Improving Asthma Care by Partnering With School Nurses to Bring Asthma Care Into the Inner-City Schools
Condition: Asthma
MeSH terms: Asthma
Study type: Interventional

Summary: 
      This is a pilot study to improve the partnership between Cincinnati Children's Medical Center
      (CCHMC), Cincinnati Public Schools (CPS), and Cincinnati Health Department (CHD) to reduce
      childhood asthma in the inner city schools of Cincinnati and CCHMC. We are calling this
      project "asthma-free schools" and bringing it to neighborhoods where the incidence of asthma
      is especially high. We have designed this study to work with school-based asthma care
      programs. Children with high-risk asthma will be asked to participate. "High-risk" will be
      defined as poorly controlled asthma, frequent school absences, and/or need for daily
      controller asthma medications. We will use a commercially available inhaler cap sensor to
      help track medication use and symptoms through a smartphone. The study visits will be done
      mostly at the school using telehealth technology similar to Skype.
    

Detailed description: 
      This study is part of a community health collaboration between Cincinnati Children's Hospital
      Medical Center (CCHMC), the local public health department and designated inner city schools.
      The purpose is to address school-based asthma care barriers and then to test the efficacy of
      this program in a pilot study to improve asthma outcomes in 30 urban core youth.

      Greater Cincinnati's geography places it at the environmentally tricky confluence of
      low-lying smog-trapping hills, three heavily traveled interstate highways, and high rate of
      allergen exposure. This makes it an area ripe for asthma. The overall rate of pediatric
      asthma in Greater Cincinnati is more than twice the national average and, in some urban-core
      neighborhoods, as high as 10 times the national rate.

      Poor asthma control across the nation and locally in Cincinnati is associated with an
      overrepresentation of children from minority groups, low-income families, and single parent
      households who deal with economic hardship and familial strain compared to those with
      well-controlled asthma. Data show that no more than 50% of patients keep appointments or fill
      prescriptions, leading to continued poor asthma control and risk for future exacerbation.

      This is an interventional pilot study where about 30 high-risk asthmatic participants will be
      identified to participate and a number of interventions will be incorporated including asthma
      specific questionnaires, use of a commercially available inhaler cap with monitoring sensor,
      a mobile software management platform that tracks adherence of all asthma medications, mobile
      based telehealth medical visits to assess asthma control, and mobile based telehealth
      adherence problem-solving interventions.

      This proposal is funded through a Luther Foundation and Verizon Foundation philanthropic
      gifts.
    

Intervention name(s): Sensor cap system for inhalers; App for SmartPhone; Motivational interviews; Telehealth clinic visits
Intervention type(s): Device; Other; Behavioral; Other
Intervention description(s): All subjects will be given a commercially available inhaler cap with monitoring sensor on clinically prescribed asthma inhalers.; All subjects will be given smart phone with mobile software management platform to motivate and record medication adherence.; All subjects will have motivational telehealth visits to assess adherence and promote problem-solving skills; All subjects will have asthma medical visits via telehealth technology to assess asthma control.
Other intervention name(s): Propeller
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Telehealth; Sensor cap; School based care; Community health; AsthmaTreatSmart Application