Acute Lower Respiratory Illness, Childhood Asthma, Pneumonia Childhood, Wheezing Lower Respiratory Illness
Conditions
Brief summary
The goal of this study is to pilot test the feasibility of a mobile health clinical decision support tool called ALRITE for the diagnosis and management of acute lower respiratory illnesses in young children in Uganda. Asthma/wheezing illness, in particular, is underdiagnosed in this setting. The main questions the study aims to answer are: * Are the intervention structure, processes, outcomes, and implementations strategies feasible to conduct in the desired settings? * Does ALRITE increase the diagnosis of wheezing illness among children seen at Ugandan health centers? Researchers will compare outcomes before and after ALRITE deployment to healthcare workers at 4 Ugandan healthcare centers using an interrupted time series design. Study participants are healthcare workers. There will be12 months of baseline data collection ("baseline period"), at the beginning of which healthcare workers will be enrolled at each site. Following the baseline period, health workers will receive ALRITE training and will be encouraged but not required to use ALRITE in clinical care for a 6-month intervention period. Health worker participants will fill out surveys and participate in focus group discussions to provide feedback.
Interventions
OTHERALRITE
ALRITE is a point-of-care mobile health clinical decision support tool designed for use by healthcare workers in Uganda. ALRITE guides the user into entering patient information and provides guideline-concordant recommendations. ALRITE also includes educational videos and weight-based dosing.
Sponsors
University of Washington
National Heart, Lung, and Blood Institute (NHLBI)
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Interrupted time series design, no comparison group
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Healthcare workers employed at each study site with a minimum of 6 months' experience of caring for children with respiratory symptoms in general outpatient care * Completed one of the following training programs: medical officer, clinical officer, nurse, midwife * proficient in reading and speaking English, one of the official languages of Uganda * at least 18 years of age
Exclusion criteria
* inability to read/write English
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Healthcare worker enrollment (study feasibility) | At enrollment | Number of healthcare workers enrolled during the baseline phase and additional healthcare workers who were enrolled during the remaining study period (ex: new hires or transfers) |
| Healthcare worker retention (study feasibility) | From enrollment through study completion, an average of 20 months | Proportion of healthcare workers active in the study over total number enrolled |
| Availability of ALRITE-enabled devices (study feasibility) | Monthly during the intervention period from ALRITE deployment through study completion, an average of 6 months | Proportion of functional devices over number of devices provided to the facility per month |
| ALRITE training completion (study feasibility) | During ALRITE deployment at the end of the baseline period, estimated 1-2 months | Number of ALRITE training sessions completed per site |
| Data completeness (study feasibility) | Monthly from baseline (day 1) through the study completion, estimated 20 months | Percentage of eligible pediatric cases correctly abstracted from the health facility records into the electronic database. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Diagnosis rate of wheezing illness | Monthly from baseline through study completion, estimated 20 months | Diagnosis rates of wheezing illness/asthma among all young children presenting to study sites, as recorded in the health record |
| Diagnosis rate of pneumonia | Monthly from baseline through study completion, estimated 20 months | Diagnosis rates of pneumonia among all young children presenting to study sites, as recorded in the health record |
Countries
Uganda
Contacts
CONTACTJane Edelson
PRINCIPAL_INVESTIGATORLaura Ellington, MD, MS
University of Washington
Outcome results
None listed