Management

• Count: Number of children aged 0- 17 years with current asthma who have received an asthma action plan from a health professional
• At-risk rate: Percent of children aged 0-17 years with current asthma who have received an asthma action plan from a health professional among all children with current asthma
• Population-based rate: N/A*

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• Count: Number of children aged 0-17 years with current asthma who have received (or their parents/guardians have received) education on how to recognize early signs or symptoms of an asthma episode.
• At rate risk: Percent of children aged 0-17 years with current asthma who have received (or their parents/guardians have received) education on how to recognize early signs or symptoms of an asthma episode among all children with current asthma
• Population-based rate: N/A.

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• Count: Number of children aged 0-17 years with current asthma who have ever used a prescription inhaler who have received (or their parents/guardians have received) instruction on inhaler use from a health professional.
• At-risk rate: Percent of children aged 0-17 years with current asthma who have ever used a prescription inhaler who have received (or their parents/guardians have received) instruction on inhaler use from a health professional among all children with current asthma who have ever used a prescription inhaler.
• Population-based rate: N/A*

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• “Has a health professional shown [child name] how to use [his/her] inhaler? (This includes showing parents for young children.)”

Benchmark data sources:

• National: National Health Interview Survey (NHIS) periodic modules: 2003 & 2008 (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)
• State: BRFSS Asthma Call-Back Survey (ACBS), average annual estimates for survey years starting in 2006 for participating states. Aggregation of at least 2 survey years is recommended to obtain reliable estimates by state. (https://www.cdc.gov/brfss/acbs/index.htm).

Note: although the ACBS question wording (“Did a health professional show [him/her] how to use the inhaler?”) differs from the NHIS question, both questions are believed to yield comparable results

• Count: Number of children aged 0-17 years with current asthma who have received (or their parents/guardians have received) education on how to respond to episodes of asthma.
• At-risk rate: Percent of children aged 0-17 years with current asthma who have received (or their parents/guardians have received) education on how to respond to episodes of asthma among all children with asthma.
• Population-based rate: N/A*

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• “Has a doctor or other health professional EVER taught [child name] or [his/her] parent or guardian how to respond to episodes of asthma?”

Benchmark data sources:

• National: National Health Interview Survey (NHIS) periodic modules: 2003, 2008, 2013 (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)
• State: BRFSS Asthma Call-Back Survey (ACBS), average annual estimates for survey years starting in 2006 for participating states. Aggregation of at least 2 survey years is recommended to obtain reliable estimates by state. (https://www.cdc.gov/brfss/acbs/index.htm).
  Note: Although the ACBS question wording (“Has a doctor or other health professional ever taught you or {child name} what to do during an asthma episode or attack?”) differs from the NHIS question, the estimates are likely to be comparable.

• Count: Number of children aged 0-17 years with current asthma who have received (or their guardians have received) education on how to monitor peak flow for daily therapy.
• At-risk rate: Percent of children aged 0-17 years with current asthma who have received (or their guardians have received) education on how to monitor peak flow for daily therapy among all children with asthma.
• Population-based rate: N/A*
  * This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• “Has a doctor or other health professional EVER taught [child name] or [his/her] parent or guardian how to monitor peak flow for daily therapy?”

Benchmark data sources:

• National: National Health Interview Survey (NHIS) periodic modules: 2003, 2008, 2013 (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)
• State: BRFSS Asthma Call-Back Survey (ACBS), average annual estimates for survey years starting in 2006 for participating states. Aggregation of at least 2 survey years is recommended to obtain reliable estimates by state. (https://www.cdc.gov/brfss/acbs/index.htm).
  Note: Although the ACBS question wording (“Has a doctor or other health professional ever taught you or {child’s name} how to use a peak flow meter to adjust his/her daily medications?”) differs from the NHIS survey question, the two questions are believed to generate comparable estimates.

• Count: Number of children aged 0-17 years with current asthma whose parents/guardians have been advised to change their home/school/work environment to improve their asthma.
• At-risk rate: Percent of children aged 0-17 years with current asthma whose parents/guardians have been advised to change their home/school/work environment to improve their asthma among all children with current asthma
• Population-based rate: N/A*

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• “Has a doctor or other health professional EVER advised you to change things in [child name]’s home, school, or work environment to improve [his/her] asthma?”

