The talking card: Randomized controlled trial of a novel audio-recording tool for asthma control.

BACKGROUND: Asthma care plans typically include complicated written instructions. Customized, audio-recorded instructions may bridge health literacy gaps and improve treatment plan understanding. OBJECTIVE: To measure the effects of a recordable greeting card-style tool (Talking Card) on asthma control and parental care of children with asthma. METHODS: Multisite randomized trial in two primary care clinics, including children 4-11 years old with uncontrolled asthma and their parents. Parent-child dyads were randomized to usual care of asthma or usual care plus the Talking Card. Dyads completed three asthma-focused visits over 3 months. At the visit, card recipients received customized instructions recorded by the pediatrician onto an audio chip in the card. Asthma control was measured by using the Childhood Asthma Control Test. Card use and parental satisfaction were measured by parental survey (card arm only). Outcomes were analyzed by using generalized estimating equations and frequency distributions. RESULTS: Sixty-four dyads participated and attended 166 clinic visits. Card use was associated with a 1.6-point increase in Childhood Asthma Control Test score (p = 0.02) and a clinic visit regardless of card use with a three-point increase (p < 0.001). Satisfaction and self-efficacy were high among the card users. The mean satisfaction score was 8.9 of 10, with 96% agreeing or strongly agreeing that the card helped them take better care of asthma. CONCLUSIONS: The Talking Card, a novel audio communication tool, was associated with improved asthma control and deemed highly desirable by parents and children struggling to control asthma. This inexpensive portable tool may be useful in other chronic disorders and in locales with low literacy and poor access to digital technology.

Sun protection counseling by pediatricians.

OBJECTIVE: We conducted a pilot study in Florida to assess the extent to which caretakers reported sun protection counseling by their physicians. We also sought to determine whether caretakers who reported receiving counseling had more favorable sun protection knowledge, attitudes, and behaviors. STUDY DESIGN: We sampled 100 caretakers who were attending a university pediatric clinic in Florida and obtained 77 responses. We estimated the proportion of respondents who reported receiving sun protection counseling and examined sociodemographic predictors of counseling. RESULTS: Thirty percent of caretakers reported having been counseled by their physician. Sunscreen and avoiding peak sun exposure were the most common items discussed. Among those counseled, 42.9% stated that their child's sun protection habits increased as a result of the counseling. Counseled caretakers had greater sun protection knowledge, were more likely to report regular use of sun protection for their child (68.2% vs 40.9%, P < 0.05), and were more likely to report teaching their children about sun protection (90.9% vs 63.3%, P =.02). CONCLUSIONS: Physician sun protection counseling, while infrequently reported, was associated with more favorable sun protection knowledge, attitudes, and self-reported behaviors of caretakers and their children.

Sun protection of children at the beach.

BACKGROUND: We wanted to determine the frequency with which sun protection measures are used by children at the beach. METHODS: A cross-sectional study was undertaken that combined a brief, structured interview with direct observation of the sun protection methods (sunscreen, clothing, hats, shade) used for children at a public beach in Florida. RESULTS: Of the 139 children observed, 97 (69.8%) had some form of sun protection used on all three body regions (head, torso, legs), while only 8 (5.8%) had none of the three body regions protected. Sunscreen was the most common method of sun protection (84.9%), and other methods were less frequently used (shirt 11.5%, pants 26.6%, hat 8.6%, shade 14.4%). Sun protection use differed by sex, with girls having better protection of their head and torso, and boys slightly better protection of their legs. CONCLUSIONS: Using direct observation, we found that parents frequently use sun protection measures (mainly sunscreen) for their children while at the beach. Parents primarily rely on the use of sunscreen, rather than such measures as avoiding the sun, using shade, or protective clothing.