Piloting REACH - a School-Based Care Coordination Service Model to Support Youth With Asthma: A Systems Approach
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Enrollment
- 430
- Locations
- 1
- Primary Endpoint
- Asthma knowledge and awareness
Study Overview
Brief Summary
This study pilots REACH, Resources and Education for Addressing Chronic Health, a service model to facilitate care coordination and communication across medical, school, and home settings. REACH seeks to address barriers to school-based asthma management, improving health and educational outcomes and reducing negative impacts for children with asthma.
Detailed Description
This study develops and tests the REACH intervention which includes (a) a strategic communication or messaging and dissemination strategy to build school and family relationships and trust, (b) capacity building activities to improve asthma knowledge and awareness through asthma education and resources, and (c) a tool/hub that allows record and communication sharing across healthcare and educational systems to facilitate care coordination. Using a Single-Arm Non-Randomized Pre-Post Cluster Trial design, this study tests the hypothesis that use of a care coordination hub will improve school-based asthma management.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Health Services Research
- Masking
- None
Eligibility Criteria
- Ages
- 3 Years to 18 Years (Child, Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Parents (N=200)/Children (N=200)
- •Inclusion criteria for recruited parents/children:
- •parents/caregivers with at least one child with asthma or present to the nurse with asthma symptoms in the partner school district,
- •child with asthma must have a diagnosis of asthma or suspected asthma due to asthma symptom-related healthcare utilization and/or multiple visits to the school nurse (>1)
- •attend a school in one of the partner school districts
- •have access to email and a computer or other mobile device
- •receive care within the BJH/ WUSM system (an indicator of participation in the electronic health record system).
Exclusion Criteria
- •for recruited families:
- •Child does not have asthma and do not present to school nurse with asthma symptoms
- •Child does not attend one of the identified schools in a partner school district
- •Children in foster care or wards of the state
- •School Nurses (Implementers) (N=15)
- •Inclusion Criteria for school nurses:
- •Employed by partner school district and work in an identified building
- •Provide care to students with asthma or present with asthma symptoms
- •Exclusion Criteria for school nurses:
- •- Do not work for partner school district or for an identified building
- •Providers (N =15)
- •Inclusion Criteria for Providers:
- •- Provide care to a child participant on the study
- •Exclusion Criteria for Providers:
- •- Do not provide care to a child participant on the study
Arms & Interventions
REACH
Consists of school nurses who serve as both participants and REACH intervention implementers, students and their caregivers, and student providers. Though there are several participant types, there is only 1 experimental group. All participants serve as their own controls.
Intervention: REACH (Other)
Outcomes
Primary Outcomes
Asthma knowledge and awareness
Time Frame: Measured at baseline and at study completion (average of 1 year)
Measured via survey. Data collected from student caregivers and school nurse implementers.
Implementation
Time Frame: Measured at mid-trial (school nurses only) and at study completion (average of 1 year)
Measured via surveys and post-trial semi-structured focus group/interview. Data collected from student caregivers, school nurse implementers, and providers.
Secondary Outcomes
- School connectedness(Measured at baseline and at study completion (average of 1 year))
- Asthma guideline adherence(Measured at baseline and at study completion (average of 1 year))
- Healthcare utilization(24 months prior to intervention, during intervention, and 12 months following intervention completion)
- School Attendance/Absence(24 months prior to intervention, during intervention, and 12 months following intervention completion)
Investigators
Kelly Harris
Assistant Professor
Washington University School of Medicine