Asthma in Central Texas Project
2 avril 2015 mis à jour par: University of Texas at Austin
Enhancing Children's and Parents' Asthma Management
Asthma is the most common chronic childhood illness and disproportionately affects children who are ethnic minorities and poor.
Few studies of childhood asthma have been conducted with children who live in rural areas or have included Mexican American children in their samples.
This study builds on the original R01NR007770 with findings that demonstrated the intervention could improve children's asthma self-management, asthma knowledge, metered dose inhaler skill, asthma severity, and parents' asthma management and access to care.
In this competing continuation, the investigators added a third arm to the current research design with schools randomized into either an in-school asthma intervention, an in-school attention-control intervention, or an alternate intervention-delivery format of a single 5.5-hour asthma day camp.
The tri-ethnic sample will be composed of 320 Mexican-American, African-American, and White rural school-aged children (grades 2-5) who have asthma and their parents.
In addition, the investigators propose adding a non-invasive measure of chronic airway inflammation (exhaled nitric oxide) to assess the impact of changes in asthma management on airway inflammation.
Families will be followed for a full year with data collection at baseline and at 1-month, 4-months, and 7-months after the intervention to assess improvement in children's asthma morbidity, asthma severity, airway inflammation, family asthma management and quality of life.
Hypotheses (H): Children in the Camp-Workshop group and the School-Home group will demonstrate equivalent improvements, but greater improvements than the Attention-Control group in:(H1.1)
their asthma severity and airway inflammation from the Time 1 assessment when compared to Time 4 assessment; (H1.2) office visits, ED visits, and hospitalizations for asthma, and absenteeism for the study year (Time 4) when compared to the pre-study year (Time 1); and (H1.4) Parents in the intervention arms will demonstrate sustained improvements in asthma caregiver's quality of life (QOL0 from the pre-study year (Time 1) to the end of the study year (Time 4) measurement, when compared to the Attention-Control group.
Aperçu de l'étude
Statut
Complété
Les conditions
Description détaillée
Families are recruited at the beginning of the school year (Time 1, October-November); parents consent and child assent obtained and baseline data collected in fall.
The intervention is provided in December-January.
Follow-up data are collected at February (Time 2), April (Time 3), and August (Time 4).
Type d'étude
Interventionnel
Inscription (Réel)
292
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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Texas
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Austin, Texas, États-Unis, 78712
- The University of Texas at Austin
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
6 ans à 13 ans (Enfant)
Accepte les volontaires sains
Oui
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- parent reports the child has a diagnosis of asthma made by a medical provider;
- has had asthma symptoms in the previous 12 months;
- speaks either English or Spanish.
Exclusion Criteria:
- has a significant co-morbidity that would preclude participation in classes (e.g., severe cerebral palsy, oxygen dependent conditions)
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Asthma in-school class
Provided in 16 15-minute sessions (4 hours total didactic time); scheduled 3 sessions/week.
The content is provided by trained asthma educators.
The Asthma Plan for Kids (AP-K) is a 7-step curriculum for children to use when responding to asthma symptoms.
Skills practice with placebo metered dose inhaler (MDI) and peak expiratory flow (PEF) meters with PEF score interpretation.
Topics include (a) identifying lung function, asthma warning signs, symptoms, and triggers; (b) learning skills to manage symptoms, including PEF meter score interpretation, communication with adults (e.g.
teachers, coaches, family members), medication use and MDI technique; (c) evaluating asthma symptoms and the effectiveness of management; and (d) discussing how to stay active in a safe manner.
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Autres noms:
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Expérimental: Asthma Day Camp
The asthma day camp is provided in a single day session (5.5 hours total) by trained camp staff.
The same skills (i.e., placebo metered dose inhaler (MDI) and peak expiratory flow (PEF) meters) and topics [a) identifying lung function, asthma warning signs, symptoms, and triggers; (b) learning skills to manage symptoms, including PEF meter score interpretation, communication with adults (e.g.
teachers, coaches, family members), medication use and MDI technique; (c) evaluating asthma symptoms and the effectiveness of management; and (d) discussing how to stay active in a safe manner] are covered as those in the asthma in-school classes.
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Comparateur factice: Health Promotion in-school class
The mock comparison follows the in-school format of 16 15-minute sessions; scheduled 3 sessions/week.
The content is provided by trained health educators and includes skills practice (i.e., handwashing and brushing teeth) and health promotion topics of nutrition, healthy snacks, preventing colds, and safe exercise.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Absenteeism, End of Study
Délai: 12 months
|
(Days absent/days enrolled)x100 = absenteeism.
Using data provided by the school district at the end of the study year.
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12 months
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Quality of Life, End of Study
Délai: 12 months
|
Self reported asthma-related quality of life.
Outcome data were collected at end of study (Time 4).
The Pediatric Asthma Quality of Life scale.
Minimum score 23 to maximum score of 115.
A higher score indicates worse quality of life.
Mean scale scores are computed.
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12 months
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Number of Days Hospitalized, During Study Year
Délai: 12 months
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Number of days hospitalized for asthma.
