Provider-adolescent discussion and provider education about asthma triggers during pediatric visits: results of a randomized trial

Abstract

Objective

We examined how an asthma question prompt list with video intervention influenced discussion of and provider education about asthma triggers.

Methods

English or Spanish-speaking adolescents ages 11–17 with persistent asthma and their caregivers were enrolled from four pediatric clinics. Adolescents were randomized to the intervention or usual care groups. Adolescents in the intervention group watched the video on an iPad and then completed a one-page asthma question prompt list before their visits. All visits were audio-recorded. Generalized Estimating Equations were used to predict the number of trigger areas discussed and the number of areas providers educated adolescents about during visits.

Results

Forty providers and 359 patients participated. Triggers were discussed during 89% of intervention group visits and 81% of usual care visits; providers educated adolescents about triggers during 59% of intervention group visits and 46% of usual care visits. More triggers were significantly more likely to be discussed and providers educated about more trigger areas during visits of adolescents in the intervention group and when adolescents asked one or more questions during visits. More trigger areas were significantly more likely to be discussed if the adolescent was White and male. Providers were significantly more likely to educate adolescents whose family spoke Spanish at home about more trigger areas than adolescents who spoke English at home.

Conclusions

More trigger areas were significantly more likely to be discussed and providers educated about more trigger areas during visits of adolescents who received the intervention and when adolescents asked one or more questions.

Keywords:

• Intervention
• adolescents
• communication
• question prompt list
• respiratory

Declaration of interest

The authors have indicated they have no financial relationships relevant to this article to disclose.

Additional information

Funding

This work was supported through a Patient-Centered Outcomes Research Institute (PCORI) Program Award (1402–09777). Drs. Sleath and Reuland are also supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through Grant Award Number 1UL1TR001111.