Development and Evaluation of an Instrument to Measure Reasoning About Managing Asthma in Older School-Age Children and Adolescents

Abstract

Background and Purpose This article describes development and evaluation of a 4-scenario instrument designed to measure reasoning abilities for managing asthma symptoms. Methods Existing literature informed creation of a reasoning template and the reasoning scenarios. Think-aloud interviews appraised scenario functionality. Experts assessed content validity. Data from 2 groups of students with asthma aged 9–15 years (N = 132 and 307) were used to evaluate psychometric properties. Results The scenarios were deemed functional, content was relevant, and readability was age/grade appropriate. Cronbach’s alpha was 0.79. Exploratory and confirmatory factor analyses indicated a single component solution and revealed a good fit. Concurrent validity was established using correlations with asthma knowledge. Conclusion The instrument could be used to assess reasoning about symptom management and to evaluate educational interventions.

Comparative Effectiveness on Cognitive Asthma Outcomes of the SHARP Academic Asthma Health Education and Counseling Program and a Non‐Academic Program

“…Caregivers completed the General Health History Survey (Kintner, , 2009) and four additional instruments not reported here. Students completed the Knowledge of Asthma Survey (Kintner, ), the Reasoning about Asthma Scenarios (Kintner et al, ), and three additional instruments not reported here.…”

“…This four‐scenario information processing survey completed by students, titled “What I Would Do,” was used to measure reasoning abilities for managing asthma symptoms (Kintner et al, ). Students are directed to read each scenario and then respond to eight questions by circling the most appropriate response option(s).…”

“…In this model, education and counseling programs enhance a student’s knowledge of asthma (Kintner, 1996); reasoning about asthma symptom management, defined as introspective thinking through which situations are examined and options are considered (Kintner, 1997; Kintner, Cook, Hull, & Meeder, 2013); psychosocial acceptance of asthma and beliefs about the nature of asthma; and use of effective self-care behaviors. Knowledge of asthma is the foundation that enables students to reason about asthma symptom management, and that in turn influences psychosocial and behavioral factors that decrease asthma severity and improve condition control, use of healthcare services, school attendance, and quality of life outcomes, including participation in various life activities.…”

“…SHARP (Kintner & Sikorskii, ; Kintner et al, ; Kintner, Cook, Marti, Allen et al, ; Kintner, Cook, Marti, Gomes et al, ) is based on the acceptance of asthma model (AAM) that was developed through a series of qualitative and quantitative studies (Kintner, , , , ) from an ecological approach (Bronfenbrenner, ) within a lifespan development perspective (Lerner, , ; Santrock, ; Sugarman, ). In this model, education and counseling programs enhance a student's knowledge of asthma (Kintner, ); reasoning about asthma symptom management, defined as introspective thinking through which situations are examined and options are considered (Kintner, ; Kintner, Cook, Hull, & Meeder, ); psychosocial acceptance of asthma and beliefs about the nature of asthma; and use of effective self‐care behaviors. Knowledge of asthma is the foundation that enables students to reason about asthma symptom management, and that in turn influences psychosocial and behavioral factors that decrease asthma severity and improve condition control, use of healthcare services, school attendance, and quality of life outcomes, including participation in various life activities.…”

Triangulation approach to developing, evaluating, and applying the evolving theory of adolescent acceptance of asthma

“…Although reasoning about asthma symptom management was identified as an essential part of the process of coming to accept asthma as a chronic condition, 35 more information was needed to operationalize the concept. Findings of a second qualitative think‐aloud study were used to develop the Reasoning about Asthma Scenarios 50 . We later added the Asthma Control Test 52 as a valid measure of asthma control.…”