Data were obtained from parent report at the second, third, and fourth data collection point.
The number of hospitalization days were summed for a total number at the end of the 12 months.
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12 months
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Emergency Department Visits, Study Year
Délai: 12 months
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Number of visits to Emergency Department for asthma.
Data is obtained from parents at three time points (time 2, 3, and 4) and summed for total number of visits to the emergency department for asthma during the study year.
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12 months
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Number of Asthma Hospitalizations Pre-Study Year
Délai: 12 months before baseline
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Number of times hospitalized for asthma.
Data is obtained from parents for the pre-study year for the previous 12 months.
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12 months before baseline
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Absenteeism Pre-study Year
Délai: 12 months before baseline
|
(Days absent/days enrolled)x100 = absenteeism.
Using data for the 12 months prior to study enrollment as the pre-study year.
Data is provided by the participating school districts.
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12 months before baseline
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Number of Days in Hospital for Asthma, Pre-Study Year
Délai: 12 months before baseline
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Number of days hospitalized for asthma.
Data is obtained from parents for the pre-study year for the previous 12 months.
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12 months before baseline
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Number of Asthma Hospital Stays, During Study Year
Délai: 12 months
|
Number of hospital admissions for asthma.
Data were obtained from parent report at the second, third, and fourth data collection point.
The number of hospitalizations were summed for a total number at the end of the 12 months.
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12 months
|
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Emergency Department Visits, Pre-study Year
Délai: 12 months before baseline
|
Number of visits to Emergency Department for asthma.
Data is obtained from parents for the pre-study year for the previous 12 months.
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12 months before baseline
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Quality of Life, Pre-study Year
Délai: 12 months before baseline
|
Self reported asthma-related quality of life.
Data were collected at study enrollment (time 1).
The Pediatric Asthma Quality of Life scale.
Minimum score 23 to maximum score of 115.
A higher score indicates worse quality of life.
Mean scale scores are computed.
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12 months before baseline
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Asthma Self-management, Time 4
Délai: Time 4, at 12 months
|
Child self-report of asthma preventive and management activities, collected at each of 4 time points.
This is the Time 4, final measure.
Asthma Inventory for Children, 18-item scale, response scale 1-5, minimum score = 18, maximum score = 65, higher score = more frequent asthma self management behaviors.
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Time 4, at 12 months
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Home Asthma Management, Time 4, End of Study
Délai: Time 4 at 12 months
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Parent report of asthma preventive and treatment activities.
Data collected at final study visit, Time 4. Home Asthma Management scale, asthma preventive and asthma treatment behaviors performed by parent, response scale 1-5, scale range 16-70, higher scores = more frequent home asthma management behaviors.
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Time 4 at 12 months
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Metered Dose Inhaler Skill, Time 4
Délai: Time 4 at 12 months
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Observation score of child's skill in using a placebo metered dose inhaler (a teaching inhaler).
Observation data recorded by trained data collectors.
8-item scale listing the steps to perform proper inhalation technique.
Number of correct steps are summed.
Higher score = better skill in using inhaler.
Collected at final, time 4 data visit.
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Time 4 at 12 months
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Medication Adherence, Time 4
Délai: Time 4 at 12 months
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Parent report of their child remembering/forgetting to take medications.
4-item scale (forgot to take medicine, was careless in taking medicine, stopped taking medicine due to feeling better, stopped taking medicine due to feeling worse), dichotomous response scale (yes, no), sum of number of yes items.
Range 0-4, higher score means worse adherence.
Data are collected at final data point, Time 4.
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Time 4 at 12 months
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Asthma Self-management, Time 3
Délai: Time 3 at 9 months
|
Child self-report of asthma preventive and management activities, collected at each of 4 time points.
This is the Time 3 measure.
Asthma Inventory for Children, 18-item scale, response scale 1-5, minimum score = 18, maximum score = 65, higher score = more frequent asthma self management behaviors.
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Time 3 at 9 months
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Asthma Self-management, Time 2
Délai: Time 2 at 5 months
|
Child self-report of asthma preventive and management activities, collected at each of 4 time points.
This is the Time 2 measure.
Asthma Inventory for Children, 18-item scale, response scale 1-5, minimum score = 18, maximum score = 65, higher score = more frequent asthma self management behaviors.
|
Time 2 at 5 months
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Asthma Self-management, Time 1, Baseline
Délai: Time 1, baseline
|
Child self-report of asthma preventive and management activities, collected at each of 4 time points.
This is the baseline, Time 1 measure.
Asthma Inventory for Children, 18-item scale, response scale 1-5, minimum score = 18, maximum score = 65, higher score = more frequent asthma self management behaviors.
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Time 1, baseline
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Home Asthma Management, Time 1, Baseline
Délai: Time 1, baseline
|
Parent report of asthma preventive and treatment activities.
Data are collected at study enrollment, Time 1, baseline visit.
Home Asthma Management scale, asthma preventive and asthma treatment behaviors performed by parent, response scale 1-5, scale range 16-70, higher scores = more frequent home asthma management behaviors.
