• Measured within 4 weeks: Follow-up with an asthma care provider
  

• Measured at Month 6: Return ED asthma visit
  
• Measured at Week 4 and Month 6: Persistent asthma symptoms
  
• Measured at Week 4: ED visit Controller prescription by PCP
  
• Controller medication use
  
• Days of school/work missed
  
• Measured at Week 4 and Months 3 and 6: Peak expiratory flow
  
• Quality of life
  

BACKGROUND:

Inner-city children are particularly at risk for poor asthma treatment outcomes and frequently obtain their asthma care in the ED. Prior studies have had limited success in improving primary care follow-up, quality of care, and long-term outcomes after a pediatric ED visit for asthma. Prior ED-based interventions have been designed to address barriers to follow-up with a primary care provider (PCP) such as an inability to obtain a follow-up appointment or lack of transportation. Focus groups and surveys of inner-city families have found that beliefs about the benefits of follow-up care and the role of preventive asthma medications have a strong impact on adherence to therapy.

DESIGN NARRATIVE:

This study will develop a brief educational video about the benefits of follow-up asthma care using a multi-disciplinary panel of experts at the Children's Hospital of Philadelphia and focus groups of parents of children with asthma. This educational video will then be combined into an intervention along with symptom screening and a reminder phone call that has been demonstrated to improve follow-up rates in a previous study. The combined intervention will be tested using a randomized trial design to determine its efficacy on healthcare utilization, asthma controller medication use, symptoms, and quality of life during the 6 months following an ED visit. The research is conducted as part of a research career development award.