Asthma: Supportive Relationships
Background on Supportive Relationships
What are supportive relationship strategies?
- Programs or activities designed to increase social support to improve asthma care through involvement with individuals, organizations, and communities.
- These interventions may focus on increasing the information individuals have about asthma and asthma care [informational support], provide a venue for sharing experiences and feelings [emotional and appraisal support], or provide tangible support (e.g., cleaning assistance). In addition, such interventions provide opportunities to identify and address challenges collectively (e.g., collective problem solving or advocacy) rather than individually.
- Supportive relationships interventions may help to change behaviors in order to prevent the development of asthma (primary prevention), or the worsening of asthma symptoms (secondary prevention).
- This support may be provided through involvement from a variety of individuals or individuals as part of groups, organizations, or communities including:
- school nurses
- community health advisors
How do supportive relationships impact asthma related behaviors?
- Supportive relationship interventions are successful for many reasons: individuals can ask questions or clarify what they have been told, those providing support can also provide referrals and resources to assist the individual, and longer-term relationships can help to sustain behavior change over time, among others.
How can I use supportive relationship strategies in an asthma intervention?
- The strategies may be designed to discuss challenges, benefits and advice for managing asthma effectively. Supportive relationships may be provided in the form of face-to-face interactions, telephone calls, or through interactive web-based systems. These interventions may include specific information as part of each call or face-to-face session, or may be more open ended and responsive to the specific needs of the individual.
Why is it important to considering tailoring in supportive relationship strategies?
- These interventions can be very successful when the support is tailored to the individual’s needs. For example, if the individual is having difficulty being physically active the support can be around how to manage asthma and remain physically active.
- In order to provide tailored advice to the individual, the person providing the support has to determine the specific asthma management challenges the individual is facing. Therefore, this strategy may include an assessment of the individual’s health or their use of medications, inhalers, or peak flow meters.
- Supportive relationship interventions work best when the advice also takes into account the person’s gender, age, language, race or ethnicity, and other cultural factors.
What is “readiness to change” and how does it relate to supportive relationships?
- The concept of readiness to change (drawn from the Transtheoretical Model or Stages of Change) suggests that individuals may need different kinds of interventions to help them prevent or manage their asthma depending on how ready they are to change their behaviors. Supportive relationships may be particularly important when people are ready to change their self-management behaviors (i.e., supportive relationships can help to reinforce these decisions)
How do supportive relationship strategies deal with relapse?
- Often, individuals change their behaviors and then relapse, or go back to previous behaviors. Supportive relationships, therefore, include information to help individuals to recognize that this is not unusual and to work with individuals to develop strategies to help prevent relapse in the future. (See Relapse Prevention Theory.
- It can be helpful to recognize that changes in behaviors may happen in small steps. Every individual will have preferences for what steps may be the easiest to take first, and these preferences may depend to a large extent on the support of others for these changes (e.g., family, roommate, friends, co-workers).
How have supportive relationships been used in past asthma interventions?
- Increase health care provider support for asthma management and avoiding triggers for asthma attacks. For example, a health care provider may provide support to a child and his or her parents by working with them to create an asthma management plan (e.g., how to prepare for asthmatic episodes, how to monitor medication and lung capacity) or a school nurse can provide support to students by being prepared to identify symptoms and respond. Health care provider support may be offered through face-to-face interactions or telephone calls. These support efforts may be initiated by the health care provider or the patient or client (e.g., counseling during an office visit, a support line set up by telephone that allows anyone who is interested to call for support when needed).
- Increase school-based support for asthma management and avoiding triggers for asthma attacks. For example, peer educators can be trained to provide support during school based activities (e.g., buddy system); teachers, school nurses and coaches can be trained to provide formal structured support (e.g., class sessions covering these topics) or less formal support (e.g., assistance in keeping a clean classroom); and family members can be encouraged to provide support through letters, newsletters or videos sent home with the students. These cues to action (drawn from the Health Belief Model) can describe or illustrate the challenges in managing asthma and initiate discussion between school representatives, family members and students about these struggles.