Asthma in Children
Conditions
Keywords
Asthma self-management, Asthma in Children
Brief summary
The goal of this study is to improve health equity in children aged 5-16.9 years admitted to the PICU for asthma. The objectives are: * To identify the factors related to differential experiences of asthma self-management * To pilot the effectiveness of an individualized asthma navigator intervention at PICU discharge.
Detailed description
Despite available asthma treatments, nearly 50% of children with asthma experience exacerbations annually, with disadvantaged children, particularly Black and Hispanic, being the most affected. These disparities are largely due to social determinants of health (SDOH), including socioeconomics and family hardship, which explain over 80% of the racial disparities in asthma outcomes. Children in lower opportunity neighborhoods face additional challenges like poor housing and limited green spaces, increasing exposure to pollutants and allergens. At Children's Healthcare of Atlanta's Pediatric ICU (PICU), 85% of asthma admissions come from low-opportunity areas, with 36.7% having another exacerbation within a year. Significant barriers to better outcomes include limited provider understanding of SDOH and challenges in asthma self-management. Effective asthma self-management, supported by medical providers, is crucial for improving health outcomes in these disadvantaged children.
Interventions
BEHAVIORALThe asthma navigator
The asthma navigator is a Registered Respiratory Therapist and Certified Asthma Educator who will review the care plan at discharge and provide asthma education; assist with follow-up clinic appointment scheduling, medication access, and transportation; and daily as-needed telephone support.
Sponsors
Emory University
Georgia Clinical & Translational Science Alliance
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Masking description
The study team and participants will not be blinded but statistical analyses will be performed in a blinded fashion using allocations of "Intervention A" and "Intervention B." Randomization will be implemented 2:1, in blocks of 6, via a computer algorithm to minimize unintentional imbalances between groups.
Eligibility
Sex/Gender
ALL
Age
5 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
* Admitted to the PICU for asthma
Exclusion criteria
* Cystic fibrosis * Immune deficiency * Prematurity \<35 weeks * Gestation and congenital airway deformities * Non-English speaker
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Future unscheduled healthcare utilization for asthma exacerbation | Baseline, end of study (average of 52 weeks) | The occurrence of unscheduled healthcare utilization and the date and time of occurrence will be assessed through weekly screenings of each child's EMR at Children's (Epic system). |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORAnne Fitzpatrick, PhD, APRN
Emory University
Outcome results
None listed