teachers, make a plan about how you can participate!

Make sure you get enough inhalers and spacers from your doctor. Not having an inhaler with you could stop you being active.

Find out what they already know

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What do you know about the benefits children get/achieve from physical activity?”

Insight

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Children relate to other children and peers more readily – than hearing adult advise. Helping them identify how they might benefit from being more active is key. Engaging both the child and parents about what they understand about being more active, allows opportunity for you to more collaboratively share the benefits with them.

Did you know?

Children and young people with asthma who are regularly physically active have high levels of happiness and enjoyment from life.

Being active can be fun and enjoyable. Groups of physically active children have been shown to have high levels of pleasure and fulfilment from taking part in activity session.

Weight loss can help reduce asthma symptoms

Real impact

If you become fitter you can become less breathless

When exercising if you think your asthma symptoms are getting worse, stop and rest for 5 minutes to see if they improve. Focus on slow deep breaths ideally through your nose and try and keep your shoulders relaxed.

In cold weather try and wear a snood or scarf and try to breathe through your nose as this warms the air you breathe in.

Share benefits

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Is it okay if I share a few things about how moving more has helped other kids?

Insight

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Based on your discussion so far, choose to share the benefits you deem to be most relevant and important to youth. Some benefits are emotional and generalized (e.g., feeling better, having more energy, improved sleep, enhanced fitness levels, happier mood, etc.) and other benefits will be condition specific (e.g., reduce risk of serious life altering complications in the future, etc.).

Did you know?

Children and young people with asthma who are regularly physically active have high levels of happiness and enjoyment from life.

Being active can be fun and enjoyable. Groups of physically active children have been shown to have high levels of pleasure and fulfilment from taking part in activity session.

Weight loss can help reduce asthma symptoms

Real impact

If you become fitter you can become less breathless

When exercising if you think your asthma symptoms are getting worse, stop and rest for 5 minutes to see if they improve. Focus on slow deep breaths ideally through your nose and try and keep your shoulders relaxed.

In cold weather try and wear a snood or scarf and try to breathe through your nose as this warms the air you breathe in.

Encourage reflection

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What’s most important for you and I to talk about next?

Insight

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Children typically don’t reflect the depth of adults on their own change behaviours.

Focusing on things of particular importance to them will facilitate change in their behaviour. This will allow them to make very short -term goals, which are easier for them to adhere. Ask if they need anything clarifying and what concerns they or the parents might have about how the information applies to them.

Listen and reflect their concerns: ‘you’re worried about X’. Help them to address these issues by sharing the experience of children  ‘other people I’ve worked with have had those concerns, but what typically happens when they get started is…’  or  ‘whilst there is a small risk of X when you get started, this is outweighed by the risk reduction you experience once you have started moving more’. Ask what they think about what you have said.

Did you know?

Children and young people with asthma who are regularly physically active have high levels of happiness and enjoyment from life.

Being active can be fun and enjoyable. Groups of physically active children have been shown to have high levels of pleasure and fulfilment from taking part in activity session.

Weight loss can help reduce asthma symptoms

Real impact

If you become fitter you can become less breathless

When exercising if you think your asthma symptoms are getting worse, stop and rest for 5 minutes to see if they improve. Focus on slow deep breaths ideally through your nose and try and keep your shoulders relaxed.

In cold weather try and wear a snood or scarf and try to breathe through your nose as this warms the air you breathe in.

Make it personal

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What would be the most important reason for you to become more active?

Insight

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Help kids and parents/guardians to generate and articulate their own reasons, with short term goals in mind. This may or may not be health-related.


Did you know?

Children and young people with asthma who are regularly physically active have high levels of happiness and enjoyment from life.

Being active can be fun and enjoyable. Groups of physically active children have been shown to have high levels of pleasure and fulfilment from taking part in activity session.

Weight loss can help reduce asthma symptoms

Real impact

If you become fitter you can become less breathless

When exercising if you think your asthma symptoms are getting worse, stop and rest for 5 minutes to see if they improve. Focus on slow deep breaths ideally through your nose and try and keep your shoulders relaxed.

In cold weather try and wear a snood or scarf and try to breathe through your nose as this warms the air you breathe in.

Summarise without adding anything

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If it’s OK, can I go through what we have been talking about just now?

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“Let’s pause for a second, to make sure I’m getting everything you have said.”

Insight

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Don’t be tempted to impose your own plan at this stage – kids easily fatigue and can become bored with too much conversation and may agree with you just to end the conversation. Summarise the main points of the conversation and find out what they are thinking. Consider adding breaks at this juncture in the conversation to help them refocus and engage if they are less interactive at this point.

This may sound something like: ‘Some of the things that being active would help you are X, Y and Z. You would like to do more of X and that’s where being more active may help’.

Using a summary can be a good way to demonstrate and express empathy, and allows both the child and caregivers know you are seeing the world from their perspective.

Did you know?

Being physically active can increase fitness levels in asthmatics at the same rate as those without asthma.

Sedentary behaviour is linked with poor health and obesity. Sedentary behaviour includes watching television, reading, working with a computer, sitting while playing video games, or travelling in a motor vehicle.

Intensity rather than type of exercise is more important when deciding what physical activity to recommend

Real impact

Set a family challenge, make up an obstacle course to do together, walk the dog, move more at home or in the garden, get outside more – embrace the mud and rain!

Make sure you see your doctor every year for an “Asthma Plan”, and that a copy is given to your school

In cold weather doing a warm up prior to exercise can help stop cold air irritating your airways and making you wheeze.

Ask the key question

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What do you think you might try out/do next?

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“Getting more active doesn’t always have to be a chore. What are some things you all could do together to become more active as a family/together – that would be fun for all of you?”

