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The Coordinated Healthcare Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) Trial
Investigator (PI): Krishnan, Jerry A
Performing Organization (PO): (Current): University of Illinois at Chicago, College of Medicine, Department of Medicine, Division of Pulmonary, Critical Care, Sleep and Allergy / (312) 996-8039
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2014
Final Year: 2018
Record Source/Award ID: PCORI/AS-1307-05420
Funding: Total Award Amount: $3,999,821
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Background: Chicago is an epicenter for asthma health disparities in the U.S., with African American children ages 5-11 years bearing a disproportionate share of the burden. Among the most visible of these disparities is the high rate of visits to the emergency department (ED) for uncontrolled asthma. It is unclear how effective guideline recommendations and strategies to reduce environmental triggers of asthma really are, after children are discharged from the ED. Objectives: Our objective is to test interventions delivered to the patient/caregiver and to the provider, to improve clinically meaningful outcomes in minority children seeking care in the ED for with uncontrolled asthma (Coordinated Healthcare Interventions for Childhood Asthma Gaps in Outcomes [CHICAGO] Trial). Methods. We will enroll 640 English- or Spanish-speaking children ages 5-11 years and their caregivers who present to EDs with uncontrolled asthma. The specific aims are 1) complete planning activities, including qualitative interviews with caregivers, clinicians, and community health workers (CHWs), to finalize the study design and protocol, and comply with regulatory requirements from all institutional and community partners for the CHICAGO Trial; and 2) conduct a multi-center pragmatic trial comparing effectiveness in three groups: the effectiveness of a provider-level ED-based intervention (Provider-ED) v. Provider-ED combined with a patient-level CHW-led intervention that includes a focus on reducing environmental triggers at home (Provider-ED plus Patient-Home) v. usual care. In additional analyses, we will evaluate the potential for heterogeneity of treatment effects (diversity in responsiveness to treatment). Secondary aim: The secondary aim is to identify obstacles and facilitators of successfully implementing the interventions to inform later implementation studies. Patient outcomes: Caregiver input will be used to identify and prioritize study outcomes. We have provisionally proposed a strategy of two co-primary outcomes, one meaningful to children and one to caregivers/families of children with asthma. Secondary outcomes will examine adherence to self-management skills for use of medications and reduction of asthma triggers in the environment, and acute care use. Partnerships to facilitate study: Drawing on collaborations that span nearly two decades, we have assembled a broad-based ED collaborative in Chicago dedicated to eliminating asthma health disparities, including caregivers, patient advocacy groups, the City of Chicago Department of Public Health, and patient-centered outcomes researchers.
MeSH Terms:
  • African Americans
  • Asthma /ethnology
  • /*therapy
  • Caregivers
  • Chicago
  • Child
  • Child, Preschool
  • Community Health Workers
  • Emergency Service, Hospital
  • Health Status Disparities
  • Healthcare Disparities
  • Humans
  • Language
  • Multicenter Studies as Topic
  • Outcome Assessment, Health Care
  • United States
Country: United States
State: Illinois
Zip Code: 60612
UI: 20143415
CTgovId: NCT02319967
Project Status: Completed
Record History: ('2017: Project extended to 2018.',)