The development and comprehensibility of a pictorial asthma action plan

Roberts, Nicola; Mohamed, Zainab; Wong, Pei Se; Johnson, Marianne; Loh, Li‐Cher; Partridge, Martyn R

doi:10.1016/j.pec.2008.07.049

Cited by 49 publications

(62 citation statements)

References 17 publications

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“…By choosing particular statements, HCPs also inherently addressed areas in which they perceived the greatest need for decision support [22]. PCPs have indicated that such ‘user-friendly’ features could increase their likelihood of delivering AAPs [25] by addressing two important delivery barriers: a lack of time and a lack of practitioner confidence [3,5,6,7,8,26]. …”

Section: Discussionmentioning

confidence: 99%

“…Future culture- and language-specific AAPs could be developed by undertaking a distinct Wiki process with members of each cultural group. The uptake of our AAP may also be limited in populations with impaired literacy, including marginalized and immigrant populations where pictorial AAPs may be more effective [26]. Our consensus approach did not require evidence of the impact on health outcomes for each feature included in the AAP.…”

Section: Discussionmentioning

confidence: 99%

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An Asthma Action Plan Created by Physician, Educator and Patient Online Collaboration with Usability and Visual Design Optimization

Gupta

Wan²,

Hall³

et al. 2012

Respiration

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Background: Asthma action plans (AAPs), which decrease hospitalizations and improve symptom control, are recommended in guidelines, but are seldom delivered to patients. Existing AAPs have been developed by experts, without the inclusion of all stakeholders (such as patients with asthma) and without specifically addressing usability and visual design. Objective: Our objective was to develop a more usable AAP by involving all stakeholders and considering design preferences. Methods: We created a Wiki-based system for multiuser AAP development. Pulmonologists, primary care physicians, asthma educators and patients used the system to collaboratively compile a single AAP by making multiple online selections over 1 week. We combined common elements from 3 AAPs developed in this way into 1, optimized visual design features and tested face validity in focus groups. Results: A total of 41 participants averaged 646 selections/week over a login-time of 28.8 h/week. Of 35 participants, 28 (80%) were satisfied with the final AAP and 32 (91%) perceived that they would be able to use it. The plans created by the 3 groups were very similar, with a unanimous or majority agreement in the handling of 100/110 (91%) AAP options. Conclusions: Inclusion of multiple stakeholders and focus on design preferences predict enhanced usability and uptake of medical tools. The validity of our AAP is further supported by the similarity between the AAPs created by each group, user engagement and satisfaction with the plan and agreement with existing validity criteria proposed by experts. This AAP can be implemented in care with a concurrent measurement of uptake and health impact.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

An Asthma Action Plan Created by Physician, Educator and Patient Online Collaboration with Usability and Visual Design Optimization

Gupta

Wan²,

Hall³

et al. 2012

Respiration

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“…51,52 Or perhaps the use of lay educators 53 who can replace nurses and GPs to deliver in a discrete area of respiratory care. Many of the reported barriers identified by healthcare professionals were perceptions, e.g.…”

Section: Discussionmentioning

confidence: 99%

Barriers to the implementation of self management support in long term lung conditions

Roberts

Younis

Kidd

et al. 2013

London Journal of Primary Care

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Background Self-management improves outcomes in asthma and COPD and is strongly recommended in national and international guidelines; however implementation of the guidelines such as use of written action plans in practice is often poor. Setting A questionnaire survey was undertaken to identify the healthcare professional barriers to implementation of self-management for asthma and COPD in West London. Question Why is self-management education not being undertaken in respiratory conditions? Methods A questionnaire was designed to elicit healthcare professionals' views about barriers to implementation of self-management in asthma and COPD. Results Response rates were 33% (58/175). Results showed strong support for guideline recommendations, however implementation was patchy. Seventy six percent of respondents discussed asthma selfmanagement with patients; however only 47.8% of patients received a written action plan. For COPD patients, 55.1% discussed self-management, with 41% receiving a written action plan. In COPD, there was greater GP involvement and less delegation of

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“…Recent AAP research has utilized novel methods including the integration of images with different amounts of supporting text [23,24], and utilization mobile applications to communicate asthma treatment [25]. However, the focus of this recent AAP research has been the development of pictorial and electronic AAP [26,27], the feasibility and acceptability of their use [25,28], from the perspectives of providers and parents, and on parent behavior [24]. The impact on comprehension of asthma treatment among children has not been investigated to date, nor has the impact of pictorial AAPs on parent or youth asthma management behavior.…”

Section: Introductionmentioning

confidence: 99%

Comparing Written Versus Pictorial Asthma Action Plans to Improve Asthma Management and Health Outcomes Among Children and Adolescents: Protocol of a Pilot and Feasibility Randomized Controlled Trial (Preprint)

Hynes¹,

Durkin²,

Williford³

et al. 2018

Preprint

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BackgroundAsthma is an important focal point for health-focused research as ineffective symptom management and control can lead to significant morbidity and mortality. Current treatment guidelines for asthma recommend the use of a written asthma action plan (WAAP) to include individualized instruction for daily care and medication use. However, WAAPs are typically written at a 7 th to 9 th grade reading level, which can be a barrier to patients understanding their treatment, having confidence in using a WAAP, and engaging in asthma education during clinic visits. ObjectiveUtilizing a feasibility and pilot Randomized Controlled Trial (RCT) design, the objective of the Take Action for Asthma Control (TAAC) study is to test a symptom-based, computer-generated pictorial asthma action plan (PAAP) in contrast to a standard WAAP, and assess the feasibility and acceptability of the AAP intervention and study procedures. The study has three primary aims: (1) estimate the effect sizes of PAAPs compared to WAAPs, (2) evaluate feasibility and acceptability from the perspectives of key stakeholders, and (3) establish whether parent and youth literacy levels are associated with treatment outcomes. MethodsThis feasibility and pilot RCT is a block randomized, 2-arm, parallel-group clinical trial, lasting 6-months in duration. At baseline, participants are randomly assigned to receive a PAAP or WAAP, which is generated for them and review with them by their asthma physician. Study procedures take place over four separate time points, including a baseline clinic appointment, 1-month telephone follow-up, and 3-and 6-month clinic-based follow-ups. At each time point date are collected related to the main outcomes of AAP knowledge, AAP satisfaction, asthma control, pulmonary function, and adherence to daily asthma medication. A sample size of up 60 participants (ages 8-17 years) is being recruited. Feasibility and acceptability data are collected via one-to-one qualitative interviews with providers involved in the study, and a sub-group of families that participate in the study. ResultsRecruitment for the current phase of the study began in May 2017. It is anticipated that recruitment will continue through May 2018. Full results will immediately follow follow-up data collection. ConclusionsAn asthma action plan is an individualized, evidence-based strategy for patient education and asthma management. The standard WAAP, however, is dense and may be a barrier for families with lower literacy levels. Due to these concerns, many families are not prescribed a WAAP despite national guidelines encouraging its use. Moreover, pictorial asthma action plans (PAAPs) may be an acceptable and feasible alternative for these families.

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The development and comprehensibility of a pictorial asthma action plan

Cited by 49 publications

References 17 publications

An Asthma Action Plan Created by Physician, Educator and Patient Online Collaboration with Usability and Visual Design Optimization

An Asthma Action Plan Created by Physician, Educator and Patient Online Collaboration with Usability and Visual Design Optimization

Barriers to the implementation of self management support in long term lung conditions

Comparing Written Versus Pictorial Asthma Action Plans to Improve Asthma Management and Health Outcomes Among Children and Adolescents: Protocol of a Pilot and Feasibility Randomized Controlled Trial (Preprint)

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