Assistant Professor Connecticut Children's Medical Center Hartford, Connecticut, United States
Background: Provision of written asthma treatment plans (ATPs) is a core tenet of asthma management. The 2020 focused update recommends single maintenance and reliever therapy (SMART) as the preferred therapy for individuals (≥4 years) with moderate to persistent asthma. There is an evidence-to-practice gap and a need for an understandable and actionable SMART ATP. Objective: The purpose of this research was to field-test and refine a SMART ATP this is understandable to families of children with asthma. Design/Methods: Caregivers of children with asthma were approached in waiting rooms of primary care clinics in Hartford, CT. Participants were presented the ATP and probed with questions to assess their understanding and interpretation. Demographic data such as self-identified race/ethnicity, education, and insurance type was collected. Iterative rounds of field-testing and thematic analysis were used to recognize, categorize, and contextualize major themes. Results: From November 2022 to June 2023, 101 participants were approached. Thirteen English-speaking participants and 5 Spanish-speaking participants were enrolled (n=18). Participants’ mean age was 37 years, with the majority reported as the biological mother (89%) and of Latino/Puerto Rican ethnicity (78%). Two rounds of field-testing were conducted. Themes identified in the first iteration include confusion around timing and dosage of SMART therapy. Themes from the second iteration included confusion between the daily vs the sick treatment plan. Results differed between English and Spanish speakers.
Conclusion(s): The SMART ATP was well received by participants. Analysis from each field-testing iteration has provided insight into necessary changes to improve understanding. Next steps will include focus groups with English and Spanish-speaking families to achieve consensus on a final version.
