JMIR Publications

ABSTRACT

Background:

Asthma Action Plans (AAPs) are recommended for pediatric patients to help improve asthma control. Studies have shown variable results for unscheduled doctor and emergency room visits. There may be an impact on parental self-efficacy for asthma management and other daily living factors, such as missed school or parent work days, or school or caregiver management that are valuable for patients and families.

Objective:

The purpose of this study was to understand parent perceptions of AAPs. The goals of this study were threefold, including examining: 1) the association between pediatric AAPs and parental self-efficacy, 2) parent perception of helpfulness of an AAP for daily living factors, and 3) associations with the type of provider who gave the AAP (primary care provider or asthma specialist).

Methods:

A national cross-sectional online survey was completed by parents of children ages 0-17 years with asthma in October 2018. Survey questions included presence or absence of pediatric Asthma Action Plan (AAP), Bursch Parental Self-Efficacy for Asthma, parental perceptions of helpfulness of AAP with regard to daily living factors ranked on a 5-point Likert scale, and provider type who gave AAP. Survey responses were summarized in terms of percentages or means +/− standard deviations. A two-sample t-test was used to compare self-efficacy for asthma and parental perception for helpfulness scores between subjects with an AAP versus subjects without an AAP. All reported P-values were two-sided.

Results:

A total of 704 parents with a child with asthma completed the survey. Parents had a mean age of 37.5 years (SD 10.9,) 82% were female and 77% were Caucasian. Most (80%) parents had an AAP for their child (65% written, 47% online, 84% available at school). Bursch Self-Efficacy Scale was significantly higher for parents with AAP (Mean=57.7, SD=8.6) vs no AAP (Mean=55.1, SD=9.9) (P=0.0008). Parents ranked at level of agreed/strongly agreed that AAP was helpful for daily living factors including managing asthma (80%), decreased parental missed work days (68%), decreased child missed school days (73%), when child is at school (78%), when child is with other caregivers (80%), child doing normal activities (78%) and child leading a normal life (81%). Parents agreed/strongly agreed that AAP was helpful from all provider types: pediatric provider (82.8%), family practice provider (79%) and asthma specialist (84.4%). There was not a significant difference (P=.53) by type of provider who gave the AAP.

Conclusions:

Parents who had pediatric AAPs for their children had improved parental self-efficacy compared to those who did not have AAPs. Parents found AAPs helpful for decreasing missed time from work and school and for asthma management when at home, school and when with other caregivers. Significant AAP helpfulness was seen regardless of provider who gave AAP, parent education and income level. Findings support the usefulness of pediatric AAPs for families and the development of easily sharable electronic AAPs for children.