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Canadian Respiratory Journal
Volume 19, Issue 1, Pages 26-31
Original Article

Evaluation, Modification and Validation of a Set Of Asthma Illustrations in Children with Chronic Asthma in the Emergency Department

Joanie Tulloch,1,2 Régis Vaillancourt,1 Danica Irwin,1 and Elena Pascuet1

1Children’s Hospital of Eastern Ontario, Department of Pharmacy, Ottawa, Canada
2Doctor of Pharmacy Program, Faculty of Pharmaceutical Science, The University of British Columbia, Vancouver, British Columbia, Canada

Copyright © 2012 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


OBJECTIVES: To test, modify and validate a set of illustrations depicting different levels of asthma control and common asthma triggers in pediatric patients (and/or their parents) with chronic asthma who presented to the emergency department at the Children’s Hospital of Eastern Ontario, Ottawa, Ontario.

METHODS: Semistructured interviews using guessability and translucency questionnaires tested the comprehensibility of 15 illustrations depicting different levels of asthma control and common asthma triggers in children 10 to 17 years of age, and parents of children one to nine years of age who presented to the emergency department. Illustrations with an overall guessability score <80% and/or translucency median score <6, were reviewed by the study team and modified by the study’s graphic designer. Modifications were made based on key concepts identified by study participants.

RESULTS: A total of 80 patients were interviewed. Seven of the original 15 illustrations (47%) required modifications to obtain the prespecified guessability and translucency goals.

CONCLUSION: The authors successfully developed, modified and validated a set of 15 illustrations representing different levels of asthma control and common asthma triggers.

PRACTICE IMPLICATIONS: These illustrations will be incorporated into a child-friendly asthma action plan that enables the child to be involved in his or her asthma self-management care.