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Asthma

Open the conversation

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Today I was hoping we could spend 4-5 minutes talking about how becoming active can help with your health and wellbeing, and get your thoughts about physical activity. Would that be OK with you?

Insight

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Spending a moment to set the scene and asking permission can open a constructive young person-centred conversation around behaviour change. This keeps the youth actively engaged in the conversation and shared decision making. Young people often have conditional relationships with adults and can perceive advise as putting them in a child-like role. By engaging them with the use of open-ended questions and engaging them on their terms will lead to better outcomes.

Did you know?

More active children have better psychological and physical health than less active children.

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

When I dance it makes me smile

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 has your condition affected your physical activity levels and the things you enjoy?

Insight

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Most youth are ambivalent about, rather than “resistant to”, increasing their physical activity levels. Your challenge is to help a young person to consider and share their own ‘pros’ for increasing their physical activity levels and help them develop these ideas into a workable plan that fits into their life.

Try to understand the youth’s perspective, agenda and priorities and do not assume they:

  • ought to change
  • want to change
  • are primarily motivated by their health
  • either ARE or ARE NOT motivated to increase their activity levels
  • will respond well to a tough approach from you
  • must (or will) follow your advice

Learning skills like 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?

More active children have better psychological and physical health than less active children.

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

When I dance it makes me smile

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 good things of regular physical activity for young people?

Insight

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As youth are more likely to change if they can personally identify with the ‘pros’ for change, it is important to help them to identify how they might benefit from being more active. Find out what they know first so you can add to their existing understanding by sharing some of the wide-ranging benefits of being more active.

Did you know?

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

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

Physical Activity helps you get to sleep at night

Physical Activity can help you feel happier about your body.

There are lots of different ways to exercise; individually, with friends or a group, playing sport on your own or as a team, in public or at home. Online videos can be a useful for home exercise.

Share benefits

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Would it be OK if I share some other things young people find beneficial in making changes and see what you make of them?

Insight

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Based on your discussion so far, choose to share the benefits you judge will be most relevant and important to the young person. Some benefits are quite general (feel better, have more energy, improve sleep, improve fitness levels, improve mood, etc.) and others will be condition specific (reduce risk of serious complications in the future, etc.).
Remember the conversation won’t work if you take away the youth’s control of the conversation. Asking permission to bring up change topics and keeping this a conversation not a lecture will allow a focus on opportunities and not conflict with you.

Did you know?

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

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

Physical Activity helps you get to sleep at night

Physical Activity can help you feel happier about your body.

There are lots of different ways to exercise; individually, with friends or a group, playing sport on your own or as a team, in public or at home. Online videos can be a useful for home exercise.

Encourage reflection

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What are your thoughts on what we have discussed so far?

Insight

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Allow some space for young people to talk and explore the information rather than asking ‘do you understand?’ which can shut things down. Ask if they need clarification and what concerns they might have about how the information applies to them. Adolescents and young adults, depending on their level of development, can sometimes border in between the two.
Listen and reflect youth’s concerns: ‘you’re worried about X’. Validate their perspective, using reflective empathy statements, whilst offering a new view point on what they disclosed with you. A young person’s reasons for change may not be the same as yours or other adults, and is important to recognise this and be non-judgmental in your approach.

Did you know?

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

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

Physical Activity helps you get to sleep at night

Physical Activity can help you feel happier about your body.

There are lots of different ways to exercise; individually, with friends or a group, playing sport on your own or as a team, in public or at home. Online videos can be a useful for home exercise.

Make it personal

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What can you see as being the top reasons for you to become physically active, if you decided to?

Insight

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Help youth to generate and articulate their own reasons, which may or may not be health-related. Saying ‘if you decided to’ reminds them they are the decision maker, not you. This helps keep the discussion open and active, maintaining your role in providing support while continuing to guide the conversation to focus on change in physical activity.

Did you know?

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

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

Physical Activity helps you get to sleep at night

Physical Activity can help you feel happier about your body.

There are lots of different ways to exercise; individually, with friends or a group, playing sport on your own or as a team, in public or at home. Online videos can be a useful for home exercise.

Summarise without adding anything

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You’ve shared with me……

Insight

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Don’t be tempted to impose your own plan at this stage – youth may agree with you just to end the conversation. Summarise the main points of the conversation and find out what they are thinking/considering in the change process, thus far.
This may sound like: ‘Some of the benefits that are important about physical activity for you are…. ’.
Using a summary can be a good way to demonstrate and express empathy, and convey you can see the world from the youth’s perspective.

Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

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.

Physical activity helps develop neuromuscular awareness (i.e. coordination and movement control)

Real impact

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

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Psychologically, it helps to have a goal to aim for. This helps motivation turn into habit. That goal could be to get fitter, learn a new skill or how about raising money for a charity?

Ask the key question

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What would you like to do next?