THEN move on to planning. Continue to keep the focus on them generating their own ideas for change, rather than telling and instructing. People are much more likely to make successful changes if they develop their own plans.

Insight

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The child and the parents have heard about the benefits of physical activity for someone like them and they have had the chance to consider the benefits they would most like to experience. They have heard their ideas spoken back to them, which can help to reinforce them. Now it’s decision time.

Asking an open question ‘what do you think you will do?’ rather than a closed question, such as ‘are you going to do physical activity?’ helps remind them that they – not you – are the decision maker.

Did you know?

Being physically active can increase fitness levels in asthmatics at the same rate as those without asthma.

Sedentary behaviour is linked with poor health and obesity. Sedentary behaviour includes watching television, reading, working with a computer, sitting while playing video games, or travelling in a motor vehicle.

Intensity rather than type of exercise is more important when deciding what physical activity to recommend

Real impact

Set a family challenge, make up an obstacle course to do together, walk the dog, move more at home or in the garden, get outside more – embrace the mud and rain!

Make sure you see your doctor every year for an “Asthma Plan”, and that a copy is given to your school

In cold weather doing a warm up prior to exercise can help stop cold air irritating your airways and making you wheeze.

Agree a plan

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There are some things that some, but not all children and parents find helpful when making a plan. Can I share with you some of these with you now and you both can let me know what sounds most interesting to do next?
We could also discuss your plan using new ideas too! Not everything works for everyone – and you both have great ideas!

If they agree, ask them which of these might suit them

Share the relevant resource from the list below with your patient

Activity Wheel

Children can pick an activities which they would like to do and brings an element of fun when choosing what to do. This can be done spontaneously and with the family.

Idea Board

This allows children to be creative and chose what activities that they may have seen on TV or in a magazine and bring them to life.

Reward Chart

The reward chart provides aprogress incentive for children to use with the support of their parents/guardians. When an activity is achieved a smiley face can be drawn or sticker will be received in the appropriate box.

Insight

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At this stage it is important to engage parents when making a plan, as they will need to facilitate any physical activity which occurs. There is not strong evidence around the following in children and a lot of this will have to actioned by parents.

Did you know?

Being physically active can increase fitness levels in asthmatics at the same rate as those without asthma.

Sedentary behaviour is linked with poor health and obesity. Sedentary behaviour includes watching television, reading, working with a computer, sitting while playing video games, or travelling in a motor vehicle.

Intensity rather than type of exercise is more important when deciding what physical activity to recommend

Real impact

Set a family challenge, make up an obstacle course to do together, walk the dog, move more at home or in the garden, get outside more – embrace the mud and rain!

Make sure you see your doctor every year for an “Asthma Plan”, and that a copy is given to your school

In cold weather doing a warm up prior to exercise can help stop cold air irritating your airways and making you wheeze.

Arrange follow up

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Would you like to come back and talk to someone a little more about this and tell us about all the fun things you have been getting up to?

Insight

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Ongoing support is a key factor of successful behavioural change.

Useful things to organise for people with asthma may include:

  • A follow up appointment with you or a colleague
  • Onward signposting

Signpost the patient information section, which contains links to physical activity opportunities regionally.

Did you know?

Being physically active can increase fitness levels in asthmatics at the same rate as those without asthma.

Sedentary behaviour is linked with poor health and obesity. Sedentary behaviour includes watching television, reading, working with a computer, sitting while playing video games, or travelling in a motor vehicle.

Intensity rather than type of exercise is more important when deciding what physical activity to recommend

Real impact

Set a family challenge, make up an obstacle course to do together, walk the dog, move more at home or in the garden, get outside more – embrace the mud and rain!

Make sure you see your doctor every year for an “Asthma Plan”, and that a copy is given to your school

In cold weather doing a warm up prior to exercise can help stop cold air irritating your airways and making you wheeze.

Signpost support organisations

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We can also give some information which you can provide to your school, any clubs you might be interested in joining or any other family members so they can understand your condition a little more, and how being active can help

Support organisations
Asthma UK

Asthma UK is an organisation and charity for people with asthma. They aim to raise the awareness of asthma, and help people to manage their daily life with asthma effectively. They try and achieve this by providing access to the best information and advice available through their website. They have a helpline which accesses expert asthma nurses for advice.

NHS – Asthma

The NHS have a website with some useful information about asthma. Although they do not talk specifically about being physically active with asthma, it is a useful website which gives information about asthma symptoms, causes, diagnosis, treatment, and asthma attacks.

National Education Union

The National Education Union is a trade union in the United Kingdom for school teachers, further education lecturers, education support staff and teaching assistants. Their website has good guidance and advice for schools on how to manage students with asthma, and is a good resource to direct schools too if you have concerns about how your child’s asthma is being managed at school.

Insight

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Did you know?

Being physically active can increase fitness levels in asthmatics at the same rate as those without asthma.

Sedentary behaviour is linked with poor health and obesity. Sedentary behaviour includes watching television, reading, working with a computer, sitting while playing video games, or travelling in a motor vehicle.

Intensity rather than type of exercise is more important when deciding what physical activity to recommend

Real impact

Set a family challenge, make up an obstacle course to do together, walk the dog, move more at home or in the garden, get outside more – embrace the mud and rain!

Make sure you see your doctor every year for an “Asthma Plan”, and that a copy is given to your school

In cold weather doing a warm up prior to exercise can help stop cold air irritating your airways and making you wheeze.

Survey

Public Health England and partners would like to hear from healthcare professionals using the Moving Medicine website. Please follow the link below to participate in our survey. It takes around 5 minutes to complete.

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