BACKGROUND & AIMS:
:Disparities in pediatric asthma morbidity and healthcare utilization exist on the basis of race, ethnicity, environment, and income; interventions are needed to address these inequities. The following protocol describes an evidence-based intervention, RVA Breathes, designed to coordinate pediatric asthma care across family, home, community, and medical sectors. Community stakeholder feedback was utilized to refine the intervention specifically for the Richmond, Virginia community. The aims of this study are to assess the effect of RVA Breathes on asthma-related healthcare utilization, as well as secondary outcomes of asthma control, asthma symptoms, and quality of life. We will enroll 300 elementary school children from the Richmond City Public School system. Participants will be between the ages of 5-11, have a diagnosis of asthma, and have had an asthma exacerbation (as indicated by an asthma-related ED visit, hospitalization, unscheduled PCP visit, or use of systemic steroids) in the last two years. Participants will be randomized to one of three groups: asthma education + home environment remediation + school intervention, asthma education + home environment remediation, or a comparator condition. Data will be collected across one baseline research visit, four intervention sessions, and four follow-up research visits over the course of 18 months. A General Linear Mixed Model (GLMM) will be used to test primary aims. We expect the findings will provide support for coordination of asthma care across sectors. Further, we hope RVA Breathes will serve as a model of community-based pediatric asthma care.
背景与目标:
:小儿哮喘的发病率和医疗保健利用存在差异,取决于种族,种族,环境和收入;需要采取干预措施来解决这些不平等现象。以下协议描述了一种基于证据的干预措施,即RVA呼吸,旨在协调家庭,家庭,社区和医疗部门的小儿哮喘护理。利用社区利益相关者的反馈意见,专门针对弗吉尼亚州里士满社区改进了干预措施。这项研究的目的是评估RVA呼吸对哮喘相关医疗保健利用的影响,以及哮喘控制,哮喘症状和生活质量的次要结果。我们将招收来自列治文市公立学校系统的300名小学生。参加者的年龄介于5-11岁之间,具有哮喘的诊断,并且在最近两个月中患有哮喘加重症(如与哮喘相关的ED就诊,住院,计划外的PCP访视或使用全身性类固醇)年。参与者将被随机分为三组之一:哮喘教育家庭环境修复学校干预,哮喘教育家庭环境修复或比较者条件。在18个月的过程中,将在一次基准研究访问,四个干预会议和四个后续研究访问之间收集数据。通用线性混合模型(GLMM)将用于测试主要目标。我们希望这些发现将为跨部门哮喘护理的协调提供支持。此外,我们希望RVA呼吸将成为社区小儿哮喘护理的典范。