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Addressing Pediatric Asthma Disparities through RI-AIR's Community Approach: A Randomized Trial.

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Summary
This summary is machine-generated.

The Rhode Island-Asthma Integrated Response (RI-AIR) Program significantly improved asthma control and symptom-free days for children. Community engagement is crucial for better asthma outcomes in high-burden areas.

Keywords:
asthma outcomeshealth disparitiesrandomized controlled trial

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Area of Science:

  • Environmental Health
  • Community Health
  • Pediatric Asthma Management

Background:

  • Social and environmental risk factors in low-income neighborhoods contribute to racial and ethnic asthma disparities.
  • Integrating school and home-based interventions tailored to disease risk is essential for children with high asthma burden.

Purpose of the Study:

  • To evaluate the Rhode Island-Asthma Integrated Response (RI-AIR) Program's effectiveness in improving individual and community asthma outcomes.
  • To utilize community collaborations and technology to identify and intervene for high-risk children with asthma.

Main Methods:

  • A stepped wedge cluster randomized hybrid type-II effectiveness-implementation study was conducted in 32 high asthma burden school catchment areas.
  • Children received school-based or school and home-based interventions based on asthma control levels (Not Well Controlled vs. Poorly Controlled).
  • Community Health Workers facilitated communication, with follow-ups every 3 months for 1 year.

Main Results:

  • Asthma control and symptom-free days improved significantly at 3 months (d=0.47 and d=0.37, respectively) and were sustained at 12 months.
  • Community-level healthcare utilization showed no significant change (RR=1.16), but was slightly lower in areas with higher family participation.
  • Sensitivity analyses indicated potential benefits of increased family engagement on healthcare utilization.

Conclusions:

  • Intensive, multi-component interventions are necessary to improve asthma outcomes in high-burden areas.
  • Community engagement strategies are vital for the success of asthma management programs.
  • The RI-AIR program demonstrates a promising approach for managing pediatric asthma in vulnerable populations.