Rhode Island Asthma Integrated Response Program
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Asthma |
| Therapuetic Areas: | Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 2 - 12 |
| Updated: | 3/30/2019 |
| Start Date: | November 27, 2018 |
| End Date: | August 31, 2024 |
The study's purpose is to evaluate the RI-Asthma Integrated Response (RI-AIR) Asthma Care
Implementation Program (ACIP). RI-AIR ACIP uses an electronic information system to screen
children with asthma and identify what specific services each child needs based on the
child's asthma symptom and health care status. Our main goal is to see if children experience
better asthma outcomes as a result of participation in the program. We will provide our
intervention to 1500 urban, ethnically diverse children, between 2-12 years old with asthma,
and their families and evaluate whether participating in the program improves children's
asthma outcomes. The second goal is to evaluate how well the program is set up and how we can
make improvements to better serve families of children with asthma. The third goal is to
gather information and advice from community experts so that we can make the program
sustainable.
Families that take part in RI-AIR ACIP will participate in the program over the course of a
year, including participating in the intervention, and brief follow up visits at 3, 6, 9 and
12 months after completing the intervention. All families will complete the CASE program,
which takes place over the course of about 4 weeks and involves in-school asthma education
for school aged children, after-school education sessions for their parents, asthma care
training for school staff, and an evaluation of asthma triggers in the school. Families of
children who have more frequent asthma symptoms and emergency healthcare visits will also
compete the HARP program, a home-visiting program consisting of 3 home visits (over about 6
weeks) that include individualized asthma education and strategies and supplies for
controlling environmental asthma triggers. Both CASE and HARP programs are carried out by
certified asthma educators and community health workers.
Each child's healthcare provider (HCP) and school nurse teacher (SNT) will receive a
standardized, secure email indicating the child is participating in RI-AIR. This email will
include a summary of the child's baseline assessment of asthma control and prior health care
use, and a description of the program. At the conclusion of the child's participation, the
HCP and SNT will receive a summary by secure email summarizing the child's asthma control at
the end of the intervention, services delivered, and referrals made, and for HARP
participants, triggers observed in the home and supplies and referrals provided.
Implementation Program (ACIP). RI-AIR ACIP uses an electronic information system to screen
children with asthma and identify what specific services each child needs based on the
child's asthma symptom and health care status. Our main goal is to see if children experience
better asthma outcomes as a result of participation in the program. We will provide our
intervention to 1500 urban, ethnically diverse children, between 2-12 years old with asthma,
and their families and evaluate whether participating in the program improves children's
asthma outcomes. The second goal is to evaluate how well the program is set up and how we can
make improvements to better serve families of children with asthma. The third goal is to
gather information and advice from community experts so that we can make the program
sustainable.
Families that take part in RI-AIR ACIP will participate in the program over the course of a
year, including participating in the intervention, and brief follow up visits at 3, 6, 9 and
12 months after completing the intervention. All families will complete the CASE program,
which takes place over the course of about 4 weeks and involves in-school asthma education
for school aged children, after-school education sessions for their parents, asthma care
training for school staff, and an evaluation of asthma triggers in the school. Families of
children who have more frequent asthma symptoms and emergency healthcare visits will also
compete the HARP program, a home-visiting program consisting of 3 home visits (over about 6
weeks) that include individualized asthma education and strategies and supplies for
controlling environmental asthma triggers. Both CASE and HARP programs are carried out by
certified asthma educators and community health workers.
Each child's healthcare provider (HCP) and school nurse teacher (SNT) will receive a
standardized, secure email indicating the child is participating in RI-AIR. This email will
include a summary of the child's baseline assessment of asthma control and prior health care
use, and a description of the program. At the conclusion of the child's participation, the
HCP and SNT will receive a summary by secure email summarizing the child's asthma control at
the end of the intervention, services delivered, and referrals made, and for HARP
participants, triggers observed in the home and supplies and referrals provided.
The RI-AIR ACIP is community-based; it addresses community needs and gaps in care by: 1)
enhancing asthma outcomes with services tailored to the child's level of asthma risk, 2)
decreasing family burden by delivering services in homes and the local community, 3)
enhancing communication between school, HCPs, and family, and 4) utilizing the RI-AIR
Information Data System (IDS) to integrate data sources and generate a tailored referral.
This study uses a randomized, stepped wedge trial (SWT) design to evaluate the effectiveness
of the RI-AIR ACIP at both the individual and community levels. In an SWT, groups of
individuals receive the intervention at different time points, the order in which they
receive the treatment is randomized, and data are collected from groups over time.
In this study, groups will be randomized at the community level. Selected high risk
communities are geographic school catchment areas with the highest asthma utilization rates.
High-risk areas will be randomly allocated to the "Step," or year of active trial using a
random numbers table. Thus, the year each catchment area receives intervention (i.e.,
participates in the active trial phase) will be randomized, and all families in this SWT will
participate in both control (standard care) and intervention (active trial). This SWT design
allows us to evaluate both individual-level outcomes as well as community-specific outcomes.
During the active trial phase, families of children with asthma within the randomly selected
communities will receive an asthma intervention. Families of children with asthma will be
assigned to an intervention based on the child's level of asthma control. Individual-level
data will be assessed over the course of the year of the active trial phase, while
community-level data will be assessed annually over the study period.
enhancing asthma outcomes with services tailored to the child's level of asthma risk, 2)
decreasing family burden by delivering services in homes and the local community, 3)
enhancing communication between school, HCPs, and family, and 4) utilizing the RI-AIR
Information Data System (IDS) to integrate data sources and generate a tailored referral.
This study uses a randomized, stepped wedge trial (SWT) design to evaluate the effectiveness
of the RI-AIR ACIP at both the individual and community levels. In an SWT, groups of
individuals receive the intervention at different time points, the order in which they
receive the treatment is randomized, and data are collected from groups over time.
In this study, groups will be randomized at the community level. Selected high risk
communities are geographic school catchment areas with the highest asthma utilization rates.
High-risk areas will be randomly allocated to the "Step," or year of active trial using a
random numbers table. Thus, the year each catchment area receives intervention (i.e.,
participates in the active trial phase) will be randomized, and all families in this SWT will
participate in both control (standard care) and intervention (active trial). This SWT design
allows us to evaluate both individual-level outcomes as well as community-specific outcomes.
During the active trial phase, families of children with asthma within the randomly selected
communities will receive an asthma intervention. Families of children with asthma will be
assigned to an intervention based on the child's level of asthma control. Individual-level
data will be assessed over the course of the year of the active trial phase, while
community-level data will be assessed annually over the study period.
Inclusion Criteria:
- Child age between 2 to 12 years
- Child lives in the identified catchment area
- Child meets screening criteria for current asthma
- Child's asthma status is not well-controlled or poorly controlled
- Caregiver must speak English or Spanish.
Exclusion Criteria:
- Children with complex medical conditions (i.e., requiring on-site medical supervision
of CHW)
We found this trial at
1
site
593 Eddy Street
Providence, Rhode Island 02903
Providence, Rhode Island 02903
401-444-4000
Phone: 401-793-8450
Rhode Island Hospital Founded in 1863, Rhode Island Hospital in Providence, RI, is a private,...
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