Provide Education (RAP) for Students with Asthma
RAP is an evidence-based self-management asthma program developed by Shawna McGhan at the Alberta Asthma Centre. The program consists of 6 weekly sessions typically delivered to students with asthma during the lunch hour.
See Roaring Adventures of Puff (RAP) to view and download RAP Instructor’s Guide
Things to Consider:
- Try to schedule RAP on the same day of the week, time and location to make it easier for the school staff and students to remember when and where to attend.
- The best time is during a lunch period. Be aware of the time allocated for eating & recess. Time must be allowed for students to eat. There will not be time for them to go out for recess on these days.
- During the lunch hour, spend the first 10-15 minutes, while students are eating, to gather missing students and review content from the previous class.
- Schools on a balanced schedule generally have 2 shorter sessions (30-40 minutes). Try to hold the session during the longer nutrition break.
- If possible, avoid scheduling RAP on special event days or Mondays and Fridays due to holidays. Ask in advance about any planned field trips for the age group as this will impact on attendance and may require a change in scheduling.
- Where possible, allow the students some time out for recess at the end of the session. This can lead to improved attendance if students feel they are not missing their whole recess to come to the class.
- The room should be large enough to accommodate everyone comfortably and allow some room to move around for certain activities.
- Best locations include:
- Extra classroom
- Resource room
- Gymnasium - if tables can be set up
- Access to gym equipment can allow for some fun and different games that incorporate physical activity.
- Having access to the room early is beneficial as it allows time to set up before the children arrive.
- With one facilitator it is very challenging to fit the content into a 40-60 minute class while dealing with behaviour issues and other unexpected delays.
- It is ideal to have 2 facilitators to provide additional support for students who are younger or for those with learning difficulties.
- The optimal group size with 2 facilitators is 10 students.
- Groups of less than 4 students can be difficult for team activities, sharing and discussion.
- If the group is small, consider having students invite a friend (with or without asthma) to the classes. Having students who do not have asthma in the class is a good way to raise awareness in the school. Some activities will need to be adapted to accommodate those without asthma.
- School newsletter inserts announcing RAP dates at the school, including a contact number, is helpful to promote participation.
- Offer a parent "Meet & Greet session" to encourage student's participation. Mail a brief outline of the program, including a calendar of events to all parents who do not attend "Meet & Greet".
- Remind children to attend RAP sessions weekly by having the school office staff make an announcement just prior to the start of the lunch break.
- Make reminder phone calls if possible to high-needs families the day before each weekly session. This can help to improve attendance.
- Adapt RAP to the different age levels of the students by changing the games and activities.
- Provide small token prizes, stickers, incentives to encourage attendance and participation.
- Refer to RAP as a "club" as opposed to asthma group. Encourage the students to take ownership of the "club" by naming it and coming up with their own rules.
Use these rules to refer to throughout the sessions when behavioural issues arise.
- Identify a different student each week to act as the group leader and assist with organization and distribution of materials.
- Allow children to learn by doing. Introduce concepts with a short discussion followed by a more interactive activity or game. This will also help to decrease behavioural issues for students who have a shorter attention span and encompasses different learning styles.
- Be aware of the developmental stages of students in the group when choosing activities. The age gap amongst group members can make it challenging to find an activity for all to benefit and enjoy.
- Grouping the students according to age for the program will make it easier to plan activities and teaching strategies according to developmental stage. Grades 2/3 and grades 4/5 should be grouped separately.
- Enlist the help of older students in organizing the younger students and distributing handouts etc. to keep them engaged.
- Some older students may not be engaged by "Puff", the Asthma puppet. Introducing Puff as a mascot at the start and letting the students decide on the level of his involvement in the group is helpful in determining the appropriateness of using him.
- Facilitate feelings of mutual respect and co-learning between students and facilitator by allowing time for sharing of personal stories and discussion.
- Use an agenda so that students can anticipate activities to come and feel a sense of control with respect to their learning. Let students know what activities they can look forward to for the next week to encourage ongoing participation.
- At the end of each session challenge the students to tell at least one person about what they learned in class that day.
- A large repertoire of active games/activities for all age groups are available in the RAP Instructor's Guide that can be viewed and downloaded
at Roaring Adventures of Puff (RAP)
- Have the class complete an asthma diary entry each week during the RAP session. Consider using the Puff puppet during this activity and have the children question Puff about his day and complete his diary together as a group. Discussion of the factors leading to Puff's symptoms and medication use can reinforce for students how and why they should be completing their own diaries.
- Some students do not complete RAP Funbooks or asthma diaries. Potential reasons include: too much homework, other activities in the evening or they forget to do it. Consider giving an incentive prize at the end of the session for those students who make the effort to complete these activities.
- Students that were disruptive or not interested did not make it a pleasurable experience for anyone, including other students and the instructors.
- Practice proper medication technique in sessions 3, 4 and 5 as the repetition can help to break any bad habits regarding poor technique.
Most participants of RAP enjoy bringing a friend for the "wRAP-up" session (in addition to a parent/guardian).
The students enjoy preparing and performing asthma skits for the wRAP-up session, however if there is not enough time to practice within the session
they may not be able to clearly present the concepts to the audience.
See Resources provided:
- RAP Instructor's Guide
- Sample Invitation to Meet & Greet session
- Sample Follow-up Letter including Calendar for Parents