Improving Pediatric Asthma Control: A Storybook Initiative

Between 2009 and 2013, Davis County combined asthma prevalence rate increased from the Utah state average of 8.6% to 9.5%, the highest in the state. Pediatric patients account for 25% of total asthmatics, but accrue over 50% of total emergency room (ER) visits and hospitalizations for asthma exacerbations. The cost of controlled asthma is one-half of that of uncontrolled asthma. Quality of life is significantly greater among those with controlled asthma compared to those with uncontrolled asthma. Low patient and caregiver knowledge about asthma is the largest barrier to asthma control. Asthma education reduces asthma exacerbations, ER use, and improves selfmanagement. Education that includes priority topics that are outlined in the National Heart Lung & Blood Institute's Expert Panel Report 3 (EPR3) produce optimal improvements in asthma control. Interactive, multimedia education materials with colorful illustrations are very effective in pediatric patients. Storybook format provides vicarious experience that pediatric patients are more likely to retain than other educational formats. There is a lack of complete materials that are engaging for children and accessible to families with low socioeconomic status. The aim of this project was to create a free educational storybook on pediatric asthma control for residents of Davis County, Utah. The objectives of this project were to first create an educational storybook addressing priority content and using an appropriate health literacy level. The second objective is to distribute the created resource in a way that is accessible to families with low socioeconomic status and to health care providers. The third objective was to disseminate the findings to peers. The storybook manuscript was created using the topics recommended in the EPR3 guidelines, The Global Initiative for Asthma (GINA) guidelines, and expert review. Collaboration with an artist, health literacy expert, and Spanish translator was undertaken to create a first draft. A pilot study was then performed to test the knowledge gain and utility of the storybook in pediatric asthma patients. The storybook was then distributed in digital format through the Davis County Health Department (DCHD) web site and also on the Google Play online marketplace. An application was also submitted to the Annual Snowbird NP/PA Conference to disseminate the findings of this project to peers. How To Tame Your Asthma is a pediatric asthma educational resource that is both accessible and appropriate for pediatric asthmatics. The resource has a 3.2 Flesch-Kincaid readability score, a 1st person antagonist and storyline, engaging illustrations, and built in retention questions on priority topics. The storybook has been well received and has been integrated into the Davis County Health Department and Utah Health Departments asthma and clean air programs.