Nancy Cantey Banasiak

Accuracy of asthma information on the world wide web.

PURPOSE An essential component of asthma management is education. Parents often turn to the Internet, a 24-hour source of health information. DESIGN AND METHODS In this descriptive study, two researchers evaluated websites using eight core educational concepts developed by the National Heart, Blood, and Lung Institute (NHLBI) to determine the accuracy of the health information regarding asthma on the Internet. RESULTS Of the 68 websites reviewed, only 6 (8.8%) had accurate and complete information regarding asthma according to NHBLI recommendations. PRACTICE IMPLICATIONS Nurses must be educated regarding the selection of accurate websites on asthma so that in turn, they may educate patients and their families.

Childhood Asthma Practice Guideline Part Three: Update of the 2007 National Guidelines for the Diagnosis and Treatment of Asthma

Journal of Pediatric Health Care The National Asthma Education and Prevention Program (NAEPP) has released updated guidelines for the diagnosis and management of asthma called ‘‘Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma,’’ which can be obtained via the Internet at http://www. nhlbi.nih.gov/guidelines/asthma/ asthgdln.htm (2007). The following is a review of the major changes from the 1997 and select 2002 Expert Panel reports (NAEPP, 2007).

Understanding the Relationship Between Asthma and Sleep in the Pediatric Population

The Centers for Disease Control and Prevention reports that 9.5% of children have been diagnosed with asthma. Sleep disturbances affect 20% to 30% of the pediatric population. The prevalence of nocturnal symptoms of asthma is high, and most children regularly experience nighttime symptoms. Sleep is important for growth and development, and untreated sleep disturbances have adverse effects on school performance, mental health, physical health, and functioning. This review will explore the relationship between asthma and sleep disturbances. Clinicians need to assess children with asthma for sleep disturbance.

Evaluating asthma websites using the Brief DISCERN instrument

Purpose The primary purpose of this study was to examine the quality of sponsored and unsponsored asthma websites using the Brief DISCERN instrument and to evaluate whether the Health On the Net Code of Conduct (HONcode) logo was present, thereby indicating that the site met the criteria. The Internet is an important source of health information for patients and their families. The primary purpose of this study was to examine the quality of sponsored and unsupported asthma websites. A secondary aim was to determine the readability and reading ease of the materials for each website along with the grade level. Methods We queried seven Internet search engines using the keyword “asthma.” The websites were evaluated using the six-item Brief DISCERN instrument and by ascertaining whether the HONcode quality label was present. The websites were also evaluated for readability employing Flesch-Kincaid grade level and Flesch reading ease tools using Microsoft Office Word 2013 software. Results A total of 22 unique websites were included in the study. Approximately 68% of the websites reviewed had a Brief DISCERN cutoff score of ≥16. The overall Brief DISCERN scores ranged from 6 to 30, and the mean score was 17.32 (SD =6.71). The Flesch-Kincaid grade level scores ranged from 2.9 to 15.4, and the average reading grade score was 9.49 (SD =2.7). The Flesch reading ease scores ranged from 17 to 82.7, with a mean reading ease score of 53.57 (SD =15.03). Sites with a HONcode quality label had significantly higher Brief DISCERN scores than those without one (t=2.3795; df=20; p=0.02). Conclusion Brief DISCERN scores revealed that there is quality asthma information for children and their families available on the Internet. The grade level ranged between 2.9 and 15.4 among the websites. However, the mean grade level scores were 9.3–9.89, which is high for the average consumer. Access to accurate information via the Internet, with appropriate readability, may enable pediatric asthma patients and their caregivers to better control and manage asthma.

Community partnership for healthy sleep: Research protocol

Beginning early in life, sleep health, including adequate quality, quantity, and consistent sleep routines, is critical to growth and development, behavior, and mental and physical health. Children who live in economically stressed urban environments are at particular risk for sleep deficiency and its negative consequences. Although efficacious sleep health interventions are available, few address the context of economically stressed urban environments. The purpose of this paper is to describe a two-phase protocol for an ongoing NIH/NINR-funded community-engaged study designed to understand the perspectives of parents, community child care and pediatric health care providers about sleep habits, factors that contribute to sleep and sleep habits, sleep difficulty, and potentially useful sleep promotion strategies among children living in economically stressed urban environments. The social-ecological model guides this study. Phase I employs a convergent mixed-methods design, in which we are conducting semi-structured interviews with parents, childcare providers, and primary health care providers. We are collecting 9 days of objective sleep data (wrist actigraphy) from children who are 6-18 months (n = 15) and 19-36 months of age (n = 15) and parent reports of sleep and sleep-related factors using standard questionnaires. In Phase I, we will use a qualitative descriptive approach to analyze the interview data, and descriptive statistics to analyze the survey and actigraph data. In Phase II, we will use the information to develop a contextually relevant program to promote sleep health. Our long-term goal is to improve sleep health and sleep-related outcomes in these children.

Implementation of the Asthma Control Test in Primary Care to Improve Patient Outcomes

BACKGROUND Asthma is one of the major chronic diseases in the pediatric population, affecting 9.5% of children. The National Heart, Lung, and Blood Institute recommends the use of the Asthma Control Test (ACT) for periodic assessment of asthma control. The purpose of this evidence-based project was to implement the Asthma Control Test screening tool into the primary care practice to improve management of patients with asthma by more accurately addressing asthma control. METHODS The project was a pre- and post-implementation study comparing two different groups of patients with asthma seen at the clinic over 5-week periods. RESULTS After the implementation of the educational program and project, 82.6% of advanced practice registered nurses and 30.7% of pediatric resident physicians used an Asthma Control Test, resulting in identification of 9 (21%) patients who were considered not well-controlled. All (100%) of those children identified as not well-controlled through the Asthma Control Test received an adjustment in their medication therapy. CONCLUSIONS The Childhood ACT and ACT are simple, self-administered, validated questionnaires that can easily be incorporated into a primary care practice to assess the level of asthma control and to identify patients with asthma that is not well controlled.

The Long-Term Effects of Inhaled Corticosteroid Treatment in Children With Asthma

Inhaled corticosteroids (ICS) are the preferred method of therapy for persistent asthma in children, providing the most effective anti-inflammatory treatment available. This article defines treatment with ICS in children and discusses current research findings related to the long-term side effects and safety concerns related to ICS therapy in children with asthma. Major safety concerns associated with long-term treatment with ICS include the potential effect on adrenal function, the inhibition of linear growth and growth velocity, osteoporosis, and ocular disorders. This article describes side effects associated with ICS and implications in pediatric primary care.