title: Delivering tailored asthma family education in a pediatric emergency department setting: a pilot study.
abstract: OBJECTIVE
  Many children are brought to the pediatric emergency department (ED) with acute asthma symptoms. Emergency asthma care is costly, and many ED visits may be preventable. Families often do not have written asthma action plans and lack asthma self-management skills. This study tests a tailored self-management intervention delivered in the ED for families of children with asthma. The primary hypotheses were that the intervention group would have greater confidence to manage asthma 14 days postintervention and more well-asthma visits and fewer urgent care/ED visits at 9 and 12 months.
  
  
  METHODS
  This randomized intervention/usual-care study was part of a larger ED asthma surveillance project in 4 urban pediatric ED sites. Asthma educators used a computer-based resource to tailor the intervention messages and provide a customized asthma action plan and educational summary. Children with acute asthma were enrolled during an ED visit, and follow-up telephone interviews were conducted during the next 9 months. The ED clinician classified the child's acute and chronic severity.
  
  
  RESULTS
  To date, 464 subjects aged 1 to 18 years have been enrolled. The ED clinicians reported that 46% had intermittent and 54% had persistent chronic severity with 51% having mild acute severity episodes. The confidence level to prevent asthma episodes and keep them from getting worse was significantly higher in the intervention group at 14 days postintervention. More subjects in the intervention group reported well-asthma visits by 9 months. Return ED visits were significantly lower in the intervention group in those with intermittent asthma. Twelve-month follow-up is in process.
  
  
  CONCLUSIONS
  The tailored ED self-management intervention demonstrates significant effects on caregiver self-confidence and well-visit follow-up. Additional evaluation is needed to determine what impact this intervention has long-term.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, 6621 Fannin, MC 1040.00, Houston, Texas 77030, USA. mmsockrider@texaschildrenshospital.org
authors.forename: Marianna M
authors.initials: MM
authors.lastname: Sockrider
authors.forename: Stuart
authors.initials: S
authors.lastname: Abramson
authors.forename: Edward
authors.initials: E
authors.lastname: Brooks
authors.forename: A Chantal
authors.initials: AC
authors.lastname: Caviness
authors.forename: Susan
authors.initials: S
authors.lastname: Pilney
authors.forename: Christine
authors.initials: C
authors.lastname: Koerner
authors.forename: Charles G
authors.initials: CG
authors.lastname: Macias
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic; D010865:Pilot Projects; D016032:Randomized Controlled Trials as Topic; D012648:Self Care