Psychometric properties and predictive validity of the PP-ACT

Shepperd, James A.; Webster, Gregory D.; Pogge, Gabrielle; Fedele, David A.; Prabhakaran, Sreekala; Hunleth, Jean; Waters, Erika A.

doi:10.1080/02770903.2022.2036755

Cited by 5 publications

(6 citation statements)

References 24 publications

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“…Recall that recent studies suggest that the PP-ACT has two components: control of symptoms and impairment and subjective control. 17 , 18 Consistent with prior evidence that the two measures represent different constructs, 17 , 18 we observed a small, negative correlation between these two measures in our sample, r (565) = −0.28, p <0.001. Greater subjective asthma control corresponded with reports of less control over symptoms and impairment.…”

Section: Resultssupporting

confidence: 90%

“…Regarding asthma, caregivers’ gist may or may not arise from specific symptoms their child experiences and can be disconnected from biomedical evidence. Recent research finds that caregivers’ global ratings of their child’s asthma control correlate weakly at best with their reports of symptoms and impairment linked to their child asthma, 17 , 18 suggesting that caregivers’ subjective evaluations or gist regarding their child’s asthma may align poorly with biomedical indicators. Instead, the gist can arise from a variety of contextual factors.…”

Section: Discussionmentioning

confidence: 99%

“…Participants responded to a revised version of the five-item Parent Proxy Asthma Control Test (the PP-ACT), 15 which is based on the Asthma Control Test (ACT) 16 but yields two scores representing caregivers’ evaluation of their child’s asthma control in the past four weeks: a measure of control of symptoms based on the sum of four items (impairment from asthma, shortness of breath, sleep disruption, and albuterol use), and a one-item measure of subjective control that represents the caregivers’ global, subjective judgment of their child’s asthma control. 17 Higher scores indicate greater control. We report results for these two forms of asthma control for descriptive purposes only.…”

Section: Methodsmentioning

confidence: 99%

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Caregiver Perceptions of Change in Pediatric Asthma Control During the COVID-19 Pandemic

Pogge¹,

Waters²,

Webster³

et al. 2022

JAA

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Although several indicators suggest that pediatric asthma control in the United States improved early in the pandemic, other indicators suggest not. Missing are reports from caregivers of the experiences of their children with asthma early in the pandemic. Methods: Using the PP-ACT and other measures that we specifically constructed for our research, we conducted a cross-sectional national survey of US caregivers of children with asthma (N=595) to examine perceived change in their child's asthma control and changes in reports of ED visits and use of emergency relief medicine and controller medicine pre-pandemic (January to March 2020) versus early-pandemic (June to September 2020). Results: Caregivers fell into three groups: most caregivers perceived that their child's asthma control was improved (50.3%) or unchanged (41.2%), and few reported worse control (8.5%). Surprisingly, all three groups of caregivers reported similar frequencies of early-pandemic and pre-pandemic ED visits and use of emergency relief medicine. Also surprising, caregivers who perceived their child's asthma as more controlled (compared with the other two groups) reported more frequent ED visits and use of emergency relief medicine, yet also more use of controller medicine at both early-pandemic and pre-pandemic. Conclusion:The mismatch between caregivers' perceptions of their child's early-pandemic asthma control and their reports of ED visits and use of emergency relief medicine suggests that caregivers may rely on a gist (a global evaluation that can include nonbiomedical evidence) when estimating their child's asthma control. Caregivers and their families could benefit from help from clinicians in understanding the discrepancy between subjective asthma control and asthma control indicators and in understanding what well-controlled asthma looks and feels like.

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Section: Resultssupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Caregiver Perceptions of Change in Pediatric Asthma Control During the COVID-19 Pandemic

Pogge¹,

Waters²,

Webster³

et al. 2022

JAA

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“…Consistent with recent research (Przybyszowski et al, 2021;Shepperd et al, 2022), the first four PP-ACT items showed high inter-correlations (rs from 0.57 to 0.66), yet lower correlations with the fifth item (rs from 0.34 to 0.42). As a result, we examined the fifth item (which we labeled subjective control) separately from the first four items (which we summed and labeled asthma control).…”

