Engaging end-users in intervention research study design

Area of Science:

• Implementation Science
• Pediatric Asthma Research
• Health Services Research

Background:

• Childhood asthma is a significant public health concern, particularly for high-risk populations in urban settings.
• The Coordinated Healthcare Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) Plan trial aims to evaluate asthma interventions for children presenting to emergency departments (EDs).
• A formative evaluation was conducted to gather end-user input for optimizing trial design and outcome measures.

Purpose of the Study:

• To incorporate end-user feedback into the design of a pragmatic trial for childhood asthma interventions.
• To enhance the feasibility and relevance of the CHICAGO Plan trial through formative evaluation.
• To identify and address potential challenges in study implementation and recruitment.

Main Methods:

• Employed a multi-level data gathering framework combining design principles and qualitative methods.
• Conducted focus groups with Community Health Workers and caregivers, in-home interviews with caregivers, and key informant interviews at clinical sites.
• Included direct observation through ED tours and site visits.

Main Results:

• Identified that ED discharge protocols often deliver patient education at inopportune times, reducing family receptiveness.
• Recommended and implemented modifications to the trial design, including repositioning discharge asthma plan education to earlier "teachable moments."
• Reassigned the delivery of asthma discharge plans to study-employed ED coordinators to improve effectiveness.

Conclusions:

• End-user engagement in the design phase of implementation research is crucial for enhancing research feasibility and relevance.
• Tailoring intervention delivery to optimal "teachable moments" can improve patient education and engagement.
• Addressing practical implementation challenges proactively through formative evaluation leads to more effective research designs.