Benchmark data sources:

• National: National Health Interview Survey (NHIS) periodic modules: 2003, 2008, 2013 (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)
• State: BRFSS Asthma Call-Back Survey (ACBS), average annual estimates for survey years starting in 2006 for participating states. Aggregation of at least 2 survey years is recommended to obtain reliable estimates by state. (https://www.cdc.gov/brfss/acbs/index.htm).

• “Has a doctor or other health professional EVER told you that your child had asthma?”
• AND
• “Does your child still have asthma?”

Benchmark data sources:

• National: National Health Interview Survey (NHIS), 2001 onward ()
• State: Behavioral Risk Factor Surveillance System (BRFSS), data available for children 0-17 years of age for selected states, 2006 onward (https://www.cdc.gov/brfss/)

This measure is related to Healthy People 2020 Respiratory Disease Objective RD-7.5: Increase the proportion of persons with current asthma who have been advised by a health professional to change things in their home, school, and work environments to reduce exposure to irritants or allergens to which they are sensitive according to NAEPP guidelines, http://www.healthypeople.gov/2020/topics-objectives/topic/respiratory- diseases/objectivesExternal.

• Behavioral Risk Factor Surveillance System (BRFSS): Asthma Call-Back Survey (ACBS), starting 2006. (https://www.cdc.gov/brfss/acbs/2006/pdf/acbs_2006_child_codebook.pdfCdc-pdf )
  The ACBS has the advantage of being collected annually and providing state level estimates. ACBS is not collected in all states. ACBS data on advising to make environmental changes is also available at https://www.cdc.gov/asthma/acbs/table8a.htm.

• Taught how to recognize early symptoms
• Taught how to respond to episodes of asthma
• Taught how to use an inhaler
• Taught how to monitor peak flow for daily therapy
• Asthma Action Plan
• Insurance coverage
• Usual source of health care
• Personal doctor

• Count: Number of children aged 0-17 years with current asthma whose health care provider asked them how often they had asthma symptoms at the last visit.
• At-risk rate: Percent of children aged 0-17 years with current asthma whose health care provider asked them how often they had asthma symptoms at the last visit among all children with asthma.
• Population-based rate: N/A*

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• “At his/her last visit, did [child name]’s doctor or other health professional ask HOW OFTEN [he/she] had asthma symptoms?”

Benchmark data source:

• National Health Interview Survey (NHIS) periodic modules: 2013 (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)

• “Has a doctor or other health professional EVER told you that your child had asthma?”
• AND
• “Does your child still have asthma?”

Benchmark data sources:

• National: National Health Interview Survey (NHIS), 2001 onward (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)
• State: Behavioral Risk Factor Surveillance System (BRFSS), data available for children 0-17 years of age for selected states, 2006 onward (https://www.cdc.gov/brfss/)

This measure is related to Healthy People 2020 Respiratory Disease Objective RD-7.7: Increase the proportion of persons with current asthma whose doctor assessed their asthma control at the last visit according to NAEPP guidelines, http://www.healthypeople.gov/2020/topics-objectives/topic/respiratory- diseases/objectivesExternal.

• National Health Interview Survey (NHIS) (https://www.cdc.gov/asthma/nhis/2013/data.htm)

• Asked about relief inhaler frequency
• Asked about limitation of daily activities
• Insurance coverage
• Usual source of health care
• Personal doctor

• Count: Number of children aged 0-17 years with current asthma whose health care provider asked about frequency of inhaler use.
• At-risk rate: Percent of children age 0-17 years with current asthma whose health care provider asked about frequency of inhaler use.
• Population-based rate: N/A*

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• “At his/her last visit, did [child name]’s doctor or other health professional ask HOW OFTEN he/she used relief inhaler at the last visit?”

Benchmark data source:

• National Health Interview Survey (NHIS) periodic modules: 2013 (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)

• “Has a doctor or other health professional EVER told you that your child had asthma?”
• AND
• “Does your child still have asthma?”

Benchmark data sources:

• National: National Health Interview Survey (NHIS), 2001 onward (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)
• State: Behavioral Risk Factor Surveillance System (BRFSS), data available for children 0-17 years of age for selected states, 2006 onward (https://www.cdc.gov/brfss/)

This measure is related to Healthy People 2020 Respiratory Disease Objective RD-7.7: Increase the proportion of persons with current asthma whose doctor assessed their asthma control at the last visit according to NAEPP guidelines, http://www.healthypeople.gov/2020/topics-objectives/topic/respiratory- diseases/objectivesExternal.

