RVA Breathes: A Richmond City Collaboration to Reduce Pediatric Asthma Disparities
| Status: | Recruiting |
|---|---|
| Conditions: | Asthma |
| Therapuetic Areas: | Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 5 - 11 |
| Updated: | 6/29/2018 |
| Start Date: | May 31, 2018 |
| End Date: | June 2021 |
| Contact: | Robin Everhart, PhD |
| Email: | reverhart@vcu.edu |
| Phone: | (804) 828-7249 |
The goal of this study is to evaluate a sustainable, community-engaged program to reduce
asthma disparities among 5 to 11-year-old children in Richmond, Virginia. Richmond, an urban
center, has been named the Asthma Capital, or "most challenging place to live in the U.S.
with asthma," by the Asthma and Allergy Foundation three times in the last 5 years. To date,
however, the city has no comprehensive, community-engaged asthma care program for those
children at highest risk for poor asthma outcomes. To address this disparity, the study team
engaged with community partners and completed a mixed-methods needs assessment to enhance
understanding of the barriers and supports to asthma care for children and their families
living in Richmond. Several key priority areas emerged: peer support, advocacy, treating the
home as a system, increased school nurse education, and coordination with schools and
providers. Working together, the community-engaged team translated needs assessment findings
to RVA Breathes, a program coordinating asthma care across 4 sectors: family, home,
community, and medical care.
asthma disparities among 5 to 11-year-old children in Richmond, Virginia. Richmond, an urban
center, has been named the Asthma Capital, or "most challenging place to live in the U.S.
with asthma," by the Asthma and Allergy Foundation three times in the last 5 years. To date,
however, the city has no comprehensive, community-engaged asthma care program for those
children at highest risk for poor asthma outcomes. To address this disparity, the study team
engaged with community partners and completed a mixed-methods needs assessment to enhance
understanding of the barriers and supports to asthma care for children and their families
living in Richmond. Several key priority areas emerged: peer support, advocacy, treating the
home as a system, increased school nurse education, and coordination with schools and
providers. Working together, the community-engaged team translated needs assessment findings
to RVA Breathes, a program coordinating asthma care across 4 sectors: family, home,
community, and medical care.
RVA Breathes includes family-based asthma self-management education (delivered by Community
Health Workers [CHWs] with the Institute for Public Health Innovation), homeenvironmental
remediation (with Richmond City Health Department's Healthy Homes Initiative), and a
schoolnurse component (with elementary schools in the Richmond City Public School System).
These interventions capitalize among existing resources and relationships with stakeholders
in Richmond, each of which is committed to RVA Breathes. Three-hundred children with asthma
and their caregivers will participate in a randomized clinical trial of RVA Breathes. After
completing a baseline assessment, families will be randomized to one of three conditions: 1)
asthma education + home remediation + school intervention, 2) asthma education + home
remediation and 3) comparator condition (Enhanced Standard of Care, E-SOC). Families will
participate in the program for 12 months and complete follow-up assessments (post-treatment
and 3-, 6-, and 12-month) to measure changes in healthcare utilization and the impact of the
program on child asthma outcomes. Conditions will be compared on the primary outcomes of
healthcare utilization, including asthma specific ED visits and hospital admissions, school
absences, and controller medication use; secondary outcomes include asthma control, symptoms,
and quality of life. We will also evaluate the sustainability of RVA Breathes after 12 months
(without active intervention), including a review of qualitative data from participants and
stakeholders in the program. Findings from this trial will allow for dissemination and
implementation of RVA Breathes as a sustainable program in the Richmond are.
Health Workers [CHWs] with the Institute for Public Health Innovation), homeenvironmental
remediation (with Richmond City Health Department's Healthy Homes Initiative), and a
schoolnurse component (with elementary schools in the Richmond City Public School System).
These interventions capitalize among existing resources and relationships with stakeholders
in Richmond, each of which is committed to RVA Breathes. Three-hundred children with asthma
and their caregivers will participate in a randomized clinical trial of RVA Breathes. After
completing a baseline assessment, families will be randomized to one of three conditions: 1)
asthma education + home remediation + school intervention, 2) asthma education + home
remediation and 3) comparator condition (Enhanced Standard of Care, E-SOC). Families will
participate in the program for 12 months and complete follow-up assessments (post-treatment
and 3-, 6-, and 12-month) to measure changes in healthcare utilization and the impact of the
program on child asthma outcomes. Conditions will be compared on the primary outcomes of
healthcare utilization, including asthma specific ED visits and hospital admissions, school
absences, and controller medication use; secondary outcomes include asthma control, symptoms,
and quality of life. We will also evaluate the sustainability of RVA Breathes after 12 months
(without active intervention), including a review of qualitative data from participants and
stakeholders in the program. Findings from this trial will allow for dissemination and
implementation of RVA Breathes as a sustainable program in the Richmond are.
Inclusion Criteria:
- Enrolled in Richmond Public Schools
- Asthma-related emergency department visit/hospitalization within last year
- Physician-diagnosed asthma
- Richmond city resident
Caregiver inclusion: child's legal guardian living in same home for the last 6 months
Exclusion Criteria:
- Severe medical or psychiatric condition (child or caregiver)
We found this trial at
1
site
Virginia Commonwealth University Since our founding as a medical school in 1838, Virginia Commonwealth University...
Click here to add this to my saved trials
