Asthma, Children, Quality of Life
Conditions
Keywords
Pediatric Asthma, Low-income, Arkansas Delta Region
Brief summary
The overall goal of this proposal is to examine the efficacy of a school-based asthma telemedicine intervention in a predominately minority, low-income rural pediatric population.
Detailed description
A total of 1110 subjects will be enrolled in this research study. Five hundred forty (540) subjects will be between the ages of 7-14 years. The remaining 540 subjects will be comprised of the primary caregiver of the participants. Thirty (30) school nurse/s providing care to the 270 intervention participants will also be enrolled in the study. To test our hypotheses, the investigators will conduct a cluster randomized trial with 540 children, ages 7-14 years and their parent/guardian(s), to address the following specific aims: Specific Aim 1: Examine the efficacy of a school-based asthma telemedicine intervention in improving asthma-related health outcomes in an intervention group compared to children receiving usual care. Specific Aim 2: Determine the effects of a school-based asthma telemedicine intervention on asthma self-management skills of intervention caregivers and participants compared to a usual care group. The investigators will compare changes in asthma self-efficacy, quality of life, and knowledge between groups. Specific Aim 3: Determine the cost of the intervention in relation to health outcomes.
Interventions
OTHERAsthma Education Sessions
Comprehensive asthma education sessions delivered via telemedicine.
OTHERAsthma Health Assessment via Telemonitoring
Each intervention participant will undergo assessment of asthma via school-based telemonitoring to measure lung function and provide a self-report of asthma symptoms.
OTHERProvider Treatment Prompt
A treatment prompt will be mailed to the primary care provider at baseline and 3 months.
OTHERSchool Absenteeism
Absenteeism before and after the intervention will be compared in the intervention group and also will be compared to absentee rates of the usual care group.
OTHERPrescription Filling Profile
Study personnel will monitor participants' prescription profiles.
Sponsors
National Heart, Lung, and Blood Institute (NHLBI)
University of Arkansas
Arkansas Children's Hospital Research Institute
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
7 Years to 14 Years
Healthy volunteers
Yes
Inclusion criteria
The investigators will recruit students (ages 7-14 years) with asthma who are currently enrolled in public school districts located in the Delta region of Arkansas. Eligibility of identified children will be determined by a brief telephone survey. The survey questions will determine if the child fulfills inclusion/
Exclusion criteria
. 1. Age ≥ 7 and ≤ 14 years. 2. Use of asthma medications for acute relief of symptoms (rescue) or for control of symptoms (preventive) in the past 6 months. Children not on a controller who report using a rescue medication only for prevention of exercised-induced symptoms will not be eligible for the study. 3. Physician-diagnosed asthma by parent/caregiver report. OR 4. In the absence of a formal physician diagnosis, the caregiver must report symptoms consistent with at least mild persistent asthma. The investigators will use asthma screening criteria to ensure that participants meet eligibility requirements. Participants must establish a history of episodic airflow obstruction or airway hyperresponsiveness and meet National Heart Lung and Blood Institute (NHLBI) guidelines for persistent asthma. Mild persistent asthma will be defined as any 1 of the following during the prior 4 weeks (by caregiver report): * An average of \> 2 days per week with asthma symptoms * \> 2 days per week with rescue medication use * \> 2 nights per month awakened with nighttime symptoms * Minor limitation of activity * ≥ 2 episodes of asthma during the past year that have required systemic corticosteroids
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Symptom Free Days | The number of symptom-free days (SFD) during the prior 2 weeks assessed at the end of the intervention. | Examine the efficacy of a school-based asthma telemedicine intervention. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Secondary Clinical Outcomes | Secondary outcomes will be measured during the intervention, at the end of the intervention and at 6-month follow-up. | Secondary clinical outcomes will be measured at specific time points during the intervention. |
Countries
United States
Outcome results
None listed