Design of a community-based, Hybrid Type II effectiveness-implementation asthma intervention study: The Rhode Island Asthma Integrated Response (RI-AIR) program.

Community intervention program Effectiveness and implementation Home-based intervention Hybrid Type II Pediatric asthma School-based intervention

Journal

Contemporary clinical trials
ISSN: 1559-2030
Titre abrégé: Contemp Clin Trials
Pays: United States
ID NLM: 101242342

Informations de publication

Date de publication:
06 2023
Historique:
received: 01 12 2022
revised: 18 04 2023
accepted: 19 04 2023
medline: 29 5 2023
pubmed: 24 4 2023
entrez: 23 04 2023
Statut: ppublish

Résumé

Pediatric asthma is among the most common health conditions and disproportionately impacts Black and Latino children. Gaps in asthma care exist and may contribute to racial and ethnic inequities. The Rhode Island Asthma Integrated Response (RI-AIR) program was developed to address current limitations in care. The aims of the RI-AIR Hybrid Type II effectiveness-implementation trial were to: a) simultaneously evaluate the effectiveness of RI-AIR on individual-level and community-level outcomes; b) evaluate implementation strategies used to increase uptake of RI-AIR. In this manuscript, we outline the design and methods used to implement RI-AIR. School-based areas (polygons) with the highest asthma-related urgent healthcare utilization in Greater Providence, R.I., were identified using geospatial mapping. Families with eligible children (2-12 years) living in one of the polygons received evidence-based school- and/or home-based asthma management interventions, based on asthma control level. School-based interventions included child and caregiver education programs and school staff trainings. Home-based interventions included individualized asthma education, home-environmental assessments, and strategies and supplies for trigger remediation. Implementation strategies included engaging school nurse teachers as champions, tailoring interventions to school preferences, and engaging families for input. A total of 6420 children were screened throughout the study period, 811 were identified as eligible, and 433 children were enrolled between November 2018 and December 2021. Effective implementation of pediatric asthma interventions is essential to decrease health inequities and improve asthma management. The RI-AIR study serves as an example of a multi-level intervention to improve outcomes and reduce disparities in pediatric chronic disease. NCT03583814.

Sections du résumé

BACKGROUND
Pediatric asthma is among the most common health conditions and disproportionately impacts Black and Latino children. Gaps in asthma care exist and may contribute to racial and ethnic inequities. The Rhode Island Asthma Integrated Response (RI-AIR) program was developed to address current limitations in care. The aims of the RI-AIR Hybrid Type II effectiveness-implementation trial were to: a) simultaneously evaluate the effectiveness of RI-AIR on individual-level and community-level outcomes; b) evaluate implementation strategies used to increase uptake of RI-AIR. In this manuscript, we outline the design and methods used to implement RI-AIR.
METHODS
School-based areas (polygons) with the highest asthma-related urgent healthcare utilization in Greater Providence, R.I., were identified using geospatial mapping. Families with eligible children (2-12 years) living in one of the polygons received evidence-based school- and/or home-based asthma management interventions, based on asthma control level. School-based interventions included child and caregiver education programs and school staff trainings. Home-based interventions included individualized asthma education, home-environmental assessments, and strategies and supplies for trigger remediation. Implementation strategies included engaging school nurse teachers as champions, tailoring interventions to school preferences, and engaging families for input.
RESULTS
A total of 6420 children were screened throughout the study period, 811 were identified as eligible, and 433 children were enrolled between November 2018 and December 2021.
CONCLUSIONS
Effective implementation of pediatric asthma interventions is essential to decrease health inequities and improve asthma management. The RI-AIR study serves as an example of a multi-level intervention to improve outcomes and reduce disparities in pediatric chronic disease.
CLINICAL TRIALS REGISTRATION NUMBER
NCT03583814.

Identifiants

pubmed: 37088129
pii: S1551-7144(23)00127-1
doi: 10.1016/j.cct.2023.107204
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT03583814']

Types de publication

Clinical Trial Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

107204

Subventions

Organisme : NIMH NIH HHS
ID : T32 MH019927
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54 GM115677
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL138677
Pays : United States

Informations de copyright

Copyright © 2023. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of Competing Interest No authors have competing interests to disclose.

Auteurs

Grace K Cushman (GK)

Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; Bradley-Hasbro Children's Research Center, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI, USA.

Daphne Koinis-Mitchell (D)

Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; Bradley-Hasbro Children's Research Center, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI, USA; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA.

Miosotis Alsina (M)

Bradley-Hasbro Children's Research Center, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI, USA.

David Barker (D)

Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; Bradley-Hasbro Children's Research Center, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI, USA.

Linnea Drew (L)

Bradley-Hasbro Children's Research Center, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI, USA.

Catherine DeCesare (C)

Bradley-Hasbro Children's Research Center, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI, USA.

Anna J Yeo (AJ)

Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; Bradley-Hasbro Children's Research Center, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI, USA; Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.

Kristine Durkin (K)

Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; Bradley-Hasbro Children's Research Center, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI, USA.

A Rani Elwy (AR)

Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.

Barbara Jandasek (B)

Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; Bradley-Hasbro Children's Research Center, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI, USA; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA.

Deborah N Pearlman (DN)

Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.

Patrick Vivier (P)

Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.

Elizabeth L McQuaid (EL)

Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; Bradley-Hasbro Children's Research Center, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI, USA; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA. Electronic address: Elizabeth_mcquaid@brown.edu.

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