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Published on: September 16, 2019
A community-based asthma program: Study design and methods of RVA Breathes
Robin S Everhart1, Suzanne E Mazzeo1, Rosalie Corona1
1Virginia Commonwealth University, Richmond, VA, United States of America.
Insights
This study introduces RVA Breathes, an intervention to coordinate pediatric asthma care. It aims to reduce healthcare use and improve asthma control in children by integrating family, home, community, and medical support.
Area of Science:
- Environmental Health
- Pediatric Pulmonology
- Health Services Research
Background:
- Pediatric asthma morbidity and healthcare disparities persist across racial, ethnic, environmental, and income lines.
- Effective interventions are crucial to address these inequities in asthma care.
- Existing care models often lack coordination across key sectors impacting child health.
Purpose of the Study:
- To assess the impact of the RVA Breathes intervention on pediatric asthma-related healthcare utilization.
- To evaluate secondary outcomes including asthma control, symptom frequency, and quality of life.
- To refine and test a community-based, multi-sectoral asthma care coordination model.
Main Methods:
- A randomized controlled trial involving 300 elementary school children (ages 5-11) with asthma exacerbations.
- Participants randomized into three groups: comprehensive intervention, education/home remediation, or a comparator.
- Data collection over 18 months including baseline, intervention sessions, and follow-up visits; analysis via General Linear Mixed Model (GLMM).
Main Results:
- The study is designed to provide evidence on the effectiveness of coordinated care.
- Expected findings will quantify reductions in asthma-related healthcare utilization.
- Anticipated improvements in asthma control, symptom reduction, and enhanced quality of life are expected.
Conclusions:
- The RVA Breathes intervention demonstrates a promising model for coordinating pediatric asthma care.
- Findings are expected to support the integration of family, home, community, and medical services.
- This approach can serve as a scalable model for community-based pediatric asthma management.
Abstract:
Disparities in pediatric asthma morbidity and healthcare utilization exist on the basis of race, ethnicity, environment, and income; interventions are needed to address these inequities. The following protocol describes an evidence-based intervention, RVA Breathes, designed to coordinate pediatric asthma care across family, home, community, and medical sectors. Community stakeholder feedback was utilized to refine the intervention specifically for the Richmond, Virginia community. The aims of this study are to assess the effect of RVA Breathes on asthma-related healthcare utilization, as well as secondary outcomes of asthma control, asthma symptoms, and quality of life. We will enroll 300 elementary school children from the Richmond City Public School system. Participants will be between the ages of 5-11, have a diagnosis of asthma, and have had an asthma exacerbation (as indicated by an asthma-related ED visit, hospitalization, unscheduled PCP visit, or use of systemic steroids) in the last two years. Participants will be randomized to one of three groups: asthma education + home environment remediation + school intervention, asthma education + home environment remediation, or a comparator condition. Data will be collected across one baseline research visit, four intervention sessions, and four follow-up research visits over the course of 18 months. A General Linear Mixed Model (GLMM) will be used to test primary aims. We expect the findings will provide support for coordination of asthma care across sectors. Further, we hope RVA Breathes will serve as a model of community-based pediatric asthma care.
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