1. Physical Activity Promotion Project in asthmatic children and adolescents Amélia Fernandes Belarmino João José Carlos Gomes Sérgio Fernandes Context: Asthma is one of the most frequent chronic diseases in Portugal (more than 600 000 asthmatics in 2001). National Asthma Control Program National priority in terms of Public Health. Partnership: GINA Movement (Global Initiative for Asthma) Portuguese Society of Allergology and Clinical Immunology Portuguese Society of Pneumology Portuguese Asthmatics Association.

2. Physical Activity Promotion Project in asthmatic children and adolescents Amélia Fernandes Belarmino João José Carlos Gomes Sérgio Fernandes Aim: To increase the asthmatics childrens participation in the physical education classes in their schools Objectives: Our project goal is to empower teachers in their relation with the asthmatic children. Physical activity is the centre of our endeavour. This could: Promote asthmatic children participation in schools activities. Increase the asthmatic children self-esteem. Improve the asthmatic children self-image. Teachers sensitisation to develop adequate exercises to every child (asthmatics and not asthmatics). Improve their physical performance

3. Physical Activity Promotion Project in asthmatic children and adolescents Amélia Fernandes Belarmino João José Carlos Gomes Sérgio Fernandes Effectiveness (1) Physical training can improve cardiopulmonary fitness without changing lung function. Physical activity can reduce risk behaviours such as use of tobacco, alcoholism, unhealthy alimentation or violence. It improves psychological well-been; reduce stress and feelings of depression School heath promotion interventions can be effective in transmitting knowledge, developing skills, and supporting positive health choices.

4. Physical Activity Promotion Project in asthmatic children and adolescents Amélia Fernandes Belarmino João José Carlos Gomes Sérgio Fernandes Effectiveness (2) Evidence indicates greatest effectiveness where programs are comprehensive and holistic, linking the school with agencies and sectors dealing with health It has been estimated that the implementation of a self-management program in 20 patients prevents 1 hospitalization, and successful completion of such a program by 8 patients prevents 1 emergency department visit Adequate attention needs to be given to teacher training for health promotion

5. Physical Activity Promotion Project in asthmatic children and adolescents Amélia Fernandes Belarmino João José Carlos Gomes Sérgio Fernandes Strategies of Intervention and Process (1) Partnership between the General Health Directorate, the ENSP (National Public Health School of Lisbon), the Lisbon Health Department and the PNHPS European Commission Programme of Community Action in the Field of Public Heath (PE-CONS 3627/02).

6. Physical Activity Promotion Project in asthmatic children and adolescents Amélia Fernandes Belarmino João José Carlos Gomes Sérgio Fernandes Strategies of Intervention and Process (2) Elaboration of a Handbook for Physical Educations teachers Using the PNHPSs resources, each teacher will receive the handbook and have access to a continuum educational program by the Health Promotion Technicians from the Local Supportive Teams Dissemination through the health professionals using the Lisbon Health Department resources. Parents sensitisation through parents associations Students sensitisation through students associations

7. Physical Activity Promotion Project in asthmatic children and adolescents Amélia Fernandes Belarmino João José Carlos Gomes Sérgio Fernandes Pilot project (First year) Elaboration of the Handbook for Physical Educations teachers Dissemination through the health professionals Educational program for teachers Sensitisation of parents

8. Physical Activity Promotion Project in asthmatic children and adolescents Amélia Fernandes Belarmino João José Carlos Gomes Sérgio Fernandes Pilot project (2nd and 3rd year) Choose randomly 20 schools which will receive our intervention project and 20 other which will work as control schools. The case schools and the control schools will be paired sample regarding to childrens age, socio- economic status and urban or rural area as a way to control confounders variables. Focus on the Physical Education Teachers, parents, and health professionals linked to the schools.

9. Physical Activity Promotion Project in asthmatic children and adolescents Amélia Fernandes Belarmino João José Carlos Gomes Sérgio Fernandes Evaluation of strategies The impact of the Handbook for Physical Educations teachers Teachers messages were reaching the students Information is properly and effectively transmitted to the health professionals The participation of childrens parents

10. Physical Activity Promotion Project in asthmatic children and adolescents Amélia Fernandes Belarmino João José Carlos Gomes Sérgio Fernandes Evaluation of results Presences of the asthmatics students in physical education classes The number of hospitalization or emergency department visit from each asthmatic children The evaluation of the degree of satisfaction through the questionnaire Questionário de qualidade de vida na asma (Asthmas Quality of Life Questionnaire)

11. Physical Activity Promotion Project in asthmatic children and adolescents Amélia Fernandes Belarmino João José Carlos Gomes Sérgio Fernandes Projects marketing (1) Results internally communicated to the General Health Directorate, to the PNHPS Coordinator, the Lisbon Health Department Coordinator and the ENSP (National Public Health School), and to all the stakeholders involved. Externally publication of a paper in a scientific publication and in an Internet page.

12. Physical Activity Promotion Project in asthmatic children and adolescents Amélia Fernandes Belarmino João José Carlos Gomes Sérgio Fernandes Projects marketing (2) At the end of the 1st year: press conference regarding the aims and steps of the project, part of a public presentation of the project including data regarding asthma in Portugal. At the end of the third year: a second press conference to ensure the dissemination of individual results (concerning schools and asthmatic/no asthmatic children)

13. Physical Activity Promotion Project in asthmatic children and adolescents Amélia Fernandes Belarmino João José Carlos Gomes Sérgio Fernandes YEAR FIRSTSECONDTHIRD Two months period561234561234561234 Contacts with stakeholders Ellaboration of the Handbook for physical teachers Teacher´s continuum educational program Dissemination through the health professionals Parent´s sensitisation Student´s sensitisation Media contact Pilot project Strategies evaluation Result´s evaluation Report Planning