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Time 1, baseline
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Home Asthma Management, Time 2.
Délai: Time 2 at 5 months
|
Parent report of asthma preventive and treatment activities.
Data collected at the time 2 visit.
Home Asthma Management scale, asthma preventive and asthma treatment behaviors performed by parent, response scale 1-5, scale range 16-70, higher scores = more frequent home asthma management behaviors.
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Time 2 at 5 months
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Home Asthma Management, Time 3
Délai: Time 3 at 9 months
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Parent report of asthma preventive and treatment activities.
Data collected at third time point (Time 3).
Home Asthma Management scale, asthma preventive and asthma treatment behaviors performed by parent, response scale 1-5, scale range 16-70, higher scores = more frequent home asthma management behaviors.
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Time 3 at 9 months
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Metered Dose Inhaler Skill, Time 3
Délai: Time 3 at 9 months
|
Observation score of child's skill in using a placebo metered dose inhaler (a teaching inhaler).
Observation data recorded by trained data collectors.
8-item scale listing the steps to perform proper inhalation technique.
Number of correct steps are summed.
Higher score = better skill in using inhaler.
Collected at time 3 data visit.
|
Time 3 at 9 months
|
|
Metered Dose Inhaler Skill, Time 2
Délai: Time 2 at 5 months
|
Observation score of child's skill in using a placebo metered dose inhaler (a teaching inhaler).
Observation data recorded by trained data collectors.
8-item scale listing the steps to perform proper inhalation technique.
Number of correct steps are summed.
Higher score = better skill in using inhaler.
Collected at final, time 2 data visit.
|
Time 2 at 5 months
|
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Metered Dose Inhaler Skill, Time 1
Délai: Time 1 at baseline
|
Observation score of child's skill in using a placebo metered dose inhaler (a teaching inhaler).
Observation data recorded by trained data collectors.
8-item scale listing the steps to perform proper inhalation technique.
Number of correct steps are summed.
Higher score = better skill in using inhaler.
Collected at enrollment visit, Time 1 data visit.
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Time 1 at baseline
|
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Medication Adherence, Time 1
Délai: Time 1 at baseline
|
Parent report of their child remembering/forgetting to take medications.
4-item scale (forgot to take medicine, was careless in taking medicine, stopped taking medicine due to feeling better, stopped taking medicine due to feeling worse), dichotomous response scale (yes, no), sum of number of yes items.
Range 0-4, higher score means worse adherence.
Data are collected at study enrollment, Time 1.
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Time 1 at baseline
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Medication Adherence, Time 2
Délai: Time 2 at 5 months
|
Parent report of their child remembering/forgetting to take medications.
4-item scale (forgot to take medicine, was careless in taking medicine, stopped taking medicine due to feeling better, stopped taking medicine due to feeling worse), dichotomous response scale (yes, no), sum of number of yes items.
Range 0-4, higher score means worse adherence.
Data are collected at Time 2 visit.
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Time 2 at 5 months
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Medication Adherence, Time 3
Délai: Time 3 at 9 months
|
Parent report of their child remembering/forgetting to take medications.
4-item scale (forgot to take medicine, was careless in taking medicine, stopped taking medicine due to feeling better, stopped taking medicine due to feeling worse), dichotomous response scale (yes, no), sum of number of yes items.
Range 0-4, higher score means worse adherence.
Data are collected at Time 3 visit.
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Time 3 at 9 months
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Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Lung Inflammation, Time 4
Délai: Time 4 at 12 months
|
Exhaled breath condensation collected and sent for lab analysis of NO3.
Data collected at Time 4 visit.
Higher values represent greater airway inflammation.
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Time 4 at 12 months
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Lung Inflammation, Time 1
Délai: Time 1 at baseline
|
Exhaled breath condensation collected and sent for lab analysis of NO3.
Data collected at Time 1 visit.
Higher values represent greater airway inflammation.
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Time 1 at baseline
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Lung Inflammation, Time 2
Délai: Time 2 at 5 months
|
Exhaled breath condensation collected and sent for lab analysis of NO3.
Data collected at Time 2 visit.
Higher values represent greater airway inflammation.
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Time 2 at 5 months
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Lung Inflammation, Time 3
Délai: Time 3 at 9 months
|
Exhaled breath condensation collected and sent for lab analysis of NO3.
Data collected at Time 3 visit.
Higher values represent greater airway inflammation.
|
Time 3 at 9 months
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Collaborateurs
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude
1 décembre 2008
Achèvement primaire (Réel)
1 septembre 2013
Achèvement de l'étude (Réel)
1 novembre 2014
Dates d'inscription aux études
Première soumission
24 août 2012
Première soumission répondant aux critères de contrôle qualité
30 août 2012
Première publication (Estimation)
31 août 2012
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
24 avril 2015
Dernière mise à jour soumise répondant aux critères de contrôle qualité
2 avril 2015
Dernière vérification
1 avril 2015
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- R01NR007770 (Subvention/contrat des NIH des États-Unis)
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