Acceptability of applying asthma action plan for asthma patients at a hospital in Hochiminh City, Vietnam: an implementation research

Objectives: The asthma management strategy at respiratory departments in Vietnam so far does not include the implementation of an asthma action plan (AAP). This study aimed to implement an AAP in the hospital and analyze the acceptability for the implementation procedures of patients, clinicians and asthma management units. Methods: The implementation consisted of 2 phases. Phase 1 was a cross-sectional design that combined quantitative and qualitative methods to assess the asthma control and analyse potential obstacles of the hospital for AAP implementation. Phase 2 was a pre-experimental design to assess the acceptability in implementing the APP. Asthma control was assessed by GINA’s criteria. Implementation strategies included interventions at both organization (issued a procedure and a guideline of consulting the AAP for patients) and individual levels (trained doctors in counseling and monitoring of AAP for patients; provided instruction leaflets of APP for patients). Results: The proportion of asthma sufficient control was 59%, partial control was 30.8%, and insufficient control was 10.2%. Most of obstacles related to asthma management and control were of health facility, such as no concrete procedures in monitoring, insufficiency of infrastructure, overload of patients. Implementation strategies of AAP in this study got the acceptability of patients, clinicians and asthma management units. Conclusion: The study showed the importance of deployment of AAP for asthma patients in Vietnam hospitals. It is essential to provide more staffs for the asthma and COPD management units, especially trained nurses. Keywords: Asthma Action Plan; implementation research; Vietnam, acceptability; asthma control.

Health literacy levels and its determinants among people with asthma in Malaysian primary healthcare settings: a cross-sectional study

Background Limited health literacy among people with asthma is associated with poor adherence to self-management activities, thus poor clinical outcomes. This study aimed to determine the prevalence of health literacy level and its determinants among people with asthma in the Malaysian primary healthcare settings. Method A cross-sectional study was conducted among participants aged > 18 years with asthma who attended five primary health clinics in Malaysia. Systematic random sampling was employed with a final sample of 550 participants. The questionnaires included the validated Malay version of Health Literacy Scale (HLS) and asthma control questionnaire (ACQ). Statistical analysis was done using SPSS version 25. Multiple logistic regression was performed to determine the determinants for limited health literacy. Results The participants mean age of the participants was 48 (SD15.4) years. Most of the participants were women (64%) and of Malay ethnicity (51.1%). Nearly half had a secondary level of education, n = 112, (45.8%). Mean duration of asthma diagnosis is 20.6 (SD 15.9) years. More than half (62.5%) had a family history of asthma. About half (50.9%) had uncontrolled asthma, with 87.3% self-rated themselves as having controlled asthma. About a third (29.1%) received education on of asthma action plan, but only 7.1% of these owned a written version an asthma action plan. Limited health literacy accounts for 60.5% of the participants. The significant determinants for limited health literacy included lower educational attainment (p < 0.001), family history of asthma (p = 0.034), < 20 years duration of asthma diagnosis (p = 0.031) and not receiving asthma action plan education (p < 0.001). Conclusion In this study population, more than half of the people living with asthma were found to have limited health literacy, which was associated with not having received self-management education supported by an asthma action plan. Future interventions should include strategies that ensure they meet the needs of people with limited health literacy.

Cross-section of self-reported asthma triggers on children with asthma in China: data from smartphone-based Chinese Children's Asthma Action Plan

The authors have requested that this preprint be removed from Research Square.

Formative Evaluation for Implementation of a Low Literacy Pictorial Asthma Action Plan Delivered via Telehealth Improves Asthma Control

Consistently uncontrolled asthma in children is an increasing concern in the United States. The use of asthma action plans with asthma education is inconsistent and may be improved with adaptations for low literacy. The objective of this study was formative evaluation for implementation of the New Mexico Pictorial Asthma Action Plan (NM PicAAP). Quality improvement processes guided NM PicAAP face validation and telehealth direct patient care implementation. The asthma control test was selected to measure asthma control. NM PicAAP was revised for face validity, and training curriculum on its use and telehealth implementation processes were developed. Seven youth received NM PicAAP via telehealth direct care, which increased overall asthma control scores over 1 month. NM PicAAP may be useful and effective for improving asthma care in children via telehealth. Additional testing is needed to assess applicability.