title: Parental impressions of the benefits (pros) and barriers (cons) of follow-up care after an acute emergency department visit for children with asthma.
abstract: OBJECTIVE
  Asthma morbidity, with increasing emergency department (ED) visits, is prevalent among low-income, urban children. Follow-up care after ED visits is infrequent. We developed and evaluated an instrument that describes the parental benefits (pros) and barriers (cons) of obtaining follow-up care for interventions to promote follow-up.
  
  
  METHODS
  We enrolled a convenience sample of low-income, urban parents who brought their children to the ED for treatment of asthma. These parents rated 41 items about the pros and cons of making a follow-up visit. Principal component analysis was used to identify the underlying structure of the instrument.
  
  
  RESULTS
  One hundred forty-seven participants were interviewed in the ED. Principal component analysis retained 24 total items, which were identified by this sample as highly associated with deciding to take their child to a follow-up visit. Two types of pros were identified, informational and attitudinal, including "ask the doctor questions," and " children with asthma are healthier if they see their doctor regularly." Two types of cons were identified, practical and attitudinal, including "I have to find transportation," and "I don't need to see the doctor unless my child is sick." The mean total pro and con scores were 4.05 +/- 0.63 and 1.73 +/- 0.67, respectively.
  
  
  CONCLUSIONS
  The pros and cons are not unidimensional. Even among those with infrequent follow-up, pros were endorsed more highly than cons. Programs that target these pros and cons may improve adherence to follow-up and regular care for low-income urban children.
authors.affiliation: Division of Emergency Medicine, Department of Pediatrics, St Louis Children's Hospital, St Louis, Missouri 63110, USA. smith_s@kids.wustl.edu
authors.forename: Sharon R
authors.initials: SR
authors.lastname: Smith
authors.forename: Gabrielle R
authors.initials: GR
authors.lastname: Highstein
authors.forename: David M
authors.initials: DM
authors.lastname: Jaffe
authors.forename: Edwin B
authors.initials: EB
authors.lastname: Fisher
authors.forename: Robert C
authors.initials: RC
authors.lastname: Strunk
mesh_terms: D000328:Adult; D001249:Asthma / Q000517:prevention & control / Q000628:therapy*; D002648:Child; D003266:Continuity of Patient Care; D004636:Emergency Service, Hospital; D015438:Health Behavior; D006801:Humans; D010290:Parents / Q000523:psychology*; D011203:Poverty; D011795:Surveys and Questionnaires; D014481:United States; D014505:Urban Population