Asthma education program for First Nations children: an exemplar of the knowledge-to-action framework.
BACKGROUND
The prevalence of asthma in Aboriginal children is 6% to 14%. Gaps in knowledge regarding asthma and its management exist in First Nations (FN) communities, and culturally relevant education and resources are required. Studies have recommended that the children's asthma education program, the 'Roaring Adventures of Puff', be modified through partnership with FN communities to be culturally appropriate.


OBJECTIVE
To adapt this knowledge tool and design an effective implementation process for FN knowledge users (children with asthma and care providers), guided by the Canadian Institutes of Health Research knowledge translation framework.


METHODS
The problem was identified, knowledge was identified⁄reviewed⁄selected (literature review); knowledge was adapted to the local context (FN working and advisory groups); barriers to knowledge use were assessed (by knowledge users); and interventions were selected, tailored and implemented (modified curricula and the creation of a new activity book and web-based resources, and regional coordinators, asthma educator mentors and community teams were recruited).


RESULTS
Major outcomes were the adapted tools and blueprints for tailoring implementation. Additional outcomes were preliminary observations and outputs from the iterative processes, including information about local context and barriers. Specific additions were roles for community members supported by asthma educators (applying FN teaching models and addressing health care demands); relevant triggers (addressing knowledge gaps); and FN images and stories, themes of circle, sacred teachings, nature and family⁄elders (culture and addressing low reading levels).


CONCLUSIONS
The framework model provides a logical, valuable tool for adapting a knowledge tool and implementation process to new knowledge users. Future research should measure uptake, effect on health outcomes of FN asthma sufferers and sustainability.
Alberta Asthma Centre, University of Alberta, Edmonton.
Maureen L
ML
Douglas
Shawna L
SL
McGhan
Danielle
D
Tougas
Nancy
N
Fenton
Christopher
C
Sarin
Oxana
O
Latycheva
A Dean
AD
Befus
D000293:Adolescent; D001249:Asthma / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy*; D002170:Canada / Q000453:epidemiology; D017028:Caregivers / Q000193:education; D002648:Child; D003479:Curriculum; D019468:Disease Management; D006801:Humans; D007198:Indians, North American / Q000208:ethnology; D033181:Information Dissemination; D010353:Patient Education as Topic / Q000379:methods*; D012196:Review Literature as Topic; D057170:Translational Research, Biomedical / Q000379:methods*