Improved Asthma Control in High-Utilizer Pediatric Population Delivered By Certified Asthma Educator in an Urban Clinic

Rationale: Asthma is a leading chronic illness among children in the United States and poor childhood asthma outcomes are associated with lack of parental knowledge regarding asthma treatment, emphasizing the need for adequate asthma education for caregivers. We hypothesized that tailored asthma education would improve asthma control.

Methods: Breathe California’s All About Asthma Program is a bilingual, tailored, NHLBI-NAEPP guidelines-based education intervention for families of high-utilizer asthmatic children, who receive primary care through a pediatric clinic in San Francisco’s Mission District. Through this multi-session one-on-one educational intervention with a Certified Asthma Educator, the program aimed to increase knowledge and confidence of 120 caregivers in caring for their asthmatic children, and improve asthma control in low-income Hispanic/Latino children. The intervention utilized two measurement tools administered multiple times over 12 months, an Asthma Control Test (ACT) and a Knowledge, Confidence and Behavior Survey.

Results: Caregivers increased their average asthma knowledge score, using a 5-point scale, from 1.92 at baseline to 4.25 post-intervention. They also increased their average asthma care confidence score from a 2.20 at baseline to a 4.11 post-intervention. Ninety percent of children whose caregivers participated in the program also experienced marked improvement in the control of their asthma, as indicated by an increased ACT score >19.

Conclusions: Tailored asthma education is associated with improved asthma control and improved knowledge and confidence in caring for high-need urban asthmatic children when delivered by a Certified Asthma Educator.