Educational video improves spirometry success in preschool children

BACKGROUND: This study investigated the feasibility of performing spirometry without technical errors in preschool children. It also evaluated the effect of an educational intervention on the success rates and duration of spirometry in this age group. METHODS: This randomized controlled study was conducted in Greece during two separate time periods due to the COVID-19 pandemic. The study included 132 children aged 3-6 years who had not previously undergone spirometry. Children who were born prematurely, had neurological disorders and/or developmental delays, or refused to attempt an FVC maneuver were excluded from the study. Participants were randomly allocated to the intervention ( = 65) and control ( = 67) groups. The mean (SD) ages were 4.5 ± 0.88 and 4.6 ± 0.92 years, respectively. The control group received standard verbal instructions, whereas the intervention group watched a short educational video. All spirometry tests were performed by the same operator. RESULTS: The overall success rate of spirometry was 74.2%. Success rates were significantly higher in the intervention group compared with the control group (84.6% vs. 65.7%,  = 0.015). The educational intervention increased the likelihood of achieving successful spirometry by 3.85-fold (OR 3.85, 95% CI 1.5-107,  = 0.05). It also increased the number of acceptable FVC maneuvers and reduced the total time required to complete the test (11.7 ± 6.5 min in the intervention group vs. 16.2 ± 8.6 min in the control group;  = 0.002). The median number of attempts did not differ significantly between the groups. CONCLUSIONS: Spirometry is generally feasible in preschool children; however, a brief educational video can substantially improve the likelihood of successful performance and reduce the time needed to complete the test.