Multisystemic Therapy to Reduce Health Disparities in Adolescents With Asthma
Condition: Asthma
MeSH terms: Asthma
Study type: Interventional

Summary: 
      Asthma is a chronic lung disease that inflames and narrows the airways. Symptoms can include
      recurring periods of wheezing, chest tightness, shortness of breath, and coughing. Minority,
      inner city teens are at increased risk for complications from the disease, possibly because
      of poor illness management. The purpose of this study is to test the effectiveness of
      Multisystemic Therapy (MST)-an intensive, home- and community-based psychotherapy-for
      improving asthma management and overall health and for reducing healthcare costs for inner
      city African American teens with asthma.
    

Detailed description: 
      Although rates of childhood asthma are increasing worldwide, more alarming is the
      disproportionate rise in rates of asthma among urban, disadvantaged, minority children. Inner
      city children, particularly adolescents, also appear to be most at risk for morbidity,
      mortality, and emergency department visits as a result of asthma. This may be caused by poor
      illness management.

      Because of the multiple factors that affect whether or not a family is able to adequately
      manage a youth's asthma, educational interventions alone are typically insufficient to reduce
      morbidity and healthcare utilization, particularly in high-risk urban populations. As a
      result, more intensive, multi-component interventions are necessary to improve asthma
      management and outcomes for those youth at highest risk. MST is an innovative, flexible,
      home- and community-based family therapy that has been shown to improve health outcomes in
      urban children and adolescents with other chronic medical conditions such as type 1 diabetes
      and HIV infection. The purpose of this study is to determine the effectiveness of MST in
      improving health outcomes and reducing healthcare costs in high-risk urban adolescents with
      moderate to severe persistent asthma.

      Participants will include high-risk African-American adolescents with moderate to severe
      asthma. High-risk youth are defined as those with one or more hospitalizations for asthma
      treatment in the previous 12 months. At a baseline hospital visit, participants will complete
      questionnaires and an interview, both of which will focus on the participant's family and
      asthma history. Participants will also have the option of having the study personnel visit
      their home instead. Participants will then be randomly assigned to receive either MST plus
      standard multidisciplinary specialty care or standard multidisciplinary care alone.

      Participants assigned to MST will attend psychological treatment sessions in their homes for
      about 6 months. Treatment sessions will be attended by both children and parents, occur at a
      time designated by the participants, and last about 1 hour. Participants will also complete
      questionnaires about their interactions with the therapist and their satisfaction with
      treatment.

      Participants assigned to standard multidisciplinary specialty care alone will receive weekly
      home-based, supportive family counseling for about 6 months. The treatment will provide
      emotional support to the family regarding asthma, help the family spot problems in asthma
      care, and address specific support that may help them with asthma management. Counseling
      sessions will last about 45 minutes.

      Participants in both groups will receive treatment for 6 months and follow-up for 12 months.
      Participants will be evaluated at baseline and after 7 and 12 months. Families will also be
      contacted during Months 3 and 9 for medical information. During the study, the medical charts
      of participants with asthma will be reviewed for medical history and clinic visits. Other
      medical providers who directly care for the participant's asthma (e.g., primary care
      provider) may also be contacted. At the Month 6 evaluation, height and weight measurements
      will be taken.

      The study completion date listed in this record was obtained from the "Completed Date"
      entered in the Query View Report System (QVR).
    

Intervention name(s): Multisystemic Therapy; Home-based, Non-Directive Family Support
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Treatment will consist of a home- and community-based intensive intervention. Psychological treatment sessions will be provided in participants' homes, at a time designated by the participant and will last about 1 hour.; Treatment will consist of Rogerian, client-centered, non-directive counseling. Participants will receive weekly home-based, supportive family counseling, with sessions lasting about 45 minutes.
Other intervention name(s): MST
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Adolescents; African American