Communication and Education About Triggers and Environmental Control Strategies During Pediatric Asthma Visits

Overview

Journal Patient Educ Couns

Publisher Elsevier

Specialties Health Services
Nursing

Date 2011 May 24

PMID 21600721

Citations 10

Authors

Deidre Washington

Karin Yeatts

Betsy Sleath

Guadalupe X Ayala

Chris Gillette

Dennis Williams

Stephanie Davis

Gail Tudor

Affiliations

Soon will be listed here.

Abstract

Objective: To determine the extent to which providers, caregivers, and pediatric asthma patients discussed environmental trigger control during primary care visits, and any demographic characteristics associated with having these discussions.

Methods: Children ages 8-16 with persistent asthma and their caregivers were recruited at five pediatric practices in non-urban areas of North Carolina. All of the medical visits were audio-tape recorded. We administered questionnaires to the child's caregiver following the visit.

Results: Two hundred and ninety-six patients had useable audio-tape data. Providers typically discussed at least one type of asthma trigger during these visits (86% of visits). The most common discussions were about exercise (70%), the weather/season (42%), and allergies/pollen (35%). Environmental control strategies were discussed less frequently (27% of visits). Providers educated the patient and their caregiver about environmental control strategies during 14% of the visits.

Conclusion: Although providers frequently discuss some environmental triggers and provide education, there is room for more comprehensive discussions of these issues, which may contribute to decreased asthma exacerbations.

Practice Implications: Providers, or alternatively, asthma health educators, should devote more time to discussing environmental asthma triggers and control strategies with pediatric asthma patients and their families, as they are important components of overall asthma control.

Citing Articles

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Provider-adolescent discussion and provider education about asthma triggers during pediatric visits: results of a randomized trial.

Sleath B, Carpenter D, Davis S, Sayner R, Lee C, Loughlin C J Asthma. 2020; 58(12):1565-1573.

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Sage A, Roberts C, Geryk L, Sleath B, Tate D, Carpenter D JMIR Hum Factors. 2017; 4(1):e5.

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Carpenter D, Geryk L, Sage A, Arrindell C, Sleath B Transl Behav Med. 2016; 6(4):509-518.

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References

Finkelstein J, Fuhlbrigge A, Lozano P, Grant E, Shulruff R, Arduino K . Parent-reported environmental exposures and environmental control measures for children with asthma. Arch Pediatr Adolesc Med. 2002; 156(3):258-64. DOI: 10.1001/archpedi.156.3.258. View

Albrecht T, Ruckdeschel J, Ray 3rd F, Pethe B, Riddle D, Strohm J . A portable, unobtrusive device for videorecording clinical interactions. Behav Res Methods. 2005; 37(1):165-9. DOI: 10.3758/bf03206411. View

Kozyrskyj A, Kendall G, Jacoby P, Sly P, Zubrick S . Association between socioeconomic status and the development of asthma: analyses of income trajectories. Am J Public Health. 2009; 100(3):540-6. PMC: 2820073. DOI: 10.2105/AJPH.2008.150771. View

Martin M, Hernandez O, Naureckas E, Lantos J . Reducing home triggers for asthma: the Latino community health worker approach. J Asthma. 2006; 43(5):369-74. DOI: 10.1080/02770900600709781. View

Lieu T, Quesenberry Jr C, Capra A, Sorel M, Martin K, Mendoza G . Outpatient management practices associated with reduced risk of pediatric asthma hospitalization and emergency department visits. Pediatrics. 1997; 100(3 Pt 1):334-41. DOI: 10.1542/peds.100.3.334. View

Camargo Jr C, Ramachandran S, Ryskina K, Lewis B, Legorreta A . Association between common asthma therapies and recurrent asthma exacerbations in children enrolled in a state Medicaid plan. Am J Health Syst Pharm. 2007; 64(10):1054-61. DOI: 10.2146/ajhp060256. View

Postma J, Karr C, Kieckhefer G . Community health workers and environmental interventions for children with asthma: a systematic review. J Asthma. 2009; 46(6):564-76. DOI: 10.1080/02770900902912638. View

Pesek R, Vargas P, Halterman J, Jones S, McCracken A, Perry T . A comparison of asthma prevalence and morbidity between rural and urban schoolchildren in Arkansas. Ann Allergy Asthma Immunol. 2010; 104(2):125-31. PMC: 5645070. DOI: 10.1016/j.anai.2009.11.038. View

Ahmad N, Biswas S, Bae S, Meador K, Huang R, Singh K . Association between obesity and asthma in US children and adolescents. J Asthma. 2009; 46(7):642-6. DOI: 10.1080/02770900802503123. View

10.

Shah S, Toelle B, Sawyer S, Roydhouse J, Edwards P, Usherwood T . Feasibility study of a communication and education asthma intervention for general practitioners in Australia. Aust J Prim Health. 2010; 16(1):75-80. DOI: 10.1071/py09056. View

11.

Ward A, Willey C, Andrade S . Patient education provided to asthmatic children: a historical cohort study of the implementation of NIH recommendations. J Asthma. 2001; 38(2):141-7. DOI: 10.1081/jas-100000032. View

12.

Bryant-Stephens T, Kurian C, Guo R, Zhao H . Impact of a household environmental intervention delivered by lay health workers on asthma symptom control in urban, disadvantaged children with asthma. Am J Public Health. 2009; 99 Suppl 3:S657-65. PMC: 2774193. DOI: 10.2105/AJPH.2009.165423. View

13.

Evans 3rd R, Gergen P, Mitchell H, Kattan M, Kercsmar C, Crain E . A randomized clinical trial to reduce asthma morbidity among inner-city children: results of the National Cooperative Inner-City Asthma Study. J Pediatr. 1999; 135(3):332-8. DOI: 10.1016/s0022-3476(99)70130-7. View

14.

Sleath B, Ayala G, Washington D, Davis S, Williams D, Tudor G . Caregiver rating of provider participatory decision-making style and caregiver and child satisfaction with pediatric asthma visits. Patient Educ Couns. 2010; 85(2):286-9. PMC: 3070191. DOI: 10.1016/j.pec.2010.09.016. View

15.

Akinbami L, Moorman J, Garbe P, Sondik E . Status of childhood asthma in the United States, 1980-2007. Pediatrics. 2009; 123 Suppl 3:S131-45. DOI: 10.1542/peds.2008-2233C. View

16.

Kroegel C, Wirtz H . History of guidelines for the diagnosis and management of asthma: from opinion to control. Drugs. 2009; 69(9):1189-204. DOI: 10.2165/00003495-200969090-00004. View

17.

Diette G, Markson L, Skinner E, Nguyen T, Wu A . Nocturnal asthma in children affects school attendance, school performance, and parents' work attendance. Arch Pediatr Adolesc Med. 2000; 154(9):923-8. DOI: 10.1001/archpedi.154.9.923. View

18.

Szefler S, Gergen P, Mitchell H, Morgan W . Achieving asthma control in the inner city: do the National Institutes of Health Asthma Guidelines really work?. J Allergy Clin Immunol. 2010; 125(3):521-6. DOI: 10.1016/j.jaci.2010.01.025. View

19.

Sleath B, Ayala G, Davis S, Williams D, Tudor G, Yeatts K . Child- and caregiver-reported problems and concerns in using asthma medications. J Asthma. 2010; 47(6):633-8. DOI: 10.3109/02770901003692785. View

20.

Cabana M, Slish K, Nan B, Clark N . Limits of the HEDIS criteria in determining asthma severity for children. Pediatrics. 2004; 114(4):1049-55. DOI: 10.1542/peds.2003-1162-L. View