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Objective: Learning the critical elements that should be included in a comprehensive measure reflecting the key concepts underlying asthma self-management for adolescents is important to ensure the transfer of optimal care to adolescents. This review identifies and evaluates adolescent self-reported measures for asthma management in experimental and quasi-experimental studies. Data Sources: Eighteen studies were identified using CINAHL, Nursing Allied Health Prevention, Medline, ProQuest, and PubMed databases. Search terms were based on the National Library of Medical subject headings (MeSH terms) and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Study Selections: Studies included were peer-reviewed and published in English between 2010-2022. Experimental and quasi-experimental studies that used asthma measures for children and adolescents between 10 and 19 years old were considered to identify high-quality, validated measures. Results: In total, 18 studies were included, comprised of 14 experimental and four quasi-experimental. This review revealed six major concepts: quality of life, disease control, self-efficacy, knowledge, attitudes, and asthma self-management. The review found an apparent heterogeneity of measures and a deficiency of comprehensive measurements focused on actual ASM behaviors. Conclusion: A comprehensive measure was not uncovered; therefore, the development of a reliable and valid comprehensive asthma measure is necessary to assess adolescents’ asthma self-management abilities and to evaluate the essential components of educational interventions. In terms of assessment and evaluation, research studies and clinical practices would greatly benefit from a standardized measure that encompasses the identified major concepts.

Identification of patients with asthma at increased risk for hospitalization and emergency department (ED) visits presents opportunity for intervention.Retrospective analysis of computerized health plan claims data.Texas Children's Health Plan, a large Medicaid managed care program, developed an asthma risk scoring algorithm using the clinically relevant parameters of hospitalization for asthma, ED visits for asthma, short-acting β agonist medication dispensing, inhaled corticosteroid medication dispensing, number of prescribing providers, loss to follow-up, and oral corticosteroid dispensing. The risk score performance was evaluated using 2016-2018 risk scores to predict 2017-2019 asthma hospitalizations and ED visits.We identified 107,811 unique members aged 1 to less than 18 years with an asthma diagnosis. For those aged 3 to less than 18 years, the area under the receiver operating characteristic curve (AUC) for risk score predicting hospitalization ranged from 0.72 to 0.79. For those aged 1 to less than 3 years, the AUC ranged from 0.65 to 0.69. Those with a risk score of 1 or greater accounted for 20% to 23% of pediatric members 3 to less than 18 years with asthma but 53% to 56% of asthma hospitalizations in the follow-up year. Sixteen to eighteen percent of those aged 3 to less than 18 years with a risk score of 9 or greater were hospitalized in the follow-up year.Texas Children's Health Plan asthma risk score stratifies risk of asthma hospitalization and ED visits for Medicaid-insured children. The risk score performs better for children aged 3 to less than 18 years than for those aged 1 to less than 3 years.

This study examined control of environmental tobacco smoke (ETS) exposure in the home by new mothers and identified factors related to the establishment of home smoking control rules. Pregnant women who, at 28 weeks gestation, reported they had not smoked in the past 28 days were enrolled in a randomized smoking cessation study. Telephone interviews were conducted at 6 weeks, 3 months, 6 months, and 12 months postpartum. A Home Smoking Control Index, composed of four items (whether the mother smokes in the home, the partner smokes in the home, other household smokers are asked to smoke outside, and visitors who smoke are asked to smoke outside), was used to classify homes as having a home smoking policy in effect, no policy or an incomplete policy, or no policy needed. Sociodemographic variables and maternal self-efficacy were examined in relation to the index data among 325 women who had need to exercise control of smoking in the home: 63% had a home smoking policy in effect at 3 months, 60% at 6 months, and 64% at 12 months postpartum. Predictors of policy at 6 and 12 months included (a) having a policy in effect at the previous assessment, (b) confidence in limiting infant ETS exposure in the home, and (c) perceived difficulty in preventing exposure. Early establishment of a policy appears to be important for ensuring sustained infant ETS avoidance over time. The index measures key actions that influence infant exposure and warrants further testing for use in intervention trials.