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The Houston Home-based Integrated Intervention Targeting Better Asthma Control (HIIT-BAC) for African Americans
Investigator (PI): Hamilton, Winifred J
Performing Organization (PO): (Current): Baylor College of Medicine, Department of Family and Community Medicine, Environmental Health Service / (713) 798-1052
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2014
Final Year: 2020
Record Source/Award ID: PCORI/AS-1308-05887
Funding: Total Award Amount: $2,352,903
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Houston-area African American (AA) adults comprise approximately 19% of the population, account for roughly 34% of hospital admissions for asthma, and die at more than twice the rate of area white or Hispanic adult asthmatics. This study will enroll 300 African Americans 18 years of age and older who have poorly controlled asthma and who reside within the City of Houston and Harris County, TX. We will recruit potentially eligible patients through their providers from the Baylor College of Medicine (BCM) and Harris Health System (HH) EpicCare electronic medical records (EMR) databases, and from the Texas Department of State Health Services hospital admissions database. Potential participants will undergo a standardized clinical assessment at the HH Adult Asthma Specialty Clinic. Patients who meet the inclusion criteria will be referred to the BCM Environmental Health Specialty Clinic for enrollment into the study. All patients will undergo an EpicCare-based comprehensive exposure history and receive a tailored, trigger control and self-management education program delivered using motivational interviewing techniques. Patients will then be randomized into one of two groups: (1) enhanced in-clinic care as described above, or (2) enhanced in-clinic care plus a year-long home-based asthma control and environmental intervention. This intervention will consist of five home visits, which will include an inspection of the home and/or other key exposure sources, a customized action plan, implementation of low-cost measures to reduce asthma hazards, reinforcement of the asthma education program, and social support and referrals as appropriate. All participants will undergo a follow-up assessment at 12 months. Key outcomes that will be analyzed include pulmonary function, quality of life, control of asthma symptoms, and utilization of services for asthma. The statistical analysis will assess differences between the two groups as well as changes across time. The HIIT-BAC effort is noteworthy in its ability to target potential participants and their providers through a multi-institutional EpicCare EMR system, the availability of centralized Adult Asthma and Environmental Health specialty clinics for clinical and exposure assessments, and the articulated support of BCM and HH for implementing a standardized home-based intervention program. The City of Houston's Department of Health and Human Services will help oversee the home-based exposure assessments, as well as facilitate obtaining support for such issues as hoarding and neighborhood pollution sources. Specialists from the University of Texas MD Anderson Cancer Center Department of Health Disparities Research will guide the patient and stakeholder involvement. It is hoped, based on studies elsewhere and on the collective expertise of the collaborators, that the convenience and support of the home-based program will lead to measurable and lasting improvements in asthma control in this population.
MeSH Terms:
  • Adolescent
  • Adult
  • African Americans
  • Asthma /*ethnology
  • /*therapy
  • Electronic Health Records
  • Environmental Exposure
  • Environmental Pollutants
  • Humans
  • Middle Aged
  • Motivational Interviewing
  • Outcome Assessment, Health Care
  • Patient Selection
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Self Care
  • Texas
Country: United States
State: Texas
Zip Code: 77030
UI: 20143426
CTgovId: NCT02253433
Project Status: Completed
Record History: ('2019: Project extended to 2020\n2017: Project extended to 2019',) ('Alternate Title: Do home visits from a community health worker help African Americans with asthma more than clinical care and education alone?',)