Asthma Educational Seminar Targeting Medicaid Providers

BACKGROUND: Medicaid-insured children have high risk of asthma but are less likely to receive care in keeping with national guidelines. We targeted providers who care for a large proportion of Medicaid-insured children and presented a 2-session multimedia asthma-education seminar that emphasizes communication and teaching techniques, to enhance providers ’ asthma-care teaching skills. METHODS: Five Medicaid-approved health maintenance organizations recruited pediatric primary-care providers. Providers were surveyed at baseline, 6 months, and 12 months to deter-mine if they reported changes in their use of certain asthma-care communication techniques. RESULTS: Fifty-three of 70 participating providers completed the program and initial survey. They reported that 50 % (median) of their patients were insured by Medicaid. At baseline, providers reported they were very confident of their asthma knowledge; however, they were less confident in interactions with patients/families regarding asthma self-management skills. Providers reported use of written plans less than half of the time. The response rate was 60 % at 6 months and 71 % at 1 year. Twenty-eight providers completed all 3 surveys. They reported significantly more frequent use of communication and counseling techniques that involved patient/parent asthma education and self-management skills at the 6-month point, that were partly sustained at 1 year. Reported pro-vision of written asthma plans to patients had increased significantly at 6 months, but that increase was not sustained at the 1-year point. CONCLUSIONS: The seminar significantly enhanced knowl-edge of specific communication techniques related to asthma-teaching goals and reported use of asthma action plans to enhance self-management skills; however, these practices appear to need frequent reinforcement. Key words: asthma guidelines, inhaled corticosteroids, self-management, asthm