Formative Evaluation for Implementation of a Low Literacy Pictorial Asthma Action Plan Delivered via Telehealth Improves Asthma Control.

Consistently uncontrolled asthma in children is an increasing concern in the United States. The use of asthma action plans with asthma education is inconsistent and may be improved with adaptations for low literacy. The objective of this study was formative evaluation for implementation of the New Mexico Pictorial Asthma Action Plan (NM PicAAP). Quality improvement processes guided NM PicAAP face validation and telehealth direct patient care implementation. The asthma control test was selected to measure asthma control. NM PicAAP was revised for face validity, and training curriculum on its use and telehealth implementation processes were developed. Seven youth received NM PicAAP via telehealth direct care, which increased overall asthma control scores over 1 month. NM PicAAP may be useful and effective for improving asthma care in children via telehealth. Additional testing is needed to assess applicability.

Estimated Physical Activity in Adolescents by Wrist-Worn GENEActiv Accelerometers.

BACKGROUND: Reports of physical activity (PA) measured via wrist-worn accelerometers in adolescents are limited. This study describes PA levels in adolescents at baseline of an obesity prevention and weight management trial. METHODS: Adolescents (n = 930) at 8 high schools wore an accelerometer for 7 days, with average acceleration values of <50 mg, >150 mg, and >500 mg categorized as sedentary, moderate, and vigorous PA, respectively. In a 3-level mixed-effects generalized linear model, PA was regressed on sex, weight status, and day of week. Daily PA was nested within students, and students within schools, with random effects included for both. RESULTS: Adolescents accumulated a median of 40 minutes daily of moderate to vigorous PA (MVPA). MVPA was significantly different for teens with obesity versus teens with normal weight (-5.4 min/d, P = .03); boys versus girls (16.3 min/d, P < .001); and Sundays versus midweek (-16.6 min/d, P < .001). Average sedentary time increased on weekends (Saturday: 19.1 min/d, P < .001; Sunday: 44.8 min, P < .001) relative to midweek but did not differ by sex or weight status. CONCLUSIONS: Interventions to increase PA in adolescents may benefit from focusing on increasing weekend PA and increasing MVPA in girls.