School-Based Preventive Asthma Care Technology: A Trial Using a Novel Technology to Improve Adherence (SB-PACT)
31 december 2013 bijgewerkt door: Jill Halterman, University of Rochester
School-Based Preventive Asthma Care Technology: A Randomized Control Trial Using a Novel Technology to Improve Adherence
The goal of this new translational project is to test the feasibility and effectiveness of implementing school-based directly observed therapy of preventive asthma medications in a real-world setting, using state-of-the-art web-based technology for systematic screening, electronic report generation, and communication between nurses, caregivers, and primary care providers.
With the use of a novel method to improve adherence and subsequently reduce morbidity, the investigators hypothesize that this novel adaptation of school-based asthma care will; 1) be feasible and acceptable among this population and among school and community stakeholders, and 2) yield reduced asthma morbidity (symptom-free days, absenteeism, and emergency room / urgent care use for asthma care).
The investigators anticipate that enhancing preventive healthcare for young urban children with asthma through partnerships with the schools using a novel technology will yield improved health, prevention of suffering, decreased absenteeism from school, and reduced healthcare costs.
Studie Overzicht
Studietype
Ingrijpend
Inschrijving (Werkelijk)
99
Fase
- Niet toepasbaar
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
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New York
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Rochester, New York, Verenigde Staten, 14642
- Univeristy of Rochester
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
3 jaar tot 10 jaar (Kind)
Accepteert gezonde vrijwilligers
Nee
Geslachten die in aanmerking komen voor studie
Allemaal
Beschrijving
Inclusion Criteria (all 4 criteria must be met):
- Physician-diagnosed asthma (based on parent report).
Persistent asthma (criteria based on NHLBI guidelines). Any 1 of the following:
- An average of >2 days per week with asthma symptoms
- >2 days per week with rescue medication use
- >2 days per month with nighttime symptoms
- ≥2 episodes of asthma during the past year that have required systemic corticosteroids
- Age ≥3 and ≤10 years.
- Attending school in participating Rochester City School District preschools or elementary schools.
Exclusion Criteria:
- Inability to speak and understand English. (*Parents unable to read will be eligible, and all instruments will be given verbally.)
- No access to a working phone for follow-up surveys (either at the subject's home or an easily accessible alternate phone number).
- Family planning to leave the school district within fewer than 6 months.
- The child having other significant medical conditions, including congenital heart disease, cystic fibrosis, or other chronic lung disease, that could interfere with the assessment of asthma-related measures.
- Children in foster care or other situations in which consent cannot be obtained from a guardian.
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Enkel
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: School-Based Medication Group
For children assigned to the School-Based Medication group, an asthma coordinator will send the child's primary care physician a report indicating the child's asthma symptoms, and will recommend that the child receive a preventive asthma medication at school.
If the child's doctor agrees, the preventive asthma medication will be delivered to the child's school and to his/her home by a local pharmacy.
The child's school nurse will begin directly observed therapy of the preventive asthma medication at school, and will routinely assess the child's asthma symptoms throughout the school year.
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For children assigned to the School-Based Medication group, an asthma coordinator will send the child's primary care physician a report indicating the child's asthma symptoms, and will recommend that the child receive a preventive asthma medication at school.
If the child's doctor agrees, the preventive asthma medication will be delivered to the child's school and to his/her home by a local pharmacy.
The child's school nurse begin directly observed therapy of the preventive asthma medication at school, and will routinely assess the child's asthma symptoms throughout the school year.
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Geen tussenkomst: Usual Care Group
Children in the Usual Care group will not receive preventive medications delivered at school.
These children will continue to receive all of their asthma care from their parents and primary care physicians.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Average Number of Symptom-free Days Over 14 Days; (Symptom-free Days Are Averaged Over 4 Bi-monthly Follow-ups)
Tijdsspanne: Average number of days, over 2 weeks, throughout the school year
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The primary outcome is asthma morbidity between groups.
We will measure asthma morbidity by looking at the average number of symptom-free days, over 2 weeks, at each bi-monthly follow-up time point over the school year.
Number of days without asthma symptoms will be reported by the child's caregiver.
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Average number of days, over 2 weeks, throughout the school year
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Cost Effectiveness
Tijdsspanne: one year
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We will evaluate the cost effectiveness to implement and sustain the web-based system in schools.
We will review the cost of the intervention using three main categories of costs; programmatic costs (costs of initiating and running the program), productivity costs, and medical costs estimated at the individual child level.
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one year
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Feasibility and Acceptability
Tijdsspanne: one year
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We will conduct interviews with parents and school nurses to evaluate whether this new program is feasible and acceptable among this population.
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one year
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Onderzoekers
- Hoofdonderzoeker: Jill S. Halterman, MD, MPH, University of Rochester
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Algemene publicaties
- Halterman JS, Sauer J, Fagnano M, Montes G, Fisher S, Tremblay P, Tajon R, Butz A. Working toward a sustainable system of asthma care: development of the School-Based Preventive Asthma Care Technology (SB-PACT) trial. J Asthma. 2012 May;49(4):395-400. doi: 10.3109/02770903.2012.669441. Epub 2012 Mar 28.
- Halterman JS, Fagnano M, Montes G, Fisher S, Tremblay P, Tajon R, Sauer J, Butz A. The school-based preventive asthma care trial: results of a pilot study. J Pediatr. 2012 Dec;161(6):1109-15. doi: 10.1016/j.jpeds.2012.05.059. Epub 2012 Jul 10.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start
1 augustus 2010
Primaire voltooiing (Werkelijk)
1 augustus 2011
Studie voltooiing (Werkelijk)
1 augustus 2012
Studieregistratiedata
Eerst ingediend
16 april 2010
Eerst ingediend dat voldeed aan de QC-criteria
3 augustus 2010
Eerst geplaatst (Schatting)
4 augustus 2010
Updates van studierecords
Laatste update geplaatst (Schatting)
17 februari 2014
Laatste update ingediend die voldeed aan QC-criteria
31 december 2013
Laatst geverifieerd
1 december 2013
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 32479
- 1RC1HL099432-01 (Subsidie/contract van de Amerikaanse NIH)
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