A Multifaceted Prompting Intervention for Urban Children With Asthma (PAIR-UP)

University of Rochester

Status: Completed

Conditions: Asthma

Treatments: Behavioral: Multifaceted Prompting Intervention MPI

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT01105754

25281

1R01HL091835-01A1 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The overall goal of this project is to evaluate whether a multifaceted prompting intervention, administered in the urban primary care office setting, reduces morbidity among urban children with asthma. This study builds on our experience with a pilot study in two urban continuity clinics, in which we found that prompting clinicians about asthma severity and care guidelines at the time of an office visit resulted in improved preventive care delivery to inner-city children. This type of prompting program has the potential to substantially improve care for impoverished children with asthma, and we propose to establish: 1) whether these findings can be replicated in a similar study including a larger sample of urban children from different types of practices, and 2) whether the positive effects can be enhanced by more specific prompting directed towards both the provider and the caregiver and by providing practice-level supports and feedback. We hypothesize that children receiving a multifaceted prompting intervention (MPI) will experience less asthma-related morbidity (defined by symptom-free days at the 2-month follow-up) compared to children receiving usual care. Our secondary hypothesis is that children receiving the MPI will receive improved preventive asthma care (defined by guideline-based corrective actions taken at the index visit) compared to children receiving usual care.

Enrollment: 638 patients

Sex: All

Ages: 2 to 12 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Physician-diagnosed asthma
• Mild persistent or more severe asthma severity, or poor asthma control
• Age >2 and <12 years.
• Parent or caregiver must give permission to the study, and children >7 will must provide assent.

Exclusion criteria

• Inability to speak and understand English or Spanish
• No access to a working phone for follow-up surveys
• The child having other significant medical conditions,
• Children in foster care or other situations in which consent cannot be obtained from a guardian.
• Prior enrollment in the study.
• Child will not be seen by a physician or nurse practitioner during their visit

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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638 participants in 2 patient groups

Standard Care

No Intervention group

Description:

Parents of children in the standard care group will complete the baseline assessment, but no asthma prompt will be created for either the caregiver or provider, and no information regarding the interview will be shared with the provider. After the baseline assessment, the office visit will proceed according to usual care.

Multifaceted Prompting Intervention

Experimental group

Description:

Multifaceted Prompting Intervention

Treatment:

Behavioral: Multifaceted Prompting Intervention MPI