Many of the terms included in this glossary were gleaned from several sources. Pediatricadult asthma coalition of new jersey asthma action plans in english, spanish. The childhood asthma control test cact is a validated tool for determining pediatric asthma control. If your score is 19 or less, your asthma may not be controlled as well as it could be. Step 3 take the test to the doctor to talk about your score. Signs breathing faster than normal or trouble breathing. For each question, make sure you read all five possible answers before choosing the. Take the asthma control testtm act for people 12 yrs and. Some things that can trigger an asthma attack include allergies, cold viruses, medicines, dusts, chemicals, exercise or emotions. Asthma control test actadult spanish asthma control test actfor children 411 yrs of age.
Review of systems ros asthma control test actadult. This test will provide a score that may help your doctor determine if your childs asthma treatment plan is working or if it might be time for a change. Take the asthma control testtm act for people 12 yrs and older. The handouts correspond to specific asthma counseling modulesthe core patient education components of the asthma counseling sessions.
In spanish pdf, 72 kb massachusetts adult asthma action plan and care cards. Include the act score in your patients chart to track asthma control. Validation of a spanish version of the childhood asthma control test sc act for use in spain. I think part of it is acid reflux, part of it is allergy, and part of it is asthma so we are going to treat all of it. We evaluated the psychometric properties of the spanish version of the childhood asthma control test sc act for assessing asthma control in children ages 411. The results can help to show the level of control you actually have over your asthma, which may surprise you. Review of systems ros asthma control test act adult. The asthma control test will provide you with a snapshot of how well your asthma has been controlled over the last four weeks, giving you a simple score out of. Test for respiratory and asthma control in kids track under. Each question offers several answers, which are scored on a scale of 0 to 5. Illinois certificate of religious exemption to required immunizations form religiousexemption1015. The survey measures the elements of asthma control as defined by the national heart, lung, and blood institute nhlbi. Control test the asthma control test is a quick test for people with asthma 12 years and older. Recognized by the national institutes of health nih in its 2007 asthma guidelines.
The champs patient education handouts provide concise, visual, takehome information for patients and their families. Perform spirometry at baseline and at least every 1 to 2 years for patients 5 years of age. Continue daily controller medicines and add quickrelief medicines you have any of these. University of michigan hospitals and health centers asthma action plans providing a choice of three different plans by age of the person with asthma. Childhood asthma control test for children 4 to 11. On average, during the past week, how bad were your asthma symptoms when you woke up in the morning. How to take the childhood asthma control test step 1let your child respond to the first four questions 1 to 4. Breathing is easy no cough or wheeze can work and play can sleep all night no daily controller medicines required. Pediatricadult asthma coalition of new jersey asthma action plans in english, spanish, or englishspanish external icon links to electronic fillable forms are on the right side of page. You can control your asthma by knowing the warning signs of an asthma attack, staying away from things that cause an attack, and following your doctors advice. We evaluated the psychometric properties of the spanish version of the childhood asthma control test sc act for. Test for respiratory and asthma control in kids track. Apr, 2020 pediatricadult asthma coalition of new jersey asthma action plans in english, spanish, or english spanish external icon links to electronic fillable forms are on the right side of page. Take the asthma control test for people 12 yrs and older.
Validation of the spanish version of the asthma control test act. This project was designed to utilize pharmacists skills and knowledge to help patients better understand and manage their asthma. Childhood asthma control test for children 4 to 11 ye ars. Development and crosssectional validation of the childhood. Pdf validation of the spanish version of the asthma control test. Test for respiratory and asthma control in kids track under 4 years of age date. There are two quizzes that you can choose from to help identify your asthma control score. Washington state asthma plan 2016 about the asthma plan this updated version of the washington state asthma plan reflects the current landscape of asthma care and management in washington. Spanish guideline on the management of asthma request pdf.
The act is a triedandtested tool made up of five questions you can complete either on or offline. The childhood asthma control test is a way to help your childs healthcare provider determine if your childs asthma symptoms are well controlled. A quick test that provides a numerical score to assess asthma control. It identifies personal best peak flow, levels of symptom severity, and appropriate patient action. How to take the childhood asthma control test step 1let your child respond to. Asthma care pharmacies pharmacists on the utah asthma task force presented the idea of expanding asthma education to the pharmacy, creating asthma care pharmacies. The asthma control test provides a numerical score to help you and your healthcare provider determine if your asthma symptoms are well controlled. Regional asthma management program website writeable pdf asthma action plans in english, spanish, chinese, vietnamese. The spanish version of the c act was found to be a reliable and valid questionnaire for evaluating asthma control in spanish speaking children ages 4 to 11 in spain. Although this glossary is not exhaustive, it reflects an attempt to unify the usage of words that are consistently used in a managed care setting. Asthma action plan national heart, lung, and blood institute.
