title: A prospective examination of asthma symptom monitoring: provider, caregiver and pediatric patient influences on peak flow meter use.
abstract: OBJECTIVE
  This study examined whether provider, caregiver and child communication predicted peak flow meter (PFM) use one month later.
  
  
  METHODS
  Five practices, 35 providers and 296 children with persistent asthma and their caregivers comprised the study sample. Audio-recorded provider-caregiver-child communication during the baseline medical visit captured discussion of the PFM; and child and caregiver baseline interviews after the medical visit collected factors associated with PFM use. Child- and caregiver-reported PFM availability and use, and observed child use of PFM were collected one-month later in the family's home.
  
  
  RESULTS
  During the medical visit, provider communication about PFM use was infrequent (10% maximum) and child- or caregiver-initiated communication was nearly absent (0%-2%). Despite this, children demonstrated good use of the PFM one month later. Children were significantly more likely to perform at least six PFM steps correctly one month later when there was more communication about PFM during the medical visit. Few other factors predicted availability and use.
  
  
  CONCLUSIONS
  Few providers discussed use of a PFM; observed performance was predicted by having talked about it with the child's provider. Provider communication should be targeted in future interventions to improve asthma management skills.
authors.affiliation: Division of Health Promotion and Behavioral Science, Graduate School of Public Health, Institute for Behavioral and Community Health, San Diego State University , San Diego, CA , USA .
authors.forename: Guadalupe X
authors.initials: GX
authors.lastname: Ayala
authors.forename: Chris
authors.initials: C
authors.lastname: Gillette
authors.forename: Dennis
authors.initials: D
authors.lastname: Williams
authors.forename: Stephanie
authors.initials: S
authors.lastname: Davis
authors.forename: Karin B
authors.initials: KB
authors.lastname: Yeatts
authors.forename: Delesha M
authors.initials: DM
authors.lastname: Carpenter
authors.forename: Betsy
authors.initials: B
authors.lastname: Sleath
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000503:physiopathology*; D017028:Caregivers; D002648:Child; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D010817:Physician-Patient Relations; D012129:Respiratory Function Tests / Q000295:instrumentation*; D012720:Severity of Illness Index