If the youth decides they are NOT ready:

Thank them for taking the time to talk with you about physical activity and offer an opportunity to review the conversation. Reassure them that help is available when they feel ready to change.

If they decide to become more active:

THEN move on to planning. Continue to keep the focus on youth generating their own ideas for change, rather than telling and instructing. Young people are much more likely to make successful changes if they develop their own plans and can exchange their ideas with you serving as a guide in the change planning process.

Insight

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The young person has heard about the benefits of physical activity and has had the chance to consider the benefits of change. They have heard their own ideas spoken back to them, and your use of reflections helps to reinforce and solidify change processes.


Now it’s decision time. Asking an open question ‘what would you like to do?’ rather than a closed question that offers a yes or no response, such as: ‘Are you going to do physical activity – or not?.’ Open ended questions helps remind youth they – not you – are the final decision maker. This is especially important for young people who are highly ambivalent to make a decision to engage in change. If youth are not ready to change now, this can be challenging for you, and it is important to recognise they might have good reasons you may or may not be aware of, for keeping things the same for now/not engage in any change at this time. Encouraging further reflection can be an important part of the process of helping young people to make successful changes over time. Offering an opportunity to follow up on this conversation to review their thoughts about making changes can help to shift the focus on future potentials rather than present barriers in the change process.

Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

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.

Physical activity helps develop neuromuscular awareness (i.e. coordination and movement control)

Real impact

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

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Psychologically, it helps to have a goal to aim for. This helps motivation turn into habit. That goal could be to get fitter, learn a new skill or how about raising money for a charity?

Agree a plan

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Can I share with you some things people find helpful when making a plan?

If they agree, discuss the options below and find out which, if any, might suit them and share the relevant resource
Goal Ladder

Young people are able to make medium to long term goals. A goal ladder allows the breaking down of these goals into smaller more achievable targets. For example, a child may want to play football with their friends as more long term aim but may be worried that may not be able to achieve this.

An example of this may look something like this:
Step 1 – Get a football
Step 2 – Get more confident at kicking a ball by myself
Step 3 – Play football with family member – becoming more confident
Step 4 – Play football with friends

The attached goal ladder provides a document to support help children do this.

Action planning

Action planning can be a great intervention for young people ready to make medium to long-term goals. Self-determination theory is relevant to adolescents, and leveraging social support, whether in the form of parents or other family members can often be beneficial in promoting physical activity to this age group.

Building confidence worksheet

A child with high self-efficacy may select more challenging goals, be more motivated, and ultimately demonstrate higher goal-related performance, compared to a child with similar skills and lower self-efficacy.

This worksheet helps children spend some time reflecting on and building confidence to become more physically active, which increases their chance of being successful

Physical activity diary with self-monitoring

Adolescents are able to make plans and set goals into the future, which does not occur in younger years. Using self-determination theory by self-monitoring can also be applied here, with adolescents being able to rate how they are doing on a day to day basis.

Insight

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Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

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.

Physical activity helps develop neuromuscular awareness (i.e. coordination and movement control)

Real impact

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

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Psychologically, it helps to have a goal to aim for. This helps motivation turn into habit. That goal could be to get fitter, learn a new skill or how about raising money for a charity?

Arrange follow up

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What do you think about my arranging/scheduling a follow-up visit to discuss more about what we have talked about today?

Ongoing support is a key factor of successful behavioural change and clinical services exist to support people through their own journey with asthma.

Useful things to organise for young people with asthma may include:

  • A follow up appointment with you or a colleague
  • Referral to a multidisciplinary programme

Signpost the activity finder, which contains links to physical activity opportunities regionally

Insight

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Asking this as an open question helps make it clear that what is important is the young person’s own personal agenda, not yours. It can be appropriate to follow up by asking permission to share follow up options they may not know about such as:
The arrangement of a follow up appointment would also be appropriate for those people deciding not to become more active yet, but who want to ‘think about it some more’ The follow up appointment could be face to face but could also be via telephone or text.

Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

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.

Physical activity helps develop neuromuscular awareness (i.e. coordination and movement control)

Real impact

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

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Psychologically, it helps to have a goal to aim for. This helps motivation turn into habit. That goal could be to get fitter, learn a new skill or how about raising money for a charity?

Signpost support organisations

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What do you think about having a look at the great resources available here and on other websites showing how other young people experience challenges that you might face.

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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Young people may or may not be interested in accessing information and support groups, but they can offer unique support for those contemplating physical activity behavioural change with their condition. Particularly given the range and reliability of information on the internet, trusted resources are important to highlight.

Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

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.

Physical activity helps develop neuromuscular awareness (i.e. coordination and movement control)

Real impact

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

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Psychologically, it helps to have a goal to aim for. This helps motivation turn into habit. That goal could be to get fitter, learn a new skill or how about raising money for a charity?

Survey

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