The asthma control test is a way to help you and your healthcare provider determine if your asthma symptoms are well controlled. The cact is a validated tool to assess asthma control and identify children. Validation of a spanish version of the childhood asthma. Childhood asthma control test for children 4 to 11 years. Instructions for how to implement the asthma counseling modules are provided in the manual.
Asthma asthma is a disease in which the airways into your lungs become narrow and produce mucus. Write the number of each answer in the score box provided. The spanish version of the cact was found to be a reliable and valid questionnaire for evaluating asthma control in spanishspeaking children ages 4. This test will provide a score that may help the doctor determine if your childs asthma treatment plan is working or if it might be time for a change. Validation of a spanish version of the childhood asthma control test scact for use in spain.
Childhood asthma control test for children 4 to 11 years know your score. Privacy foia no fear act oig nondiscrimination accessibility. Study forms, the working questionnaire, and supplemental health. The american lung association supports the asthma control test and wants everyone 12 years of age and older with asthma to take it. Fillintheblank pdf form 1 mb4 pages the 2012 revised dc asthma action plan fillintheblank pdf form is now available in english and spanish based on the national heart, lung, and blood institute s 2007 guidelines for the diagnosis and management of asthma. Care health plan 2 5 things to know about asthma englishspanish l. In this context, validating the spanish version of the questionnaire is crucial, since according to the last phase iii international study of asthma and allergies in childhood isaac report, two out of four countries with the highest prevalence of asthma in children around the world are latin american countries where spanish is the language. Pdf validation of the spanish version of the asthma control.
Less air gets in and out of your lungs, and mucous that your body makes clogs up the airways. Asthma control testtm for teens 12 years and older. The first is the asthma control test act, which is a short quiz for patients 12 years of age and older. Asthma action plan new york state department of health. On average, during the past week, how often were you woken by your asthma during the night.
Assess asthma control at every visit by selfadministered standardized test or verbal history. Pediatricadult asthma coalition of new jersey asthma action plans in english, spanish, or english spanish external icon links to electronic fillable forms are on the right side of page. Among them, the 2017 updated spanish guide to asthma management gema 4. Step 1 write the number of each answer in the score box provided. The pediatric asthma control and communication instrument. The childhood asthma control test cact and the asthma control test act. During an asthma attack, the sides of the airways in your lungs swell and the airways shrink. This form, when completed by health care providers, gives parents and school personnel a written asthma management plan for children. Open these forms online and fill in all the required information before you print them out. If your score is 19 or less, your asthma may not be controlled as well as it.
First signs of a cold exposure to known trigger cough wheeze tight chest coughing at night your asthma is. The asthma control test act is a five question health survey used to measure asthma control in individuals 12 years of age or older. Asthma control test act adult spanish asthma control test act for children 411 yrs of age. The childhood asthma control test is a way to help your childs healthcare provider determine if your childs asthma symptoms are well. Asthma is getting worse cough, wheeze, chest tightness, or shortness of breath, or waking at night due to asthma, or can do some, but not all, usual activitiesorpeak flow. Fillintheblank pdf form 1 mb4 pages the 2012 revised dc asthma action plan fillintheblank pdf form is now available in english and spanish based on the national heart, lung, and blood institute s 2007.
Download the asthma control test below to know your level of control. The washington asthma initiative and the washington state department of health support the plan. Key questions focusing on the past 4 weeks are asked to determine asthma control. It provides a numerical score to help assess asthma controlasthma control test act is. It contains student medication administration authorization. Pdf validation of the spanish version of the asthma control test act. The childhood asthma control test cact and the asthma. Childhood asthma control test for children 4 to 11 years old. Connecticut department of health asthma action plans in pdf and word. Cut points for asthma control tests in mexican background. It will provide you with a snapshot reminder of how well your asthma has been controlled over the last four weeks. The cutoff point scores of 21 or higher indicated a good asthma control and their mcid was 4 points.
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