title: The impact of limited English proficiency on asthma action plan use.
abstract: OBJECTIVE
  The goal of this study was to compare rates of asthma action plan use by limited English proficiency (LEP) caregivers to English proficient (EP) caregivers.
  
  
  METHODS
  A cross-sectional bilingual survey was distributed at an urban, academic, pediatric emergency department (PED). Surveys were completed by adult caregivers of children with asthma who sought PED care for asthma related chief complaints. LEP was defined as caregiver ability to speak English less than "very well". Data were analyzed using Fisher's exact test and odds ratios (OR).
  
  
  RESULTS
  One hundred seven surveys were completed and analyzed. Fifty-one surveys (48%) were completed by LEP caregivers and 56 (52%) by EP caregivers. A 25% difference (p = .01) in action plan use rates between LEP caregivers (39%) and EP caregivers (64%) was observed. EP alone was associated with action plan use (OR 2.8 [95% CI 1.3-6.1]). Variables not associated with plan use included mother acting as caregiver (OR 2.1 [95% CI 0.7-7.0]), age of child >7 years (OR 1.0 [95% CI 0.5-2.4]), caregiver education  ≥  associate degree (OR 1.4 [95% CI 0.6-3.0]), private insurance (OR 0.7 [95% CI 0.3-1.8]), White race (OR 0.7 [95% CI 0.2-2.2]), Latino ethnicity (OR 0.5 [95% CI 0.2-1.3]) and a federally qualified health center (OR 0.8 [95% CI 0.3-2.0]). The main caregiver reasons for plan use were feeling that a plan works/gets results, helps with symptom management and appreciation towards physician attentiveness when a plan is prescribed. The main caregiver reasons for non plan use were they were not informed/given an action plan or perceived the child's asthma as mild/well controlled.
  
  
  CONCLUSIONS
  Compared with EP caregivers, those with LEP experience disparate rates of asthma action plan use.
authors.affiliation: Depatment of Pediatric Emergency Medicine, Yale University , New Haven, CT , USA .
authors.forename: Antonio
authors.initials: A
authors.lastname: Riera
authors.forename: Aledie
authors.initials: A
authors.lastname: Navas-Nazario
authors.forename: Veronika
authors.initials: V
authors.lastname: Shabanova
authors.forename: Federico E
authors.initials: FE
authors.lastname: Vaca
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D017028:Caregivers / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003144:Communication Barriers; D003625:Data Collection; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007802:Language; D008297:Male