348 - Pediatric Primary Care Provider Experiences with Delivering Asthma Education

Poster Number: 348
Publication Number: 348.1260

Background: Patient-centered asthma education is a pillar of guideline-based care, and is associated with decreased morbidity in childhood asthma. Prior studies suggest that many children with persistent asthma do not receive essential teaching in outpatient clinic settings. A better understanding of primary care provider (PCP) experiences with asthma education is necessary to optimize support for providers and families.

Objective: To assess pediatric PCP experiences delivering asthma education, and explore perspectives on a novel approach to educational support for children hospitalized due to asthma.

Design/Methods: We conducted in-depth interviews with pediatric PCPs from Rochester, NY, using purposive sampling to include providers from varied practice settings. PCPs described experiences with clinic-based asthma education. We also solicited feedback on Telehealth Education for Asthma Connecting Hospital and Home (TEACHH), a recent pilot of asthma education and management support. TEACHH was designed to engage both children (5-13y) and caregivers through the hospital-to-home transition using pictorial materials, teach-back/show-back methods, and virtual follow-up after discharge. We used a ground-up approach to coding transcripts and identifying themes.

Results: We interviewed 16 PCPs (14 physicians, 2 nurse practitioners; experience: 2-34 years), affiliated with 10 practices (4 city, 6 suburban), including 2 residency training sites. Themes were grouped into three categories. Providers described difficulty providing early education due to uncertainty of initial diagnosis and when to start teaching, priorities for management information and needed skills, various approaches to teaching, and participants in teaching (provider vs non-provider, child vs caregiver; Table 1). Challenges to teaching included limited time and competing demands, multiple caregivers in different homes, and treatment plan complexities, while acute visits and refill requests were cited as facilitators (Table 2). Finally, PCPs shared perspectives on the TEACHH intervention, including potential benefits and barriers to adapting the toolkit for clinic use (Table 3).

Conclusion(s): Although PCPs generally agree on what information families need, there is broad variability in approaches to teaching and timelines of child engagement. Easy access to a standard toolkit appropriate for engaging different learners, such as a modified TEACHH approach delivered in clinic or during telemedicine follow-up, may give pediatric PCPs an opportunity to enhance guideline-based asthma education and care.