Asthma
Conditions
Keywords
Asthma, Pediatrics, Health Technology, Meaningful Use Stage-3, Web Portal
Brief summary
This study will enroll parents/guardians of children who receive treatment at one of the pediatric primary care practice settings in the Pediatric Research in Office Settings (PROS) network or at the Children's Hospital of Philadelphia's Pediatric Research Consortium (PeRC) network. The study will use an evidence-based conceptual model to study determinants of implementation success, implementation outcomes, and health care outcomes resulting from implementing an already functional, electronic health record (EHR)-linked asthma portal, MyAsthma. The study will measure the portal's feasibility and determine the impact on providing asthma education and fostering patient engagement as well as the ability to collect patient-reported outcomes for children, evaluate medication use and side effects and track parents' preferences and goals.
Detailed description
This study uses a newly published, evidence-based conceptual model to study the determinants of implementation success, implementation outcomes, and health care outcomes resulting from implementing an asthma portal, MyAsthma, in the national, Agency for Health Care Research and Quality(AHRQ)-funded, Center for Pediatric Practice Research and Learning. Technically, the portal will be implemented with 2 innovative approaches that facilitate rapid cycle evaluation in multiple Electronic Health Records (EHRs). Although many patient portals are simple vehicles for transferring information about upcoming appointments, test results or laboratory findings, the asthma portal in this project extends this basic functionality to provide asthma education, collect patient-reported outcomes, evaluate medication use and side effects, and track parents' preferences and goals. Because asthma is an AHRQ priority condition which addresses three AHRQ priority criteria (children, low income, and special health care needs), our study will use this population to focus on stage 3 Meaningful Use (MU3) objectives. It is the hope that by conducting this study, translational knowledge will be gained to make recommendations for practice implementation and actionable policy statements.
Interventions
OTHERMyAsthma Web Portal
Parents will log on to the MyAsthma Web Portal up to three different times over a 6 month period. During each portal visit, parents will be asked to complete a survey which will include questions regarding their views on treatment preferences, goals, asthma control, and medications for their child with asthma.
Sponsors
Agency for Healthcare Research and Quality (AHRQ)
American Academy of Pediatrics
DARTNet Institute
Children's Hospital of Philadelphia
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
For Parents/Guardians: 1. Parent/guardian of a child who: * Is between the ages of 6-12 years old * Has a diagnosis of asthma on his/her problem list at the time of recruitment * Has had an office visit with asthma as a diagnosis within the past 12 months 2. Must be able to speak and read English
Exclusion criteria
For Parents/Guardians: 1. Child has not had an office visit for asthma with in the last 12 months 2. Parent or guardian does not speak or read English
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Difference Between Number of Families Who Adopted MyAsthma Portal Use and Number of Families With Sustained Use | Up to 6 Months | Implementation success was measure by comparing the of the number of enrolled families (parent/guardian) who logged on to the MyAsthma Portal once (adoption) with the number of enrolled families (parent/guardian) who logged on more than once (sustained use). Parents/guardians were asked to log on and complete the same survey on the MyAsthma Portal 3 times during a 6 month period. |
Countries
United States
Participant flow
Recruitment details
Subjects were recruited from 2 practice-based research networks. To ensure low-income children were represented, practices were required to have at least 20% insured by Medicaid or the Children's Health Insurance Program. 9,133 families were invited to enroll.
Pre-assignment details
294 parents/guardians of 294 children consented to participate in the study. Of these, 237 logged onto the MyAsthma portal at least once.
Participants by arm
| Arm | Count |
|---|---|
| MyAsthma Web Portal Sustained Use Subject (parent/guardian) logged on to the MyAsthma Web Portal and completed surveys more than once | 156 |
| MyAsthma Web Portal Adoption Subject (parent/guardian) logged on to the MyAsthma Web Portal and completed surveys only once | 81 |
| Total | 237 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Lost to Follow-up | 81 |
| Overall Study | Withdrawal by Subject | 57 |
Baseline characteristics
| Characteristic | MyAsthma Web Portal Sustained Use | MyAsthma Web Portal Adoption | Total |
|---|---|---|---|
| Age, Continuous | 38.1 years STANDARD_DEVIATION 5.5 | 37.1 years STANDARD_DEVIATION 6.5 | 37.6 years STANDARD_DEVIATION 6 |
| Age, Customized 10-12 Years | 41 participants | 21 participants | 62 participants |
| Age, Customized 6-9 Years | 115 participants | 60 participants | 175 participants |
| Child's Asthma Severity Intermittent | 37 participants | 12 participants | 49 participants |
| Child's Asthma Severity Mild Persistent | 39 participants | 12 participants | 51 participants |
| Child's Asthma Severity Moderate/Severe Persistent | 17 participants | 2 participants | 19 participants |
| Child's Asthma Severity Unknown | 63 participants | 55 participants | 118 participants |
| Medical Practice Setting Rural | 29 participants | 23 participants | 52 participants |
| Medical Practice Setting Suburban | 83 participants | 38 participants | 121 participants |
| Medical Practice Setting Urban | 44 participants | 20 participants | 64 participants |
| Parent Education Bachelor's or Higher | 93 participants | 29 participants | 122 participants |
| Parent Education High School or Less | 17 participants | 17 participants | 34 participants |
| Parent Education Some College/Associates | 46 participants | 35 participants | 81 participants |
| Parent Employment Status Self-Employed | 5 participants | 8 participants | 13 participants |
| Parent Employment Status Unemployed | 15 participants | 9 participants | 24 participants |
| Parent Employment Status Working Outside the Home | 111 participants | 46 participants | 157 participants |
| Parent Employment Status Working Without Pay | 25 participants | 18 participants | 43 participants |
| Parent's Relation to Child Mother | 149 participants | 79 participants | 228 participants |
| Parent's Relation to Child Other | 7 participants | 2 participants | 9 participants |
| Race/Ethnicity, Customized Asian | 4 participants | 0 participants | 4 participants |
| Race/Ethnicity, Customized Black/African American | 48 participants | 21 participants | 68 participants |
| Race/Ethnicity, Customized Other | 7 participants | 4 participants | 11 participants |
| Race/Ethnicity, Customized Unkown | 2 participants | 1 participants | 3 participants |
| Race/Ethnicity, Customized White | 89 participants | 55 participants | 148 participants |
| Sex: Female, Male Female | 71 Participants | 30 Participants | 101 Participants |
| Sex: Female, Male Male | 85 Participants | 51 Participants | 136 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 237 |
| serious Total, serious adverse events | 0 / 237 |
Outcome results
Primary
Difference Between Number of Families Who Adopted MyAsthma Portal Use and Number of Families With Sustained Use
Implementation success was measure by comparing the of the number of enrolled families (parent/guardian) who logged on to the MyAsthma Portal once (adoption) with the number of enrolled families (parent/guardian) who logged on more than once (sustained use). Parents/guardians were asked to log on and complete the same survey on the MyAsthma Portal 3 times during a 6 month period.
Time frame: Up to 6 Months
Population: Analysis population included every subject (parent/guardian) who logged on to the MyAsthma Web Portal at least once.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| MyAsthma Web Portal Sustained Use | Difference Between Number of Families Who Adopted MyAsthma Portal Use and Number of Families With Sustained Use | 156 participants |
| MyAsthma Portal Adoption | Difference Between Number of Families Who Adopted MyAsthma Portal Use and Number of Families With Sustained Use | 81 participants |