Section: Discussionsupporting

confidence: 90%

Linking cognitive and affective heuristic cues to interpersonal risk perceptions and behavior

et al. 2023

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People often use cognitive and affective heuristics when judging the likelihood of a health outcome and making health decisions. However, little research has examined how heuristics shape risk perceptions and behavior among people who make decisions on behalf of another person. We examined associations between heuristic cues and caregivers’ perceptions of their child's asthma risk, the frequency of caregivers’ asthma management behaviors, and child health outcomes. We used Ipsos KnowledgePanel to recruit 814 U.S. adult caregivers of children with asthma of the age <18 years. Participants completed a survey at baseline (T1) and 3 months later (T2). Caregivers who, at T1, reported greater negative affect about their child's asthma (affect heuristic cue), greater ease of imagining their child experiencing asthma symptoms (availability heuristic cue), and greater perceived similarity between their child and a child who has ever experienced asthma symptoms (representativeness heuristic cue) reported statistically significantly (p < 0.05) higher interpersonal perceived risk of their child having an exacerbation or uncontrolled asthma at T1. They also indicated at T2 that their child had poorer asthma control and more frequent exacerbations. Greater T1 negative affect was associated with more frequent T2 actions to reduce inflammation, manage triggers, and manage symptoms, and with poorer T2 child health outcomes. Heuristic cues are likely important for interpersonal—not just personal—risk perceptions. However, the interrelationship between caregivers’ ratings of heuristic cues (in particular, negative affect) and risk judgments may signify a struggle with managing their child's asthma and need for extra support from health care providers or systems.

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“…We edited the items to improve clarity and to ensure that the items assessing shortness of breath and albuterol use shared the same response options. Consistent with recent research [ 23 , 40 ], we summed the 4 items assessing symptoms and impairment as a measure of asthma control. We labeled the responses to the fifth item as subjective control.…”

Section: Methodsmentioning

confidence: 99%

Exploring Caregiver Interest in and Preferences for Interventions for Children With Risk of Asthma Exacerbation: Web-Based Survey

Pogge¹,

Fedele²,

Waters³

et al. 2023

JMIR Form Res

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Background Maintaining control of asthma symptoms is the cornerstone of asthma treatment guidelines in the United States. However, suboptimal asthma control and asthma exacerbations among young people are common and are associated with many negative outcomes. Interventions to improve asthma control are needed. For such interventions to be successful, it is necessary to understand the types of interventions that are appealing to caregivers of children with different levels of risk of exacerbation. Objective This study aimed to evaluate whether caregivers of children with high (vs low) risk of asthma exacerbation show different levels of interest in and preferences for potential intervention programs and delivery methods. Methods We contracted with Ipsos to administer a web-based survey to caregivers of children with asthma who were residing in the United States. Caregivers (N=394) reported their interest (1=not at all; 3=a lot) in 9 possible intervention programs and 8 possible intervention delivery methods. Caregivers also indicated their preferences by selecting the 3 intervention programs and 3 delivery methods that “most” interested them. Finally, caregivers completed 2 open-ended questions asking what other resources might be useful for managing their children’s asthma. We classified children as having a high risk of exacerbation if they had an exacerbation in the past 3 months (n=116) and a low risk of exacerbation if otherwise (n=278). Results Caregivers reported higher levels of interest in all intervention programs and delivery methods if they cared for a child with a high risk rather than a low risk of exacerbation. However, regardless of the child’s risk status, caregivers expressed the highest levels of interest in programs to increase their child’s self-management skills, to help pay for asthma care, and to work with the school to manage asthma. Caregivers expressed the highest levels of interest in delivery methods that maintained personal control over accessing information (websites, videos, printed materials, and smartphone apps). Caregivers’ preferences were consistent with their interests; programs and delivery methods that were rated as high in interest were also selected as one of the 3 that “most” interested them. Although most caregivers did not provide additional suggestions for the open-ended questions, a few caregivers suggested intervention programs and delivery methods that we had not included (eg, education about avoiding triggers and medication reminders). Conclusions Similar interests and preferences among caregivers of children with high and low risk of exacerbation suggest a broad need for support in managing childhood asthma. Providers could help caregivers by directing them toward resources that make asthma care more affordable and by helping their children with asthma self-management. Interventions that accommodate caregivers’ concerns about having personal control over access to asthma information are likely to be more successful than interventions that do not.

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Psychometric properties and predictive validity of the PP-ACT

Cited by 5 publications

References 24 publications

Caregiver Perceptions of Change in Pediatric Asthma Control During the COVID-19 Pandemic

Caregiver Perceptions of Change in Pediatric Asthma Control During the COVID-19 Pandemic

Linking cognitive and affective heuristic cues to interpersonal risk perceptions and behavior

Exploring Caregiver Interest in and Preferences for Interventions for Children With Risk of Asthma Exacerbation: Web-Based Survey

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