Home Visits to Optimize Medical and Educational Success Among Sacramento Schoolchildren With Asthma

Study Overview
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Brief Summary
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This study will establish a multi-disciplinary home visitation team consisting of a medical provider and school teacher or staff member, and will evaluate whether a series of visits from this team will help decrease school absenteeism among children with asthma.

Official Title
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Project HOMES: Home Visits to Optimize Medical and Educational Success

Conditions
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Asthma, Chronic School Absenteeism

Intervention / Treatment
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* Behavioral: Home Visit
* Behavioral: Standard Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Students in elementary school (K-6) in the Sacramento City Unified School District Identified as at risk for chronic absenteeism based on previous year and/or first 8 weeks of school year Have a current diagnosis of asthma Exclusion Criteria: Underlying chronic conditions such as cystic fibrosis, chronic lung disease with oxygen dependence, immunodeficiency syndromes

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The study will be a randomized wait-list control trial. Participants will be randomized to the intervention or control arm for the study observation period. At the conclusion of the observation period, the control group will receive the intervention.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>The intervention arm will receive the home visit intervention, consisting of 2 visits to the home by a team consisting of a pediatric medical provider and a school teacher or school support staff member. This team will evaluate the child's home environment to assess for potential asthma triggers that may lead to school absenteeism, and provide strategies and material goods to help reduce those triggers. | Behavioral: Home Visit<br>* The intervention will consist of a series of home visitations to chronically absent students with co-morbid asthma. These visits will consist of a home environment evaluation, medication adherence and knowledge assessment, distribution of home environmental allergen reduction items such as mattress and pillow encasements, as well as review and reinforcement of any asthma action plans or care plans provided by patient's primary care physicians or medical home.<br>|
| Other: Wait-List Control<br>The control group will receive standard interventions carried out by the school system for students at risk for chronic absenteeism. Following the study observation period, this control group will then receive the home visits performed for the intervention group. | Behavioral: Home Visit<br>* The intervention will consist of a series of home visitations to chronically absent students with co-morbid asthma. These visits will consist of a home environment evaluation, medication adherence and knowledge assessment, distribution of home environmental allergen reduction items such as mattress and pillow encasements, as well as review and reinforcement of any asthma action plans or care plans provided by patient's primary care physicians or medical home.<br>Behavioral: Standard Care<br>* Standard care will refer to the procedures carried out by the school district to address students with chronic absenteeism. This includes parent-teacher and parent-school administrator meetings and communications and may also include home visits carried out by classroom teachers or student support center staff.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Missed School Days | The number of school days missed over the course of an academic year | One academic year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Healthcare Utilization | Number of emergency department or urgent care visits for asthma | One academic year | 
| Asthma Symptom Report | Patient and family self-report of number of days where asthma symptoms were experienced, collected monthly | One academic year | 
| Asthma Control Test | Numeric score from the Childhood Asthma Control Test, collected monthly | One academic year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Home Visit, School Absenteeism