School-Based Telemedicine Enhanced Asthma Management

University of Rochester400 enrolled

Overview

This project aims to improve guideline-based asthma care using enhanced communication and screening tools, telemedicine and directly observed therapy of preventive medications in city schools. Web-based screening will be used to identify children with persistent or poorly controlled asthma and to send reports to the child's primary care doctor. Children in the SB-TEAM group will receive a telemedicine asthma assessment in school and be prescribed a daily preventive asthma medication to be taken through school-based directly observed therapy. The overall aim of this study is to evaluate the use of the SB-TEAM intervention for improving guideline based care, enhancing adherence to effective preventive medications and at reducing morbidity among young urban children with asthma.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Enrollment

400

Conditions

Pediatric Asthma

Interventions

Eligibility

Sex: ALLMin age: 3 YearsMax age: 10 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Physician-diagnosed asthma (based on parent report) 2. Persistent asthma or poor asthma control (based on NHLBI guidelines). Any 1 of the following: * In past month, \>2 days per week with asthma symptoms * \>2 days per week with rescue medication use * \>2 days per month with nighttime symptoms * \>=2 asthma episodes during the past year that required systemic corticosteroids. 3. Age \>=3 and =\<10 years 4. Attending school in Rochester City School District preschools or elementary schools Exclusion Criteria: 1. Inability to speak and understand English or Spanish 2. No access to a phone for follow-up surveys 3. Family planning to leave the district within fewer than 6 months. 4. 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. 5. Children in foster care or other situations in which consent cannot be obtained from a guardian.

Outcomes

Primary Outcomes

Average Number of Days Without Asthma Symptoms (Symptom Free Days)

The primary outcome measure is asthma morbidity between groups. We will measure asthma morbidity by looking at the average number of days without asthma symptoms (symptom free days) over 2 weeks, during each follow-up assessment during the peak winter season (November-March). Symptom free days are defined as 24 hour periods of no asthma symptoms including, coughing, wheezing, tightness in the chest or shortness of breath. The number of symptom free days will be reported by the child's caregiver.

Time frame: Average number of days, over 2 weeks, during peak winter season (November-March), assessed over 4 years.