Asthma management is only 50% in the overall population, and the adolescent/young adult population is one of the worst asthma subpopulations for asthma management.

1. Catherine Lu
November 2012
cglu@stanford.edu
Use your inhaler!
Getting an asthmatic college
The student to take the prescribed
Goal daily preventative inhaler once
a day in the morning

2. The Problem
• Overall good asthma medication
management is estimated at around only
50% of asthmatics
• Adolescent/young adults are one of the
most difficult asthmatic subpopulations to
treat
Source: Adherence and Asthma Control with Mometasone Furoate versus Fluticasone Propionate in
Adolescents and Young Adults with Mild Asthma. Friedman et al. Journal of Asthma, 47:994–1000, 2010

3. How could we motivate a
college student to use a
preventative inhaler daily?

4. Very effective in getting Sam to take daily asthma inhaler
Sam places her inhaler
Sam takes her next to her toothbrush
Sam becomes a mentor for inhaler daily for
a young asthmatic (e.g. the next week Sam inputs a daily
through a volunteer club) phone reminder to
Sam joins an asthmatics Sam puts a sign on her use her inhaler
Sam keeps track of the group on campus door to remind herself
longest streak for using to use her inhaler
her inhaler, and rewards Sam hears personal stories
Sam makes a pact with herself (e.g. by shopping: about benefits of using a
No way. We can’t get Sam to do this
an asthmatic friend to preventative inhaler Sam inputs a Google
# days x $5) calendar reminder
Yes! We can get Sam to do this
use a daily inhaler
Sam signs up for a to use her inhaler
Sam signs up for an online
rewards system
Sam attends forum for asthmatics
Sam researches where she gets Sam watches a video
a summit for prizes for reporting
benefits of using a about benefits of using
asthmatics taking medication
preventative inhaler a preventative inhaler
Sam thinks “I’m
Sam becomes a awesome” each time
campus advocate for she uses her inhaler Sam asks asthma questions
healthy behaviors at her next doctor’s visit
Sam makes a verbal
promise to her parents to
use her inhaler daily Sam watches a video
Sam buys a year-supply of about how to use an
the preventative inhaler Sam joins a inhaler properly
newsletter for
asthmatics
Sam takes an
immunology class
Sam tells herself that
where she learns
using the inhaler allows
about asthma
her to be healthier
Not effective in getting Sam to take daily asthma inhaler

5. We pick one behavior goal and
think of possible ways to get there.
Sam gets a phone call from parents Sam sees flyer in the dorm with
worried about her asthma management information about managing asthma
Parents suggest putting inhaler in an Sam reads benefits of a daily inhaler and
obvious place so that she will take it suggestions to improve management
Goal: Sam places her inhaler next to her toothbrush
Email suggests placing Sam receives an asthma Friend suggests Sam to
inhaler next to her brochure suggesting placing place her inhaler next
toothbrush inhaler next to toothbrush to her toothbrush to
Email tells Sam benefits remember
Doctor strongly recommends
of taking daily inhaler Sam to take a daily inhaler A friend tells Sam
Sam receives an email about benefits of taking
Sam is sent to the ER
from the school health daily inhaler
center Sam gets an asthma attack

6. We pick one route to the behavior
goal and test it out.
Sam gets a phone call from parents Sam sees flyer in the dorm with
worried about her asthma management information about managing asthma
Parents suggest putting inhaler in an Sam reads benefits of a daily inhaler and
obvious place so that she will take it suggestions to improve management
Goal: Sam places her inhaler next to her toothbrush
Email suggests placing Sam receives an asthma Friend suggests Sam to
inhaler next to her brochure suggesting placing place her inhaler next
toothbrush inhaler next to toothbrush to her toothbrush to
Email tells Sam benefits remember
Doctor strongly recommends
of taking daily inhaler Sam to take a daily inhaler A friend tells Sam
Sam receives an email about benefits of taking
Sam is sent to the ER
from the school health daily inhaler
center Sam gets an asthma attack

7. Trial Run
• I ask an asthmatic dormmate who lives down the hall
to describe his current asthma management (none)
• I explain benefits of a daily preventative inhaler,
which he already owns
• He explains wanting to use his inhaler more often
• We come up with a plan for him to place his inhaler
next to his toothbrush
• We set a goal for a week of preventative inhaler use

8. Trial run results: from 0 use
to 5 times in the past week

9. Insights
• A little education followed by simple
request seems to work
• May be more difficult if person is not
motivated after education to use a daily
inhaler or does not have a daily inhaler
• Asking in-person is not scalable; next step
is to see if this works without a personal
connection (via email, flyering, etc.)