This research project is in progress. PCORI will post its findings here within 90 days after our final review is complete. In the meantime, results have been published in peer-reviewed journals, as listed below.
Background: Active teen participation during medical visits is an important way in which teens with asthma can address self-management problems. Prior research has found that teens are not actively involved during their medical visits. One way to increase teen participation is through the use of question prompt lists.
Objectives: This study aims to compare an asthma question prompt list intervention with usual care.
Methods: We will conduct focus groups with providers, parents, and teens from diverse cultural backgrounds to determine how to involve teens during visits and how to improve the question prompt list. We will then develop a short educational video that emphasizes the importance of engaging teens in meaningful conversation during their visits. We will enroll 360 participants with asthma, ages 11 through 17, from four pediatric practices. Teens will be assigned to the intervention or control group. If a teen is in the intervention group:
- the teen and parent will view the short educational video encouraging teen question asking and involvement during visits and
- teens will receive the question prompt lists. We will stratify enrollment and enroll equal numbers of African-American, Hispanic, and white adolescents. Teens’ medical visits will be audiotaped, and they will be interviewed after the baseline visit and 6 and 12 months later.
Patient Outcomes: The primary outcomes are asthma control, self-efficacy in managing asthma, and quality of life. In teens, better asthma management can result in improved asthma control, fewer missed schools days, and better quality of life. The secondary outcomes are the number of questions teens ask during visits, whether providers include teen input in asthma management regimen decisions, teen satisfaction, control medication adherence, number of reported asthma medicine problems, and asthma-related healthcare utilizations. These outcomes are important to teens so they can lead more normal lives when they do not miss school and can participate in sports and other activities.
Patient and Stakeholder Engagement: Teens helped develop the asthma question prompt list that will be used in the study, and teens and their parents will help design the educational video. We will communicate with all stakeholder team members regularly, and stakeholders will participate in all project aspects and attend monthly project meetings.
Anticipated Impact: If our intervention is successful, it will empower teens to be more involved in their health management and improve outcomes. Our research fits into PCORI’s mission because it aims to increase teen engagement during pediatric asthma visits. Improved engagement allows teens to learn how to better manage their asthma and have better health outcomes.