Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
J Asthma. 2023 Apr;60(4):655-672. doi: 10.1080/02770903.2022.2087188. Epub 2022 Jun 16.
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.
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).
All 12 pictograms were validated ( = 118 respondents). Readability demonstrated a 4th grade level. Overall CIRF percentile score = 80.4%. Understandability and Actionability = 100%. Suitability score = 75%.
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.
哮喘的特点是肺部症状可逆转、频繁住院、生活质量差以及治疗方法多样。父母健康素养低与儿童哮喘结局不良有关。最近的实践更新建议使用吸入皮质类固醇治疗持续性哮喘，但指南一致的治疗并不理想。我们的目的是开发和评估哮喘行动计划（AAP），该计划可以作为低健康素养家庭的个性化计划，并为临床医生提供指南一致的护理。
我们遵循美国国立卫生研究院的五步“清晰与简洁”方法来制定统一服务 AAP。我们的 AAP 包括症状象形图（呼吸困难、咳嗽、睡眠、活动）和符合指南的临床自动化工具。护理人员评估象形图的有效性（透明度≥85%；半透明度评分≥5；≥85%的回忆率）。使用 7 种公式评估可读性。（接受程度为<6 年级）。使用消费者信息评分表（CIRF）评估可理解性、设计质量和有用性（接受程度为>80%）。使用患者教育材料评估工具-可打印版（PEMAT-P）评估理解能力和可操作性（接受程度为>80%）。使用修改后的材料适宜性评估（SAM）工具评估临床医生的适宜性（接受程度为>70%为优秀）。
所有 12 个象形图均通过验证（=118 名受访者）。可读性表现为 4 年级水平。总体 CIRF 百分位数得分=80.4%。理解能力和可操作性=100%。适宜性评分=75%。
我们的 AAP 得到了过敏与哮喘网络的正式认可。统一服务 AAP 是一种具有嵌入式临床自动化的新型工具，可以解决低健康素养问题并增强指南一致的护理。
