Validation of an Asthma Knowledge Tool to Assess the Efficacy of Comprehensive Asthma Education

Asthma is a leading cause of chronic disease in children, and poor control is often associated with a lack of asthma knowledge, which can be improved through education. Thus, it is important to have a validated tool that measures asthma knowledge. We aimed to develop an asthma knowledge tool to assess the efficacy of comprehensive asthma education for caregivers of children with asthma.

An asthma knowledge tool was designed using existing questionnaires and pilot tested amongst 10 asthma experts and 20 parents who had previously received asthma education. The Children's Hospital of Eastern Ontario Asthma Knowledge Tool (CHAT) consists of 35 true/false questions. The CHAT was then prospectively administered to caregivers between June 2021 and 2023 before receiving education, < 7 days following education, and < 2 weeks after completing posttest 1. Internal responsiveness of the CHAT was measured by comparing pre- and posttest scores using paired t-tests and determining effect size. Test-retest reliability was calculated using the two-way mixed effect Intraclass correlation coefficient (ICC) for posttest scores.

Mean CHAT scores amongst 129 participants increased by 6.2 points between pretest to posttest 1 (95% CI 5.4-7.0), with an estimated effect size of 1.2, indicating a large change (p < 0.001). Test-retest reliability was "good" to "excellent" with an estimated ICC of 0.85 between posttests.

The CHAT exhibited good discrimination, and reliably measured a significant improvement in knowledge scores following asthma education. The CHAT is a validated asthma knowledge tool for caregivers of children with asthma, having implications for future quality improvement and research studies.