Beyond Words: A Pictorial Approach to Pediatric Asthma
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Cormier, Daisey
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Abstract
Problem: Pediatric asthma affects over 7 million children in the U.S., significantly impacting their quality of life and healthcare utilization. Written Asthma Action Plans, typically at a 7th– 9th grade reading level, pose literacy barriers for many U.S. adults, reducing compliance and effectiveness. Pictorial Asthma Action Plans (pAAPs) have been shown to improve patient comprehension and adherence, especially for families with limited literacy or non-English proficiency. A retrospective chart review conducted from August to September 2023 revealed that no asthma action plans had been initiated for patients under 18 at a pediatric primary care clinic. Purpose: This quality improvement (QI) project aimed to improve pAAP completion by implementing a web-based tool in a mid-Atlantic suburban pediatric primary care practice. Methods: Over 15 weeks, a multidisciplinary team implemented a web-based pAAP tool. Staff were trained on the pAAP form and age-based asthma control assessments. Eligible patients completed the appropriate asthma control test and received a printed pAAP. Scores and management plans were documented in the EHR. Weekly chart audits collected data on pAAP completion, EHR uploads, and appropriate asthma control testing. Data were analyzed through run charts and stored in HIPAA-compliant REDCap software. Results: At baseline, pAAP completion rates were 0%. By the end of implementation, 80% (n=92) of pAAPs were completed, and of those, 90.2% (n=83) were uploaded to the EHR. Additionally, appropriate age-based asthma control testing achieved 90.9% (n=100) adherence. Conclusions: The deployment of a web-based tool for completing pAAPs within a pediatric primary care setting demonstrated both feasibility and efficacy. This approach shows promise in improving management by streamlining care delivery and addressing language and literacy challenges. Keywords: asthma, action plan, pictorial, literacy, pediatric, language barrier