Improving Parent Understanding of Instructions About Asthma Care

Asthma has an especially great impact on poor urban children and their families. In addition
to higher asthma prevalence and morbidity, those in low SES urban areas are at risk for low
health literacy. Low health literacy is associated with poorer asthma outcomes. The provision
of a written asthma action plan has been shown to help with asthma management and to reduce
hospitalizations and ER visits. Poor urban families who may have low literacy may need an
alternative asthma action plan to convey the treatment plan.

This pilot study proposes to investigate whether a plain language asthma action plan can
improve parent understanding and adherence with medication instructions, compared to standard
written materials, among parents of children with asthma. This is an RCT in which parents of
children with asthma will be randomized to either receive a pictogram-based low literacy
asthma action plan, or a standard action plan (AAAAI), to examine whether those who receive
the low literacy plan have improved asthma action plan knowledge when presented with a
hypothetical scenario.

A second part of the study is to examine whether providers who are given the pictogram-based
low literacy asthma action plan will be more likely to counsel about certain aspects of
asthma management (eg. need for daily medications even when sick, spacer use, confusion
between everyday and rescue inhaler)compared to providers who receive use a standard action
plan (AAAAI). This is an RCT in which pediatric providers are randomized to counsel a
hypothetical patient using the pictogram-based action plan or the standard action plan
(AAAAI).