• Asked about symptom frequency
• Asked about limitation of daily activities
• Insurance coverage
• Usual source of health care
• Personal doctor

• Count: Number of children aged 0-17 years with current asthma whose health care provider asked how often asthma symptoms limited daily activities.
• At-risk rate: Percent of children age 0-17 years with current asthma whose health care provider asked how often asthma symptoms limited daily activities.
• Population-based rate: N/A*

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• “At his/her last visit, did [child name]’s doctor or other health professional ask HOW OFTEN asthma symptoms limited [his/her] daily activities?”

Benchmark data source:

• National Health Interview Survey (NHIS) periodic modules: 2013 (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)

• “Has a doctor or other health professional EVER told you that your child had asthma?” AND
• “Does your child still have asthma?”

Benchmark data sources:

• National: National Health Interview Survey (NHIS), 2001 onward (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)
• State: Behavioral Risk Factor Surveillance System (BRFSS), data available for children 0-17 years of age for selected states, 2006 onward (https://www.cdc.gov/brfss/)

This measure is related to Healthy People 2020 Respiratory Disease Objective RD-7.7: Increase the proportion of persons with current asthma whose doctor assessed their asthma control at the last visit according to NAEPP guidelines, http://www.healthypeople.gov/2020/topics-objectives/topic/respiratory- diseases/objectivesExternal.

• Asked about symptom frequency
• Asked about relief inhaler frequency
• Insurance coverage
• Usual source of health care
• Personal doctor

• Count: Number of children aged 0-17 years with current asthma receiving a flu vaccine in the past year
• At-risk rate: Percent of children aged 0-17 years with current asthma receiving a flu vaccine in past year among all children with asthma
• Population-based rate: N/A*

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• “During the past 12 months, has [child’s name] had a flu vaccination? A flu vaccination is usually given in the fall and protects against influenza for the flu season.”
• Additional information about mode of vaccination:
• “Was this a shot, or was it a vaccine sprayed in the nose?”

Benchmark data source:

• National: National: National Health Interview Survey (NHIS), 2001 onward (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)
• State: Behavioral Risk Factors Surveillance System (BRFSS): Asthma Call-back Survey (ACBS), starting 2006. (https://www.cdc.gov/brfss/acbs/2012/pdf/acbs_2012_child_llcp_codebook.pdfCdc-pdf). Note: The survey questions for the ACBS differ from NHIS, but likely give comparable estimates: YES response to either:
  • “A flu shot is an influenza vaccine injected in your arm. During the past 12 months, did [child’s name] have a flu shot?” OR>/em>
  • “A flu vaccine that is sprayed in the nose is called FluMist^TM. During the past 12 months, did [he/she] have a flu vaccine that was sprayed in [his/her] nose?

• “Has a doctor or other health professional EVER told you that your child had asthma?” AND
• “Does your child still have asthma?”

Benchmark data sources:

• National: National Health Interview Survey (NHIS), 2001 onward (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)
• State: Behavioral Risk Factor Surveillance System (BRFSS), data available for children 0-17 years of age for selected states, 2001 onward (https://www.cdc.gov/brfss/)

Healthy People 2020 Objective IID-12: Increase the percentage of children and adults who are vaccinated annually against seasonal influenza. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=23External.

Disparities in influenza vaccination coverage between non-Hispanic whites and black, Hispanic and other and multiple race children have been reported(5). However, more recent data show similar vaccination rates for children of all races/ethnicities(6).

• Behavioral Risk Factor Surveillance System (BRFSS), Asthma Call-Back Survey (ACBS) (https://www.cdc.gov/brfss/acbs/index.htm)
• FluVaxView: influenza vaccination coverage estimates by season: https://www.cdc.gov/flu/fluvaxview/)
• Chronic Disease Indicators: Influenza vaccination among non-institutionalized adults aged 18-64 years with asthma (https://www.cdc.gov/cdi/definitions/asthma.html)

(2) Eisner MD. Asthma and influenza vaccination. Chest 2003;124:775-777.
(3) Groom AG, Hennessy TW, Singleton RJ, et al. Pneumonia and influenza mortality among American Indian and Alaska Native People, 1990-2009. AJPH 2014;104:S460-S469.
(4) Quinn SC, Kumar S, Freimuth VS, et al. Racial disparities in exposure, susceptibility, and access to health care in the US H1N1 influenza pandemic. Am J Public Health. 2011;101:285–293. http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2009.188029External
(5) CDC. Influenza vaccination coverage—United States, 2000–2010. In: CDC health disparities and inequalities report—United States, 2011. MMWR 2011;60(Suppl; January 14, 2011):38–41.
(6) CDC. Seasonal influenza vaccination coverage – United States, 2009-10 and 2010-11. In: CDC health disparities and inequalities report—United States, 2013. MMWR Surveill Summ. 2013 Nov 22;62 Suppl 3:65-8. https://www.cdc.gov/mmwr/pdf/other/su6203.pdfCdc-pdf

