Medicaid Asthma Home Visit Project: Improving Health and Reducing Costs of Health Care for Children With Asthma
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 373
- 主要终点
- Asthma symptom free days
研究概览
简要总结
Asthmatic children age 3-17 from low income households in King County are randomly assigned into a community health worker (CHW) intervention group and a control group. The intervention is in-home education and support related to asthma self-management. The main outcome measures are asthma symptom-free days, caretaker's asthma-related quality of life score, and health care utilization for asthma measured at baseline and 12 months after baseline enrollment.
详细描述
This is a randomized controlled trial. Potentially eligible subjects come from lists generated by health plans (Community Health Plan of Washington and Molina, who insure the majority of Medicaid enrollees in King County), individuals referred by primary care providers, and self referral. Eligible subjects that agree to participate are randomly assigned into a CHW intervention group or a control group. We expected to complete the study with 200 in each group.
The intervention is in-home education and support by a community health worker (CHW). At the first home visit, the CHW assesses the participant's knowledge and skills related to asthma self-management, current status of the child's asthma, and resources and support for asthma self-management using a baseline questionnaire. The CHW inspects the home environment using an Environmental Home Checklist to identify environmental triggers that can cause asthma symptoms and affect asthma control. The CHW makes up to three follow-up visits and two telephone visits during the year the participant is in the study. Participants receive resources to help them control asthma, including vacuum cleaner, dust covers for a pillow and mattress and a "green" cleaning kit with cleaning supplies.
The control group receives standard asthma care, as provided by a primary health care provider during the 12 months after enrollment. When the intervention period is over, the control group receives one visit with a CHW and the resources provided to the intervention group participants.
The main outcome variables include asthma symptom-free days, caretaker asthma-related quality of life, and urgent health care utilization.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 3 Years 至 17 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •caretaker is age 18 or older and child is age 3-17
- •have not controlled as thma
- •residence in King County
- •spoken language is English or Spanish
- •Child is enrolled in a Medicaid managed care health plan offered by Community Health Plan of Washington (CHPW) or Molina Health Plan of Washington, Inc (Molina).
排除标准
- •Parent/guardian plans to move out of King County within the next year or lacks permanent housing.
- •Parent/guardian has a mental or physical disability making it impossible to participate in the protocols.
- •The household appears to be unsafe for visitation by the CHW.
- •The child has other serious chronic medical conditions (e.g. poorly controlled sickle cell disease, cystic fibrosis) that cause sufficient limitation in functional status so that that asthma control is not a priority.
- •The family is enrolled in another asthma research study within the past three years. This is to avoid the potential confounding effect from other studies.
- •The child is in foster care or group care settings.
结局指标
主要结局
Asthma symptom free days
时间窗: last 14 days
14 - During the past 14 days (that is, during the past fourteen 24 hour periods that include daytime and nighttime), on how many DAYS did your child have any asthma symptoms, such as wheezing, coughing, tightness in the chest, shortness of breath, waking up at night because of asthma symptoms, or slowing down of usual activities because of asthma?
Caretaker quality of life
时间窗: last week
Juniper Mini Asthma Quality of Life Questionnaire
Health care utilization for asthma
时间窗: 12 months
number of unscheduled clinic visits+emergency department visits+hospitalization for asthma
cost analysis
时间窗: 12 months
costs associated with health care utilization for asthma
次要结局
- asthma episodes(3 months)
- days with activity limitation due to asthma(14 days)
- days used asthma rescue medicine(14 days)
- nights with asthma symptoms(14 days)
- asthma control level(14 days)