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Implementation of Asthma Community Home and School Management Program (Asthma CHAMPS)

Not Applicable
Recruiting
Conditions
Asthma in Children
Interventions
Behavioral: Asthma CHAMPS full program
Behavioral: Asthma CHAMPS Wait List Control
Registration Number
NCT05814510
Lead Sponsor
Johns Hopkins University
Brief Summary

The long-term goal is to implement an evidence-based asthma intervention based on the Center for Disease Control's recommended framework (EXHALE) within Baltimore City Public Schools (BCPS). As part of a stepped wedge pragmatic trial the investigators will:

1. Evaluate the effectiveness of a tailored implementation plan of Asthma CHAMPS in 32 Baltimore city elementary schools to reduce asthma disparities.

2. Conduct a pragmatic trail using a stepped wedge design to evaluate implementation of a school and home asthma intervention program to reduce asthma-related absences, healthcare utilization and exacerbations and improve asthma control, among children enrolled in 32 Baltimore City elementary schools.

3. Use qualitative methods (observation and semi structured interviews) to obtain stakeholder feedback (parents, community health workers, school personnel and administrators) on impact of Asthma CHAMPS, identify potential refinements in intervention and implementation strategies, and evaluate impact of local adaptation and fidelity on implementation success and sustainability.

Detailed Description

Implementation Aim: Evaluate the effectiveness of a tailored implementation plan of Asthma CHAMPS in 32 Baltimore city elementary schools to reduce asthma disparities.

Hypothesis: The investigators hypothesize that Baltimore City schools will have greater adoption and penetration of Asthma CHAMPS (e.g. more schools participating, and more staff and family asthma education sessions), greater feasibility/acceptability (e.g. more staff participating in asthma care activities, greater staff confidence in managing asthma) and greater satisfaction and appropriateness with a tailored implementation strategy compared to wait list-control group.

The long-term goal is to implement an evidence-based asthma intervention based on the Centers for Disease Control (CDC) recommended framework (EXHALE)14 within BCPS. To provide the foundation for success, the investigators will identify and engage local key stakeholders, conduct a community needs assessment to inform necessary refinement and adaptations of the interventions, and develop a tailored collaborative strategy to ensure successful implementation of an asthma intervention program. Results for this multi-phase project will identify best practices for implementation of a tailored multi-level asthma intervention program (Asthma CHAMPS: Community and Home Asthma Management Program in Schools), within Baltimore City Schools to reduce asthma disparities.

Effectiveness Aim: Conduct a pragmatic trail using a stepped wedge design to evaluate implementation of a school and home asthma intervention program to reduce asthma-related absences, healthcare utilization and exacerbations and improve asthma control, among children enrolled in 32 Baltimore City elementary schools.

Hypothesis: Children with asthma who attend schools engaged in Asthma CHAMPS program will have improved asthma outcomes, including improved asthma control, reduced ED visits/hospitalizations and courses of oral corticosteroids and impact (reduced asthma-related school absences).

Qualitative Aim: Use qualitative methods (observation and semi structured interviews) to obtain stakeholder feedback (parents, community health workers, school personnel and administrators) on impact of Asthma CHAMPS, identify potential refinements in intervention and implementation strategies, and evaluate impact of local adaptation and fidelity on implementation success and sustainability.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
1000
Inclusion Criteria
  • Aged 18 or older
  • Current caregiver of child with asthma or staff member at a Baltimore City K-8 Public School in Asthma CHAMPS
Exclusion Criteria
  • Unwilling to consent

Children with asthma

Inclusion Criteria:

  • Asthma diagnosis
  • Currently enrolled in Baltimore City K-8 Public School participating in Asthma CHAMPS

Exclusion Criteria:

  • Unwilling to provide assent

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Children with asthmaAsthma CHAMPS full programAged 5-13 and enrolled in Baltimore City Public School participating in Asthma CHAMPS
School staffAsthma CHAMPS full programSchool staff in a K-8 school participating in Asthma CHAMPS
Caregivers of children with asthmaAsthma CHAMPS full programCaregiver of a child with asthma that is aged 5-13 enrolled in a Baltimore City Public School participating in Asthma CHAMPS
School staffAsthma CHAMPS Wait List ControlSchool staff in a K-8 school participating in Asthma CHAMPS
Children with asthmaAsthma CHAMPS Wait List ControlAged 5-13 and enrolled in Baltimore City Public School participating in Asthma CHAMPS
Caregivers of children with asthmaAsthma CHAMPS Wait List ControlCaregiver of a child with asthma that is aged 5-13 enrolled in a Baltimore City Public School participating in Asthma CHAMPS
Primary Outcome Measures
NameTimeMethod
Asthma-related absences4 years

Administrative data from schools on attendance for child with asthma

Emergency Department (ED) utilization for asthma by children4 years

Counts of ED visits for asthma

Hospitalization for asthma by children4 years

Counts of hospital admissions for asthma

Oral corticosteroid steroid prescription for asthma by children4 years

Counts of prescribed oral corticosteroids for asthma

Secondary Outcome Measures
NameTimeMethod
Feasibility of Intervention (FIM) as assessed by a 4 item questionnaire4 years

4 item measure of implementation outcome often considered "leading indicator" of implementation success. Administered on a 5 point Likert scale with higher scores indicating greater agreement with specific items.

Intervention penetration as assessed by counts4 years

Counts of asthma education sessions for family and staff

Intervention Satisfaction as assessed by a composite measure4 years

Composite measure administered to staff and caregivers with items assessing asthma management motivation and confidence. Answer options are on a scale of 1-10 with higher scores generally indicating greater agreement.

Acceptability of Intervention (AIM) as assessed by a 4 item questionnaire4 years

4 item measure of implementation outcome often considered "leading indicator" of implementation success. Administered on a 5 point Likert scale with higher scores indicating greater agreement with specific items.

Intervention Appropriateness Measure (IAM) as assessed by a 4 item questionnaire4 years

4 item measure of implementation outcome often considered "leading indicator" of implementation success. Administered on a 5 point Likert scale with higher scores indicating greater agreement with specific items.

Trial Locations

Locations (1)

Baltimore City Public Schools

🇺🇸

Baltimore, Maryland, United States

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