• Count: Number of children aged 0-17 years with one or more routine checkup visits for asthma.
• At-risk rate: Percent of children aged 0-17 years with one or more routine checkup visits for asthma among all children with asthma.
• Population-based rate: N/A*

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• “During the past 12 months, how many times did [child’s name] see a doctor or other health professional for a routine checkup for [his/her] asthma? Please do not include emergency room visits, visits to urgent care centers, or other visits for acute care for an asthma episode or attack.”

Benchmark data source:

• National: National Health Interview Survey (NHIS) periodic modules: 2013 (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)
• State: Behavioral Risk Factors Surveillance System (BRFSS): Child Asthma Call-back Survey (ACBS), starting 2006. (https://www.cdc.gov/brfss/acbs/index.htm)
  Note: Although, the ACBS question wording (which omits the phrase about excluding ED and urgent care center visits) differs from the NHIS question, the two surveys likely provide comparable estimates.

• “Has a doctor or other health professional EVER told you that [child’s name] had asthma?” AND
• “Does [child’s name] still have asthma?”

Benchmark data sources:

• National: National Health Interview Survey (NHIS)), 2001 onward (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)
• State: Behavioral Risk Factor Surveillance System (BRFSS), data available for children 0-17 years of age for selected states, 2006 onward (https://www.cdc.gov/brfss/)

Nearly 74% of children aged 0-17 years reported routine checkup visits for their asthma based on 2006–2007 ACBS data analyses findings and those who reported at least one routine checkup visit are more likely to receive self-management education and appropriate medication than those who did not(2).

Healthy People 2020: Respiratory Diseases Objectives (RD-7.6): Increase the proportion of persons with current asthma who have had at least one routine follow-up visit in the past 12 months according to NAEPP guidelines. (https://www.healthypeople.gov/2020/topics- objectives/topic/respiratory-diseases/objectivesExternal)

• Insurance coverage
• Usual source of health care
• Unable to pay medical bills
• Personal doctor

• Count: Number of children aged 0-17 years with current asthma who are currently taking a preventive asthma medication.
• At-risk rate: Percent of children aged 0-17 years with current asthma who are currently taking a preventive asthma medication among all children with asthma.
• Population-based rate: N/A*

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• “The second kind of asthma medication is different from inhalers used for quick relief. It is the preventive kind that is used to protect your lungs and keep you from having attacks. It can be either a pill or an inhaler.
  Is [fill: S.C. name] NOW taking a preventive asthma medication every day or almost every day, less often, or never?” Note: This question is in a period asthma module fielded in 2013.

Benchmark data source:

• National Health Interview Survey (NHIS) periodic modules: 2008, 2013 (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)

• “Has a doctor or other health professional EVER told you that [child’s name] had asthma?” AND
• “Does [child’s name] still have asthma?”

Benchmark data sources:
National: National Health Interview Survey (NHIS), 2001 onward (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)

Approximately 34% percent of persons (31.3% children and 34.4% adults) with current asthma had taken prescription preventive asthma medicine in 2008. Anti-inflammatory medications, especially inhaled corticosteroids are most commonly prescribed preventive asthma medications to control asthma symptoms(2).

• Vital Signs: Asthma prevalence, disease characteristics and self-management education–United States, 2001-2009. MMWR May 6, 2011 / 60(17):547-552

• Overuse of short-acting beta agonists
• Asthma control
• Daytime symptoms
• Nighttime awakenings
• Activity limitation
• Short acting beta agonist use

• Count: Number of children aged 0-17 years with current asthma who were taking a preventive asthma medication every day or almost every day.
• At-risk rate: Percent of children aged 0-17 years with current asthma who were taking a preventive asthma medication every day or almost every day among all children with asthma.
• Population-based rate: N/A*

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• “Is [fill: S.C. name] NOW taking a preventive asthma medication every day or almost every day, less often, or never?”

Benchmark data source:

• National Health Interview Survey (NHIS) periodic modules: 2013 (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)

• “Has a doctor or other health professional EVER told you that [child’s name] had asthma?” AND
• “Does [child’s name] still have asthma?”

