Validation of Asthma Control Assessment Among Urban Adolescents Using the Asthma Control and Communication Instrument (ACCI)

Publication date: Available online 11 October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Sande O. Okelo, Andrew L. Bilderback, Maria Fagnano, Jill S. Halterman

ABSTRACT

Background

NIH guidelines recommend questionnaires to assess asthma control, but there are few self-reported asthma morbidity surveys validated among urban, African American, Hispanic and/or poor adolescents. The ACCI is a 12-item self-reported questionnaire previously validated among a diverse adult population, but not among adolescents.

Objective

To assess the ability of the ACCI to accurately describe asthma control in an urban adolescent population.

Methods

Between November 13, 2014 – March 2, 2017, we collected information using the Asthma Control and Communication Instrument (ACCI), Asthma Control Test (ACT), Pediatric Asthma Quality of Life Questionnaire (PAQLQ), and lung function among a population of adolescents enrolled in a school-based asthma intervention study. The ACCI measure of asthma control was validated by evaluating accuracy (based on receiver operator curve [ROC]), internal reliability and concurrent, discriminative validity.

Results

We collected information on 280 adolescents (mean age 13.4 years; 56% male; 51% African American). ACCI control showed good internal reliability and strong concurrent and discriminative validity with ACT and PAQLQ. The accuracy of the ACCI in classifying adolescents with uncontrolled asthma was good (area under the curve .83; 95% CI 0.79, 0.88).

Conclusions

The ACCI, a clinical tool developed to assist communication about asthma control, has demonstrated strong construct validity as a self-reported questionnaire within an urban, African American and Hispanic sample of adolescents. The ACCI has the potential to assist in the assessment of asthma control in urban, minority and/or poor adolescents.