title: Validation of the Pregnancy Asthma Control Test.
abstract: BACKGROUND
  Suboptimal asthma control during pregnancy may affect perinatal outcomes. US guidelines recommend questionnaires to assess asthma control including the Asthma Control Test (ACT).
  
  
  OBJECTIVE
  To validate telephone administration of a modified version of ACT during pregnancy.
  
  
  METHODS
  MotherToBaby Pregnancy Studies (2011-2013) enrolled 159 pregnant women with asthma. Participants were interviewed by telephone at intake, at approximately gestational weeks 20 and 32, and postpartum. The ACT was modified to address dyspnea specifically due to asthma; the modified version is the Pregnancy Asthma Control Test (p-ACT). Women answered the p-ACT and guideline-based asthma impairment questions and reported asthma course changes and exacerbations. Possible p-ACT scores ranged from 5 to 25; higher score indicated better control. Reliability, criterion validity, construct validity, prospective validity, and responsiveness were assessed.
  
  
  RESULTS
  Cronbach's alpha for internal consistency was similar across time points (0.84-0.90). The p-ACT score varied by impairment; for example, at intake, the mean score was 23.2 for well-controlled versus 13.7 for very poorly controlled asthma. The p-ACT score change between interviews differed by asthma course; for example, women reporting that their asthma was much better at week 20 than at intake had a mean score increase of 4.7; women reporting that their asthma was a little worse had a mean score decrease of 1.3. Lower p-ACT score was associated with previous exacerbations, whereas intake p-ACT score was not associated with future exacerbations during pregnancy.
  
  
  CONCLUSIONS
  The p-ACT demonstrated good internal consistency, varied in the expected direction by impairment level, and was responsive to changes in asthma course. Telephone administration of the p-ACT is reliable and valid for assessing asthma control during pregnancy.
authors.affiliation: Department of Pediatrics, University of California, San Diego, La Jolla, Calif. Electronic address: kpalmsten@ucsd.edu.
authors.forename: Kristin
authors.initials: K
authors.lastname: Palmsten
authors.affiliation: Department of Allergy, Kaiser Permanente Medical Center, San Diego, Calif.
authors.forename: Michael
authors.initials: M
authors.lastname: Schatz
authors.affiliation: Department of Pediatrics, University of California, San Diego, La Jolla, Calif.
authors.forename: Priscilla H
authors.initials: PH
authors.lastname: Chan
authors.affiliation: Department of Pediatrics, University of California, San Diego, La Jolla, Calif.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Johnson
authors.affiliation: Department of Pediatrics, University of California, San Diego, La Jolla, Calif; Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, Calif.
authors.forename: Christina D
authors.initials: CD
authors.lastname: Chambers
mesh_terms: D000328:Adult; D001249:Asthma / Q000175:diagnosis*; D004417:Dyspnea / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D015203:Reproducibility of Results
keywords: Asthma; Asthma Control Test; Pregnancy; Questionnaire; Telephone-based; Validation study