Benchmark data sources:
National: National Health Interview Survey (NHIS), 2001 onward (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)

In 2008, 33.5 percent of persons (31.3% children and 34.4% adults) with current asthma had taken prescription preventive asthma medicine(2). Anti- inflammatory medications, especially inhaled corticosteroids are most commonly prescribed preventive asthma medications to control asthma symptoms(2).

• Overuse of short-acting beta agonists
• Asthma control
• Daytime symptoms
• Nighttime awakenings
• Activity limitation
• Short acting beta agonist use

• Count: Number of children aged 0-17 years with current asthma who used more than three canisters of PRESCRIPTION inhaler that gives QUICK relief from asthma symptoms in the past three months.
• At-risk rate: Percent of children aged 0-17 years with current asthma who used more than three canisters of PRESCRIPTION inhaler that gives QUICK relief from asthma symptoms in the past three months among all children with asthma.
• Population-based rate: N/A*

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates

• “DURING THE PAST 3 MONTHS did [PERSON] use more than three canisters of this type of inhaler?”

Benchmark data source:

• National Health Interview Survey (NHIS) periodic modules: 2008, 2013 (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)

• “Has a doctor or other health professional EVER told you that [child’s name] had asthma?” AND
• “Does [child’s name] still have asthma?”

Benchmark data sources:
National: National Health Interview Survey (NHIS), 2001 onward (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)

Respiratory Disease Objective RD-7.4: Increase the proportion of persons with current asthma who do not use more than one canister of short-acting inhaled beta agonist per month according to National Asthma Education and Prevention Program (NAEPP) guidelines. (2,3)

• Note that this indicator differs from “Use of short-acting beta agonists” which measures SABA use according to NAEPP criteria for asthma control (2). SABA overuse, in contrast, specifically addresses excessive use that may be associated with poor outcomes (1).
• Questions asked to determine inhaler overuse in the ACBS include:
  • “Has [he/she] ever used a prescription inhaler?”
  • “In the past 3 months has [child’s name] taken prescription asthma medicine using an inhaler?”
  • “How many canisters of this inhaler has [he/she] used in the past 3 months?” This question was asked for each quick relief medications, but is not available for nebulizers.
• Questions for nebulizers ask about time used per day or per week, which can’t be used to quantify overuse of nebulizers.

• Preventive medication use
• Asthma control
• Daytime symptoms
• Nighttime awakenings
• Activity limitation
• SABA use

• Count: Number of children aged 0-17 years with current asthma who followed the advice of a doctor or health professional to change things at home, school, or work to improve their asthma.
• At-risk rate: Percent of children aged 0-17 years with current asthma who followed the advice of a doctor or health professional to change things at home, school, or work to improve their asthma.
• Population-based rate: N/A*

* This outcome is primarily of interest among persons with asthma—comparisons between groups should account for differences in asthma prevalence, and thus be made using at-risk rates.

• “Has a doctor or other health professional ever advised you to change things in (your/child’s) home, school, or work to improve (your/his/her) asthma?”
• AND response “some/most/all” to “How much of this advice did you follow?”

Benchmark data source:

• National Health Interview Survey (NHIS) periodic modules: 2008 (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)

• “Has a doctor or other health professional EVER told you that [child’s name] had asthma?” AND
• “Does [child’s name] still have asthma?”

Benchmark data sources:

• National: National Health Interview Survey (NHIS), 2001 onward (https://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm)
• State: Behavioral Risk Factor Surveillance System (BRFSS), data available for children 0-17 years of age for selected states, 2006 onward (https://www.cdc.gov/brfss/)

Healthy People 2020: Respiratory Diseases Objectives (RD-7.5): Increase the proportion of persons with current asthma who have been advised by a health professional to change things in their home, school, and work environments to reduce exposure to irritants or allergens to which they are sensitive according to National Asthma Education and Prevention Program (NAEPP) guidelines (http://www.healthypeople.gov/2020/topics-objectives/topic/respiratory-diseases/objectivesExternal).

• The measure is about ever receiving advice to change things in home, school, or work and how much of this advice was followed, but does not measure how long or how effectively the advice was followed.
• Given that those who followed advice are more likely to recall receiving advice, this measure may provide reliable estimates of the number/percentage of children for whom a caregiver recalls receiving advice and making changes in their home, school, or work.

• Routine asthma visits in past year
• Any preventive medication use
• Regular use of preventive medication
• Short acting beta agonist overuse