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Published on: November 4, 2010
Effectiveness of Evidence-Based Asthma Interventions
Suzanne Kennedy1, Ryan Bailey2, Katy Jaffee2
1Rho, Chapel Hill, North Carolina; suzanne_kennedy@unc.edu.
Insights
Community health centers successfully adapted asthma interventions for high-risk children, significantly reducing symptom days. This bridges the gap between clinical trial efficacy and real-world effectiveness in underserved populations.
Area of Science:
- Community Health
- Pediatric Asthma Management
- Clinical Trial Adaptation
Background:
- Bridging the efficacy-effectiveness gap in clinical research is crucial.
- The Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS) study adapted a proven randomized controlled trial.
- The goal was to implement evidence-based asthma interventions in community health centers.
Purpose of the Study:
- To evaluate the effectiveness of adapted evidence-based asthma interventions in community health centers.
- To reduce asthma-related morbidity in high-risk, low-income pediatric populations.
- To assess the feasibility of implementing such interventions in primary care settings.
Main Methods:
- Enrolled 590 children (aged 5-12) with moderate-to-severe asthma from intervention and control sites in underserved communities.
- Provided tailored asthma interventions over 1 year, including allergen sensitivity testing and home environmental assessments.
- Monitored study visits via electronic data capture and evaluated symptoms and healthcare utilization at baseline, 6, and 12 months.
Main Results:
- A total of 590 children were enrolled (314 intervention, 276 control).
- Intervention participants showed a significantly greater reduction in asthma symptom days compared to controls (-3.27 vs -2.28).
- Study activity completion was 70%, demonstrating feasibility in this setting.
Conclusions:
- Evidence-based asthma interventions can be effectively adapted for primary care settings serving impoverished, high-risk populations.
- These adapted interventions successfully reduced asthma morbidity in high-need children.
- The CHAMPS study demonstrates a viable model for improving pediatric asthma care in community health centers.
Background And Objectives:
Researchers often struggle with the gap between efficacy and effectiveness in clinical research. To bridge this gap, the Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS) study adapted an efficacious, randomized controlled trial that resulted in evidence-based asthma interventions in community health centers.
Methods:
Children (aged 5-12 years; N = 590) with moderate to severe asthma were enrolled from 3 intervention and 3 geographically/capacity-matched control sites in high-risk, low-income communities located in Arizona, Michigan, and Puerto Rico. The asthma intervention was tailored to the participant's allergen sensitivity and exposure, and it comprised 4 visits over the course of 1 year. Study visits were documented and monitored prospectively via electronic data capture. Asthma symptoms and health care utilization were evaluated at baseline, and at 6 and 12 months.
Results:
A total of 314 intervention children and 276 control children were enrolled in the study. Allergen sensitivity testing (96%) and home environmental assessments (89%) were performed on the majority of intervention children. Overall study activity completion (eg, intervention visits, clinical assessments) was 70%. Overall and individual site participant symptom days in the previous 4 weeks were significantly reduced compared with control findings (control, change of -2.28; intervention, change of -3.27; difference, -0.99; P < .001), and this result was consistent with changes found in the rigorous evidence-based interventions.
Conclusions:
Evidence-based interventions can be successfully adapted into primary care settings that serve impoverished, high-risk populations, reducing the morbidity of asthma in these high-need populations.
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