Children with Asthma
Hospital Emergency Departments
Asthma Education Program
Jones PK, Jones SL, Katz J. Improving compliance for asthmatic patients visiting the emergency department using a health belief model intervention. J Asthma 1987; 24(4):199-206.
The emergency department or discussion via telephone
Children and adults with asthma presenting to an emergency department with an acute attack
An asthma education program, based on the Health Belief Model, designed to increase the likelihood participants will make and keep follow-up appointments after a visit to the emergency room.
An initial assessment of the role of demographic and situational factors on patients’ compliance rates with appointment referrals was conducted. In response, an asthma education program was developed to increase how patients perceived their susceptibility to acute asthma episodes, the seriousness of an episode, the risks associated with an episode and the benefits of preventing an episode by making and keeping referral appointments. The program was tailored for participants based on individual assessments of perceived risk and benefits. A shorter version of the education program was also conducted via telephone 1-2 days after discharge from the emergency room.
A randomized control study
Patients were randomly assigned to three treatment groups and one control group. The extent of compliance was assessed by calling the agency to which patients were referred to find out if appointments were made and kept. All patients were subsequently contacted via phone by a nurse. Data were also collected on individual demographic and situational factors that might influence compliance.
74 asthmatic patients randomly assigned to four groups: (1) routine nursing care, (2) routine care in the ER with a follow up phone intervention, (3) education during ER visit with no follow up intervention, and (4) education during the ER visit and a follow up phone intervention.
The primary outcome measures were the number of follow-up referral appointments made and kept. Patients receiving any of the interventions were more likely to make (91% vs. 43%) and keep appointments (75% vs. 10%) than the control group. Other findings suggest that females were more likely to make appointments, and people over age 30 were more likely to make and keep appointments. In addition, patients whose primary health problem was rated as serious were more likely to make and keep appointments, as were those patients with low need for childcare. The telephone intervention was almost as effective as the education program in the ER; consequently, it may be the more effective approach in terms of cost-benefit.
Availability of Protocol/Materials:
The protocol and materials are not available for widespread distribution.