This prospective pilot study will use a quasi-experimental design, a time series, pretest-posttest, to test an intervention for health care providers in rural clinics in an effort to increase adherence to the National Asthma Education and Prevention Program (NAEPP) guidelines, and ultimately improve asthma outcomes in children. Preliminary data will be gathered to determine if there is a difference in asthma outcomes (pulmonary function, disease-specific quality of life, and number of asthma exacerbations) for school age children, using the patients as their own controls. Several rural clinics in the Piedmont Region of Virginia will be accessed. Compared with urban Americans, rural residents have higher poverty rates, tend to be in poorer health, have fewer doctors, hospitals, and other health resources. The NAEPP Guidelines are considered the """"""""gold standard"""""""" in asthma care but are consistently underutilized. Ting introduced the Multicolored, Simplified, Asthma Guideline Reminder (MSAGR) as a practical tool to enhance adherence to asthma guidelines. It is a color-coded, algorithmic guide that incorporates the NAEPP guidelines. The proposed intervention targets self-efficacy by providing a visual cue, increasing knowledge, building mastery experience, and saving time for the practitioner. The child will perform spirometry and the parent will complete the quality of life measure at the time of five sequential clinic or home visits. A medical record review will provide number of exacerbations. Analysis methods will include repeated measures ANOVA and paired t tests. This intervention targets self-efficacy of the clinician, and should change behavior. Increasing adherence to the guidelines should improve clinical outcomes in asthma treatment for children. ? ?
