DNP 851B Module 2 Describing the Sample and Baseline Measures Example

Who Took Part and Where They Started: The Sample and Baseline Measures of a Pediatric Asthma Project

Student Name

Doctor of Nursing Practice Program, Aspen University

DNP 851B: Project Data Analysis

Instructor Name

Month Day, Year

Who Took Part and Where They Started: The Sample and Baseline Measures of a Pediatric Asthma Project

Before any result can be read, the reader needs to know who the participants were and where they started. This paper describes the sample and baseline measures for my DNP project, a clinic nurse program that paired each child's written plan with coaching on the inhaler and a link to school. It presents the characteristics of the 91 children with complete data, reports their baseline asthma control, inhaler technique and acute care use, compares the sample with national figures and explains what the baseline means for the analysis to come. All figures come from the locked data set.

Characteristics of the Sample

The table describes the 91 children included in the paired analysis. Continuous variables are reported as means with standard deviations and categorical variables as counts with percentages.

Baseline Asthma Control

Because children were assessed with age-appropriate instruments, baseline control is reported separately for each. The 62 children aged 5 to 11 completed the Childhood Asthma Control Test, scored from 0 to 27, on which 19 or less indicates inadequately controlled asthma (Liu et al., 2007). Their mean baseline score was 16.1 (SD 3.9). The 29 children aged 12 to 17 completed the Asthma Control Test, scored from 5 to 25 with the same cut point (Nathan et al., 2004). Their mean baseline score was 17.0 (SD 3.6). Combining the two by the shared cut point, 19 of 91 children, or 21%, had well-controlled asthma at baseline, and 72 did not.

Baseline Technique and Acute Care

Before any teaching at the enrollment visit, 17 of the 91 children, or 19%, completed at least 9 of the 10 steps on the spacer technique checklist. The most common errors were not shaking the inhaler, not breathing out before the puff and breathing in too quickly. Over the 12 weeks preceding enrollment, 17 of the 91, or 19%, had been seen at least once in an emergency department or urgent care center for asthma, 21 visits altogether. Among all 104 enrolled children, the corresponding figures were 19 children and 23 visits.

Taken together, these figures describe children whose asthma was affecting daily life and whose care depended heavily on the emergency department, the pattern a primary care program is meant to change.

The Excluded Thirteen

The 13 enrolled children without paired scores are not part of the table, but they are part of the sample story. Their mean age was 10.1 years, five of their families preferred Spanish, and three were uninsured, a higher share than among the 91. Nine had a baseline control score, with a mean of 16.0, close to the included children's combined mean of 16.4. They remain in the acute care analysis, where data are complete for all 104. Chapter four will present their characteristics beside those of the 91 in a supplementary table, so that a reader can judge for themselves whether their absence is likely to have shifted the control results in either direction.

How the Sample Compares

National survey data offer a point of comparison. A federal report drawing on national survey data found asthma more common among children living in low-income families, and described declines over time in asthma attacks and acute care among children with asthma alongside a rise in the share with an action plan (Zahran et al., 2018). The project's sample is poorer than the national population of children with asthma, with most children covered by Medicaid, and a large share of families prefer Spanish. Only 30% had a documented action plan in the year before enrollment, which confirms the gap the project was designed to close. These features limit how far the results can be generalized to other populations but make them directly relevant to similar safety-net clinics.

Differences by Age Group

Older and younger children differed in ways that matter for interpretation. Adolescents were more likely to have a controller prescribed, 24 of 29 against 40 of 62, and slightly more likely to have correct technique at baseline, 7 of 29 against 10 of 62. Younger children were more often accompanied by a Spanish-speaking parent. Because the two age groups used different tests, the analysis will report change in score separately by test and combine them only through the shared cut point for control.

Sex did not differ meaningfully between the age groups, and neither did insurance type.

Neither group was large enough for separate tests.

What the Baseline Means for the Analysis

Three features of the baseline shape the analysis. First, most children began with poorly controlled asthma, so there was room to improve, but that also raises the risk of regression to the mean, since children are often seen when symptoms are worse. The paired analysis will therefore be read alongside the acute care comparison with the same calendar weeks of the previous year. Second, technique was poor for most children before teaching, which makes the change in technique an important process result. Third, nearly a third of children had no controller prescribed, so some improvement may reflect new prescriptions at or after the visit rather than the nurse intervention itself; the analysis will report how many children had a controller started during follow-up.

Conclusion

The 91 children in the analysis were mostly school-age, publicly insured and, in two cases of five, from Spanish-speaking families. Most had poorly controlled asthma, poor inhaler technique and no recent written plan when they enrolled, and about one in five had needed acute care in the previous 12 weeks. That starting point makes the program's potential benefit large and makes careful interpretation essential.

The next module turns to the tests that will measure that change.

References

Liu, A. H., Zeiger, R., Sorkness, C., Mahr, T., Ostrom, N., Burgess, S., Rosenzweig, J. C., & Manjunath, R. (2007). Development and cross-sectional validation of the Childhood Asthma Control Test. Journal of Allergy and Clinical Immunology, 119(4), 817-825. https://doi.org/10.1016/j.jaci.2006.12.662

Nathan, R. A., Sorkness, C. A., Kosinski, M., Schatz, M., Li, J. T., Marcus, P., Murray, J. J., & Pendergraft, T. B. (2004). Development of the Asthma Control Test: A survey for assessing asthma control. Journal of Allergy and Clinical Immunology, 113(1), 59-65. https://doi.org/10.1016/j.jaci.2003.09.008

Zahran, H. S., Bailey, C. M., Damon, S. A., Garbe, P. L., & Breysse, P. N. (2018). Vital signs: Asthma in children, United States, 2001-2016. MMWR. Morbidity and Mortality Weekly Report, 67(5), 149-155. https://doi.org/10.15585/mmwr.mm6705e1