544 - Using the Health Belief Model to Understand Readmissions to the PICU for Status Asthmaticus

Poster Number: 544
Publication Number: 544.242

Talia Kozlowski, University of Maryland Children's Hospital, Baltimore, MD, United States; Laura C. Murnane, University of Maryland School of Medicine, Baltimore, MD, United States; Adrian Holloway, University of Maryland Children's Hospital, Baltimore, MD, United States

Background: Asthma is the leading cause of pediatric hospitalizations and accounts for 20% of Pediatric Intensive Care Unit (PICU) admissions. Children with asthma who have multiple PICU admissions are at high risk of life-threatening status asthmaticus and presumed to have poorly-controlled asthma.

Objective: The aim of this study is to use constructs of the Health Belief Model namely perceived susceptibility, perceived severity, perceived barriers, and self-efficacy to understand parental perceptions of asthma in children who have been readmitted to the University of Maryland Medical Center (UMMC) PICU.

Design/Methods: Using a mixed-methods approach, parents or guardians of children ages 4-12 who were readmitted to the UMMC PICU for status asthmaticus participated in a survey and phone interview on their child’s asthma. The survey had 30 items on a Likert scale addressing knowledge of and attitudes towards asthma, understanding of asthma medications, and asthma follow up. The phone interview expanded on these themes including asthma history and triggers, and barriers to asthma care such as healthcare and pharmacy access, financial constraints, and provider communication and discharge coordination.

Results: Ten parents participated in the survey and nine parents participated in the phone interview. Perceived susceptibility of asthma was moderate and self-efficacy was high, but perceived severity was low. Smoking was identified as a general trigger of asthma in the surveys, but not as a personal trigger during the interviews even with tobacco use at home. Perceived barriers were rarely identified including insurance issues, medication proficiency and adherence, provider communication, hospital discharge planning, COVID-19, and primary care and pulmonology follow up.Conclusion(s): Despite readmission to the UMMC PICU for status asthmaticus, most parents reported strong asthma literacy, proper adherence to medications, and few barriers to care. They believed their child's asthma to be fairly well-controlled and felt confident in their ability to care for their child’s asthma. Future initiatives should focus on parental education on asthma severity and tobacco cessation, and explore avenues for brief interval follow ups to reduce risk of readmission to the ICU.
Perceived BarriersParental perceived barriers to asthma care on a Likert Scale of 1-5