Using Tailored Videos to Teach Inhaler Technique to Children With Asthma: Results From a School Nurse-Led Pilot Study

doi:10.1016/j.pedn.2016.02.005

Journal of Pediatric Nursing

Volume 31, Issue 4, July–August 2016, Pages 380-389

https://doi.org/10.1016/j.pedn.2016.02.005 Get rights and content

Highlights

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School nurses implemented a tailored asthma video intervention with 25 students.
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Students showed significant improvements in inhaler technique.
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Students' technique improvements were maintained at 1-month follow-up.
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Nurses thought the videos' brevity and positivity were key to its success.

Background

Our purpose was to test whether a tailored inhaler technique video intervention: (1) could be feasibly implemented by school nurses and (2) improve the inhaler technique of children with asthma.

Methods

School nurses recruited a convenience sample of 25 children with asthma (ages 7–17) and assessed their inhaler technique. Children then watched a tailored video that provided: (1) step-by-step feedback on which steps (out of 8) they performed correctly, (2) praise for correctly-performed steps, and (3) statements about why incorrectly-performed steps are important. Nurses reassessed the child's inhaler technique immediately after watching the video and again 1 month later. Non-parametric Wilcoxon signed rank tests were calculated to assess whether children's technique significantly improved from baseline to post-video and baseline to 1-month follow-up. A focus group with the school nurses was conducted post-intervention to discuss feasibility issues.

Results

Children's inhaler technique improved by 1.2 steps (with spacer; p = 0.03) and 2.7 steps (without spacer; p < 0.01) from baseline to post-video. These improvements were maintained at 1-month follow-up. School nurses believed the intervention was feasible to implement and met an important educational need.

Conclusions

A school nurse-led tailored video intervention is feasible to implement and a promising method for improving children's inhaler technique.

Section snippets

Participants

Seven school nurses from seven different schools in volunteered to participate in the pilot study and recruit a convenience sample of children. Children were eligible if they: (a) were 7–17 years old, (b) could speak English, (c) had a diagnosis of asthma in their school medical records, and (d) were currently taking an inhaled medication delivered via metered dose inhaler (MDI).

Inhaler Technique

Prior to the pilot study, school nurses were taught how to assess inhaler technique using a validated training process

Sample Characteristics

School nurses sent study information letters and written consent forms home with 64 children. Of these, 25 returned signed permission forms, yielding a participation rate of 39%. Table 1 presents the demographic characteristics of our child sample. The sample was almost evenly split between males and females, and children were 11.5 years old on average. The majority of children were White and in middle or elementary school. Children had been living with asthma for slightly over 6 years on average.

Discussion

We studied whether a school nurse-led tailored video intervention could improve the inhaler technique of children with asthma. Our hypothesis that children would demonstrate improved technique immediately after watching the video was supported. However, contrary to our hypothesis, children sustained improvements in technique at 1-month follow-up. School nurses believed that the intervention was feasible and met an educational need for their students with asthma. Nurses expressed that

Conclusions

A tailored video intervention can be feasibly implemented by school nurses and can improve the inhaler technique of children with asthma. Because schools offer access to children throughout the year and repeated instruction seems necessary to maintain improvements in children's inhaler technique (Basheti et al., 2007, Carpenter et al., 2015, Kamps et al., 2000), schools may offer an optimal setting for delivering inhaler technique education. A larger randomized control trial is needed in order

Acknowledgments

We would like to thank the school nurses of Buncombe County, NC who participated in the study. We also thank the children and teens who recorded videos for our software program. We would also like to thank Dr. Ceila Loughlin and Dr. Dennis Williams for feedback on the tailored video scripts. We would also like to thank Dr. Mark Weaver for statistical advice. Dr. Carpenter's salary was partially supported by the National Center for Research Resources and the National Center for Advancing

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View full text

Using Tailored Videos to Teach Inhaler Technique to Children With Asthma: Results From a School Nurse-Led Pilot Study

Highlights

Background

Methods

Results

Conclusions

Section snippets

Participants

Inhaler Technique

Sample Characteristics

Discussion

Conclusions

Acknowledgments

Journal of Allergy and Clinical Immunology

Respiratory Medicine

American Journal of Preventive Medicine

Preventing Chronic Disease

Status of childhood asthma in the United States, 1980–2007

Pediatrics

Asthma prevalence, health care use, and mortality: United States, 2005–2009

National Health Statistics Report

Asthma in middle schools: What students have to say about their asthma

Journal School of Health

Human agency in social cognitive theory

American Psychology

Social cognitive theory: An agentic perspective

Annual Review of Psychology

Social media, text messaging, and email—Preferences of asthma patients between 12 and 40 years old

Journal of Asthma

Partners in school asthma management: Evaluation of a self-management program for children with asthma

Journal School of Health

Asthma medication adherence among urban teens: A qualitative analysis of barriers, facilitators and experiences with school-based care

Journal of Asthma

Using videos to teach children inhaler technique: A pilot randomized controlled trial

Journal of Asthma

A model of self-regulation for control of chronic disease

Health Education & Behavior

A school health education program for children with asthma aged 8–11 years

Health Education Quarterly

Using the framework method for the analysis of qualitative data in multi-disciplinary health research

BMC Medical Research Methodology

A web-based, tailored asthma management program for urban African American high school students

American Journal of Respiratory and Critical Care Medicine