Reliable Method Developed for Measuring Asthma Symptoms in Latino

A new Spanish-English scale for measuring the control of asthma
symptoms in low-income Latino children has been developed, tested and
found reliable in a study led by Marielena Lara, M.D., M.P.H., of the
UCLA/RAND Program on Latino Children with Asthma. Peter Gergen, M.D.,
of the Agency for Healthcare Research and Quality's Center for
Primary Care Research, was a co-author of the study.

Asthma is increasing rapidly among children. Between 1980 and 1994,
for example, asthma among children in the United States 5 to 14 years
of age increased by 74 percent, and the disease is the most common
chronic illness affecting Latino children. But few reliable measures
exist for measuring the severity and frequency of asthma's symptoms
in non-English-speaking and low-literacy populations, in spite of
findings that language and literacy levels can affect the reliability
and validity of survey measures.

The eight-item instrument asks parents, in English and Spanish, to
indicate the frequency of their child's symptoms on a scale ranging
from "every day" to "never," and it includes a "don't know" response.
The symptoms listed are: coughing, wheezing, shortness of breath,
asthma attacks and chest pain. The instrument also asks parents to
indicate how often their child has been awakened at night because of
asthma during the previous four weeks, and to indicate their overall
rating of the severity of their child's asthma.

The symptom scale was tested by interviewing parents of 234 inner-
city children treated for asthma in an emergency department at the
time of their initial visit and one month later. About 69 percent of
the children, whose average age was nine, were identified by their
parents as being Latino. Over half (54 percent) the interviews of
parents about their children's symptoms were conducted in Spanish;
the rest were conducted in English. There were no major differences
in the reliability and validity of the responses between the Spanish-
and English-speaking parents.

Details are in "An English and Spanish Pediatric Asthma Symptom
Scale," published in the March 2000 issue of the journal, Medical
Care. For more information, please contact AHRQ Public Affairs, (301)
594-1364: Karen Migdail, (301) 594-6120 ([log in to unmask]).


Isabelle Melese-d'Hospital, Ph.D.
Research Specialist
Emergency Medical Services for Children National Resource Center
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