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Development and assessment of a low literacy, pictographic asthma action plan with clinical automation to enhance guideline-concordant care for children with asthma.
Reeves, Patrick T; Kenny, Timothy M; Mulreany, Laura T; McCown, Michael Y; Jacknewitz-Woolard, Jane E; Rogers, Philip L; Echelmeyer, Sofia; Welsh, Sebastian K.
Afiliação
  • Reeves PT; Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Walter Reed National Military Medical Center, Bethesda, MD, USA.
  • Kenny TM; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
  • Mulreany LT; Department of Pediatrics, Division of Pulmonology, Brooke Army Medical Center, San Antonio, TX, USA.
  • McCown MY; Department of Pediatrics, Division of Pulmonology, Brooke Army Medical Center, San Antonio, TX, USA.
  • Jacknewitz-Woolard JE; Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Walter Reed National Military Medical Center, Bethesda, MD, USA.
  • Rogers PL; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
  • Echelmeyer S; Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Walter Reed National Military Medical Center, Bethesda, MD, USA.
  • Welsh SK; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
J Asthma ; 60(4): 655-672, 2023 04.
Article em En | MEDLINE | ID: mdl-35658804
ABSTRACT

OBJECTIVE:

Asthma is characterized by reversible pulmonary symptoms, frequent hospitalizations, poor quality of life, and varied treatment. Parents with low health literacy (HL) is linked to poor asthma outcomes in children. Recent practice updates recommended inhaled corticosteroids for the management of persistent asthma, but guideline-concordant care is suboptimal. Our aim was to develop and assess an Asthma Action Plan (AAP) that could serve as an individualized plan for low HL families and facilitate guideline-concordant care for clinicians.

METHODS:

We followed the National Institute of Health 5-step "Clear & Simple" approach to develop the Uniformed Services AAP. Our AAP included symptom pictographs (dyspnea, cough, sleep, activity) and guideline-concordant clinical automation tools. Caregivers assessed the pictograms for validity (transparency of ≥ 85%; translucency score ≥ 5; and ≥ 85% recall). Readability was assessed using 7 formulas. (<6th Grade was acceptable). Comprehensibility, design quality, and usefulness was assessed by caregivers using the Consumer Information Rating Form (CIRF) (>80% was acceptable). Understandability and actionability was assessed by medical librarians using the Patient Education Materials Assessment Tool-Printable (>80% was acceptable). Suitability was assessed by clinicians using the modified Suitability Assessment of Materials (SAM) instrument (>70% was superior).

RESULTS:

All 12 pictograms were validated (N = 118 respondents). Readability demonstrated a 4th grade level. Overall CIRF percentile score = 80.4%. Understandability and Actionability = 100%. Suitability score = 75%.

CONCLUSIONS:

Our AAP was formally endorsed by the Allergy & Asthma Network. The Uniformed Services AAP is a novel tool with embedded clinical automation that can address low HL and enhance guideline-concordant care.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Asma / Letramento em Saúde Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Asma / Letramento em Saúde Idioma: En Ano de publicação: 2023 Tipo de documento: Article