Childhood Asthma Perception Study

Under-perception of asthma symptoms in children is a major risk factor for emergency
department visits, hospitalizations, and near-fatal/fatal asthma attacks. Puerto Rican and
Black children have greater asthma morbidity and mortality rates than all other racial/ethnic
groups. Interventions targeting asthma symptom perception and medication adherence may help
close this asthma health disparities gap.

The baseline visit for all families consists of standardized asthma education followed by 3
weeks of PEF prediction without feedback using a programmable, electronic spirometer.
Participants then will be randomized to intervention group or control feedback group and
receive a brief feedback session. For the next 6 weeks, all adolescents will predict their
PEF, which will be locked in before blowing into the device. Families will return at
mid-intervention and post-intervention to receive feedback sessions. All adolescents will
play an interactive asthma educational game to reinforce the baseline asthma education. At
the post-intervention visit, the spirometer will be reprogrammed for the next 4 weeks. These
symptom perception data will be downloaded at 1-month post-intervention. Controller
medication adherence will be monitored by electronic devices. Post-intervention sessions will
take place at 3, 6, 9, and 12 months to collect adherence data and conduct spirometry.
Physicians will be blinded to group assignment and rate asthma severity using national
guidelines. A 12-month retrospective medical record abstraction will compare emergency health
care use for asthma between groups.

Inclusion Criteria:

- 10-17 years of age

- Diagnosis of asthma (in medical record)

- Report of breathing problems within the past 12 months

- Prescribed a controller medication for asthma

- At least one parent self-identifies as Latino or Black

- The participating parent has primary or at least equal responsibility for the
adolescent

Exclusion Criteria:

- Cognitive learning disability (parent report)

- No prescription for asthma controller medication

- Inability to perform acceptable PEF blows

- Race/ethnicity other than Latino or Black

- Other significant pulmonary conditions (cystic fibrosis)