Duncan Christina L, Walker Heather A, Brabson Laurel, Williford Desireé N, Hynes Lisa, Hogan Mary Beth
a Department of Psychology , West Virginia University , Morgantown , WV , USA.
b University of Nevada-Las Vegas , Reno School of Medicine , Reno , NV , USA.
J Asthma. 2018 Aug;55(8):915-923. doi: 10.1080/02770903.2017.1371743. Epub 2017 Sep 26.
Asthma action plans (AAPs) provide asthma management instructions to families; however, AAPs typically are written at a 7th-9th grade reading level, making them less useful in lower literacy families. There is a need to develop simpler AAP formats and content to optimize their utility across all families, including those who are rural and may be at a risk for literacy concerns. Because using pictures can simplify and enhance health education, our study's aim was to develop a pictorial AAP through a series of focus groups with key stakeholders - youth with asthma, caregivers, and physicians.
Fourteen caregiver/youth dyads and four physicians participated in separate focus groups where their preferences for pictorial AAP structure and content were obtained. Focus groups were audio recorded, transcribed, coded with ATLAS.ti, and analyzed for themes.
Youth and their caregivers prefer that the AAPs include simple, cartoon-like pictures customized to the patient. Physicians emphasized AAP's capability to display pictures of controller medication given its importance in preventing asthma exacerbations. A stoplight format, currently used in most written AAPs, received positive reviews. Specific suggestions for pictures showing symptoms, medications, and how to take medication were suggested. Words and short phrases accompanying the pictures were thought to add clarity.
Key stakeholders viewed pictorial AAPs as positive and potentially effective alternatives to standard written AAPs. It is expected that low literacy youth and caregivers would more easily understand a pictorial AAP presentation, which should facilitate better medication adherence and asthma outcomes in these children.
哮喘行动计划（AAPs）为家庭提供哮喘管理指导；然而，AAPs通常以7至9年级的阅读水平编写，这使得它们在识字能力较低的家庭中用处较小。有必要开发更简单的AAP格式和内容，以优化其在所有家庭中的效用，包括农村地区且可能存在识字问题风险的家庭。由于使用图片可以简化并加强健康教育，我们研究的目的是通过与关键利益相关者——哮喘青少年、照顾者和医生——进行一系列焦点小组讨论来开发一种图文并茂的AAP。
14对照顾者/青少年组合以及4名医生参加了单独的焦点小组讨论，在讨论中获取了他们对图文并茂的AAP结构和内容的偏好。焦点小组讨论进行了录音、转录，使用ATLAS.ti进行编码，并分析主题。
青少年及其照顾者更喜欢AAPs包含为患者定制的简单、卡通风格的图片。医生强调了AAP展示控制药物图片的能力，因为其在预防哮喘发作方面很重要。目前大多数书面AAP中使用的红绿灯格式获得了积极评价。提出了关于展示症状、药物以及如何服药的图片的具体建议。图片旁边的文字和短语被认为能增加清晰度。
关键利益相关者认为图文并茂版的AAP是标准书面AAP的积极且可能有效的替代方案。预计识字能力较低的青少年和照顾者会更容易理解图文并茂的AAP展示内容这应有助于这些儿童更好地坚持用药并改善哮喘病情。
