PURPOSE: The NHLBI asthma guidelines stress the importance of asthma education. Despite time constraints and multiple stresses inherent in acute asthma care, these settings can offer unique opportunities for educational interventions. We report outcome measures following the use of a validated computer-based asthma educational tool, Quest for the Code(r), facilitated by Child Life Specialists (CLS) in acute care settings.
METHODS: Children with acute asthma exacerbations presenting to our ED and inpatient unit from January 2009 through December 2009 were recruited. Patients and their caregivers completed a baseline survey and Asthma Control Test (ACT) followed by an interactive computer-based curriculum and developmentally appropriate discussion with a CLS. At time of discharge children and their caregivers were instructed to access the online version of the program from home to reinforce what they had learned. Follow-up phone contacts were made at 6 months. ACT scores above 19 were considered an indicator of good asthma control. Correlations were performed utilizing Spearman correlations.
RESULTS: 27 subjects (average age 10.1 years ± 3.2) were recruited during the study. Males and females were about equally represented (48% and 52%, respectively). Parents with higher levels of asthma knowledge had children with better ACT scores (r = 0.41, p = 0.0429) and fewer systemic steroid bursts (r= 0.40, p=0.042). At 6 months, ACT scores increased from 17.7 ± 4.4 (baseline) to 20.2 ± 4.1 delta 2.5 ± 1.6 (p=0.03) by signed rank test (n = 6). There was also a positive correlation between the number of times a child played the game and the ACT score at 6 months (r = 0.95, p=0.051, n=4).
CONCLUSION: Educational interventions to improve asthma knowledge can be effective in acute care settings. Developmentally appropriate discussions help to reinforce information. Improved outcomes were maintained 6 months after the initial intervention.
CLINICAL IMPLICATIONS: This program may serve as model in acute asthma care settings where children do not have primary healthcare providers or medical homes.
DISCLOSURE: Claudia Fernandez, No Financial Disclosure Information; No Product/Research Disclosure Information