RESPONSIVENESS OF THE CHILDREN'S HEALTH SURVEY FOR ASTHMA (CHSA) IN A SAMPLE OF LOW-INCOME, INNER-CITY CHILDREN WITH ASTHMA L Asmussen, L Olson, E Grant, K Arduino, K Weiss. Department of Practice and Research, Center for Child Health Research, American Academy of Pediatrics, Elk Grove Village, IL; Rush Presbyterian St. Luke's Medical Center, Center for Health Services Research, Chicago, IL. Presented as a poster at the 2000 Pediatric Academic Societies? Annual Meeting.

OBJECTIVE: While many newly-developed functional health/quality of life instruments undergo some degree of psychometric testing prior to general public use, information is often lacking about a measure's ability to detect change over time. The purpose of this paper is to assess responsiveness of the CHSA:48, a condition-specific, self-report, functional health measure for parents of children (ages 5-12) with chronic asthma.

DESIGN/METHODS: Data from a longitudinal study were used to test sensitivity of the CHSA:48 to change over time. A total of 34 parents/guardians of children with asthma completed the CHSA:48 during an Emergency Department visit and again 3 weeks later. The sample was largely African American and over half of respondents reported annual incomes <$15,000. Five domain scores were computed from the CHSA:48 -- physical health (PH), activity [child] (AC), activity [family] (AF), emotional health [child] (EC) and emotional health [family] (EF). Raw scale scores were transformed from 0-100 with higher scores indicating better or more positive outcomes.

RESULTS: Baseline mean scale scores for the total sample ranged from a low of 57.1 (Physical Health) to a high of 77.9 (Activity [family]). Internal consistency reliability for each of the scales was high (Cronbach's alpha -- .80 -.92). Matched pairs t-tests among children whose condition was rated as "improved" over time revealed significantly higher scores at follow-up for 4 of the 5 CHSA subscales.

Scale	Baseline M	Follow-up M	t value	p value
PH	52.2	72.2	-5.79	.00
AC	68.1	74.0	-1.26	.11
AF	76.3	85.5	-2.79	.01
EC	72.5	78.1	-1.90	.03
EF	62.9	69.2	-2.76	.01

CONCLUSION: Sensitivity to change in a patient's condition is a key element in health outcome measures. In a pilot test of children enrolled in an ED setting, data suggest that the CHSA:48 is responsive to change over time.