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Asthma Quiz for Kidz


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Introduction

The Asthma Quiz for Kidz is a simple, self-administered questionnaire that correlates with the physician’s assessment of asthma control and is easily completed by school-aged children and by parents of younger children aged 1 to 6 years. It was validated for use by children aged 7 to 17 years and parents of preschool-aged children. It is written in a grade 2 language (for 7 years and older). This tool is primarily intended for monitoring a child’s asthma control and for serving as a communication tool between the child, his/her parents, and their health care professional(s).

Purpose

  • To promote accurate self-awareness of asthma control in school-aged children with asthma and parents of preschool-aged children.
  • To serve as a clinical tool for health care professionals to accurately identify the level of asthma control in children and adolescents.
  • To serve as a teaching tool to instruct children, adolescents and their parents about asthma control.

Development and validation

The Asthma Quiz for Kidz was developed using the standard Kirshner and Guaytt's approach for instrument development. The instrument development was derived from the asthma control criteria proposed by the Asthma Consensus Statement in 2003 and still valid in the latest update in 2012.

The six clinical criteria for asthma control were phrased as question and response options, and pre-tested for clarity. The clarity of the Asthma Quiz for Kidz was tested with cognitive interviews in asthmatic children 7 to 17 years of age and their parents who were interviewed separately, and in parents of children aged 1 to 6 years. Participants were asked to read each question and response option aloud, and prompted to “think aloud” while choosing their answer. Each language version was translated and back translated to ensure concordance between both the English and French versions. Editorial changes occurred until concordance was achieved. Several iterative versions were produced until at least 85% clarity was achieved regarding the questions, response options, and interpretations. The fourth and final version of the questionnaire was called, “The Asthma Quiz for Kidz.”1 Using the back-translation technique, we simultaneously designed and tested the French and English versions.

The score was compared with asthma physicians’ rating of asthma control based on history, physical examination, and pulmonary function tests when available.1 The Asthma Quiz for Kidz is a valid, reliable, and responsive measure of asthma control; it correlates with physician assessment of asthma control.

Instrument

The Asthma Quiz for Kidz is a 6-item questionnaire including:

  1. Daytime symptoms less than four days/week;
  2. Night time symptoms less than one night/week;
  3. Use of rescue β2 agonist less than four times/week;
  4. Normal physical activity;
  5. No school absenteeism due to asthma in the preceding 30 days; and
  6. No exacerbation requiring an unscheduled medical visit in the preceding 30 days.

Each criterion is phrased in the form of a question.

Interpretation

All response options are scaled as "yes" (1 point) or "no" (0 points), for a maximum score of 6, assuming an equal weight for each variable.

  • A score of 0 or 1 indicates good asthma control.
  • A score of 2 or more is suggestive of poor asthma control and should prompt patients to consult their physicians.

The Asthma Quiz for Kidz may provide complementary information but does not replace lung function testing.

Clinical use

The Asthma Quiz for Kidz is currently used for assessing asthma control in several paediatric asthma clinics across the Province of Quebec, including:

  • And across asthma education centres of the province of Quebec
    • Contact person: Patricia Côté, Réseau québécois de l’enseignement sur l’asthme et la MPOC [Quebec Network for asthma and COPD education]: www.rqam.ca.

Research use

The Asthma Quiz for Kidz has been used as a research instrument to assess asthma control.1,2,3 Its usefulness as a means to recognise and take action in case of poor asthma control has been tested in a randomized controlled trial.4

Original and validated language

  • English
  • French

Other language non-validated

  • European Portuguese
  • Belgium French
  • American Spanish

References

  1. Ducharme FM, Davis GM, Noya F, Rich H, Ernst P. The Asthma Quiz for Kidz: A validated tool to appreciate the level of asthma control in children. Can Respir J 2004;11:541-6. http://www.ncbi.nlm.nih.gov/pubmed/15611802
  2. Ducharme FM, Ochs HD, Resendes S, Zhang X, Mazer DB. A short burst of oral corticosteroid for children with acute asthma – Is there an impact on immunity? Pediatr Asthma Allergy Immunol. 2010, 23(4): 243-252. http://online.liebertpub.com/doi/abs/10.1089/ped.2010.0041
  3. Ducharme FM, Zemek R, Chalut D, McGillivray D, Noya FJ, Resendes S, Khomenko L, Rouleau R, Zhang X. Written action plan in pediatric emergency room improves asthma prescribing, adherence and control. Am J Resp Crit Care Med. 2011 (183)195-203. http://www.ncbi.nlm.nih.gov/pubmed/20802165
  4. Ducharme FM et al. Randomised Controlled Trial of a Multi-faceted Community-based Intervention to Improve Asthma in Children. NCT00238888. http://www.clinicaltrials.gov/ct2/show/NCT00238888 

©2004 Francine Ducharme
Permission for research use: Francine Ducharme

©2004 Francine Ducharme

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Updated on 6/2/2016
Created on 6/2/2016
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