This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow [QuickTime Videos]
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Rich, M.
Right arrow Articles by Schneider, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Rich, M.
Right arrow Articles by Schneider, L.
Related Collections
Right arrow Allergy & Dermatology

PEDIATRICS Vol. 105 No. 3 March 2000, pp. 469-477

VIDEO RESEARCH:
Asthma in Life Context: Video Intervention/Prevention Assessment (VIA)

Received Aug 19, 1999; accepted Nov 15, 1999.

Michael Rich*, Steven Lamola*, Colum Amory*, and Lynda SchneiderDagger

From the * Divisions of Adolescent/Young Adult Medicine and Dagger  Immunology, Children's Hospital/Harvard Medical School, Boston, Massachusetts.

Objective.  Video Intervention/Prevention Assessment (VIA) was developed to determine whether medical information gathering might be augmented by video diaries created by patients to show clinicians the realities of managing chronic disease in the contexts of their lives.

Design.  Children and adolescents who met National Heart, Lung, and Blood Institute criteria for moderate or severe asthma were enrolled from an urban pediatric hospital and an inner-city health center. Comprehensive, asthma-specific medical histories were obtained from study participants in standard clinical interviews. Participants were trained to use video camcorders and recorded visual narratives of how they lived with and managed their asthma over a 4- to 8-week period. These visual narratives were screened by a trained observer, who completed the initial comprehensive medical history based solely on viewing the video. Information from participants' medical history interviews was compared with observations of their visual narratives.

Results.  Twenty young people 8 to 25 years old completed the VIA Asthma study. Important variations were found between participants' medical history interviews and their visual narratives. All 20 participants reported specific environmental triggers for their asthma; 19 had 1 or more of these triggers documented on video in their daily living environments (video illustrations online, available at: www.pediatrics.org). Exposures to known triggers ranged from 25% (noxious fumes) to 91% (mold). Exposure to tobacco smoke that was denied in the interview was revealed on video in 63%. The 18 participants who revealed medication use in their visual narratives were assessed for adherence: 33% exceeded prescribed doses, 28% discontinued medications without consulting a clinician, and 72% used ineffective inhaler technique.

Conclusions.  VIA visual narratives extended a comprehensive, standard of care medical history, yielding a more complete and accurate understanding of exacerbating environmental exposures and inappropriate medication usage of children and adolescents with asthma. VIA is an effective tool for revealing the physical and psychosocial environments in which young people live with disease. Patient-created video can enrich our understanding of the illness experiences of children and adolescents. VIA has the potential to enhance clinical data gathering, guide the development of more effective and sensitive management strategies, and educate clinicians about the realities of the young person living with illness.  Key words:  asthma, adherence, environment, medical history, video, qualitative research.




This article has been cited by other articles:


Home page
 PediatricsHome page
M. T. Clarke
Pediatrics on the Web: 10 Years of Innovation and Discovery
Pediatrics, April 1, 2007; 119(4): 661 - 669.
[Abstract] [Full Text] [PDF]

Home page
 American Behavioral ScientistHome page
M. Rich
Health Literacy via Media Literacy: Video Intervention/Prevention Assessment
American Behavioral Scientist, October 1, 2004; 48(2): 165 - 188.
[Abstract] [PDF]

Home page
 J Pediatr PsycholHome page
D. J. Bearison, N. Minian, and L. Granowetter
Medical Management of Asthma and Folk Medicine in a Hispanic Community
J. Pediatr. Psychol., June 1, 2002; 27(4): 385 - 392.
[Abstract] [Full Text] [PDF]

Home page
 AAP NewsHome page
S. Wallace
Innovative technology contributes to better asthma management
AAP News, May 1, 2001; 18(5): 216 - 216.
[Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
R S Cane and S A McKenzie
Parents' interpretations of children's respiratory symptoms on video
Arch. Dis. Child., January 1, 2001; 84(1): 31 - 34.
[Abstract] [Full Text]