Virtual Teach to Goal vs. Brief Intervention Inhaler Study-outpatient
Condition: Asthma in Children
MeSH terms: Asthma
Study type: Interventional

Summary: 
      This study aims to evaluate the comparative effectiveness of a high-fidelity, low-resource,
      and feasible model versus a standardized brief intervention that mimics usual care to deliver
      tailored inhaler technique education to children with asthma via a randomized clinical trial.
      We have already conducted a trial of V-TTG among elementary school-aged children hospitalized
      in the inpatient setting and we now aim to test this tool in the outpatient clinic setting
      among a broader pediatric patient population.
    

Detailed description: 
      Asthma is the most common chronic childhood condition and has significant adverse
      consequences. One in 12 United States children has asthma, resulting in 13.4 million missed
      school days, 1 million emergency department visits, and 140,000 hospitalizations annually.
      Urban, minority, and underserved youth are disproportionally affected. On Chicago's South
      Side, one-in-five children have an asthma diagnosis; over half visit an urgent care or
      emergency department (55%), miss school (51.2%), or require parents to miss work annually due
      to asthma (56.1%).

      Effective self-management is crucial to optimize asthma care and improve outcomes. A key
      barrier to self-management is the improper use of respiratory inhalers, which limits disease
      control. Better inhaler technique is associated with improved asthma outcomes for children.
      Assessment and education of inhaler technique are recommended at all healthcare encounters;
      however, it is limited in practice because it is resource-intensive (both personnel and time)
      and lacks fidelity. Thus, low-resource interventions that accurately teach inhaler skills are
      needed to impact pediatric asthma outcomes.

      Teach-to-Goal (TTG) is a patient-centered strategy that uses tailored rounds of teaching and
      assessments to ensure mastery of inhaler technique. Studies show it is effective but
      resource-intensive. A "virtual TTG" (V-TTG) intervention represents an opportunity to deliver
      inhaler technique education with a high-fidelity, low-resource, and feasible strategy. The
      module utilizes innovative learning technology with video demonstrations and assessment
      questions to tailor education to each user; the cycles of assessment and education continues
      until satisfactory mastery is achieved. Our team developed a V-TTG intervention for adults
      with demonstrated efficacy. It remains unknown whether this interactive and adaptive module
      will be feasible and effective in the pediatric population due to varied developmental levels
      and parental involvement in care.

      Virtual Teach-to-Goal (V-TTG) holds the potential to improve inhaler technique in children;
      however, because learning theory indicates children and adults learn differently, the same
      learning module cannot be utilized. We have already constructed V-TTG for children with
      feedback from children with asthma, parents, and healthcare professionals. The learning
      module is tailored for age by using developmentally and age-appropriate vocabulary, concepts,
      format, and pacing.
    

Intervention name(s): Virtual Teach to Goal; Brief Instruction
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Participants will complete inhaler education on a tablet device.; Participants will be read out loud instruction on how to use their inhaler.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research