Guidelines to Practice: Reducing Asthma Health Disparities Through Guideline Implementation
NCT ID: NCT02190617
Last Updated: 2015-05-12
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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UNKNOWN
NA
550 participants
INTERVENTIONAL
2014-12-31
2016-10-31
Brief Summary
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Detailed Description
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* Health plan enhanced intervention plus traditional provider education: Health plans will enhance case management support, monitor medication fills, and increase passive guideline dissemination. Traditional provider education will consist of implementation of the PACE asthma education program. Note that all participants and clinics will receive this intervention. In effect, this will be the base active comparator arm of the study.
* Home visit intervention: Community health workers will provide in-home tailored asthma support: assess asthma self-management knowledge and skills, conduct a home environmental assessment focused on asthma triggers, and conduct follow-up visits to support patient actions to improve asthma control based on unified asthma management plan.
* Enhanced clinic intervention with system integration: Clinics will implement a multi-component intervention that includes decision support, audit and feedback, provider and staff education, team-based care, and training and feedback in implementing office spirometry and allergy testing. EHR enhancements and clinic systems redesign will support this work. The EHR will also provide a platform for sharing a common asthma management plan and enhancing communications among care team members (clinicians, CHWs, plan case managers).
All four intervention groups will receive enhanced health plan intervention + provider education. The four study arms will receive the following additional different interventions: (a) usual clinic care; (b) a + home visit, (c) enhanced clinic care + system integration, and (d) c + home visit.
Conditions
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Study Design
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RANDOMIZED
FACTORIAL
NONE
Study Groups
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Enhanced Clinic+ Unified Management Plan
Patients in study arm will receive:
* Enhanced Clinic Intervention
* Enhanced Health Plan
* Unified Management Plan
Enhanced Clinic+ Unified Management Plan
* Unified asthma management plan and asthma support team coordination: A support team (clinicians, CHWs and plan care managers) will partner with each patient to develop a single asthma management plan. An EMR will provide a web-based platform for sharing the unified asthma management plan and enhancing communications among care team.
* Enhanced clinic intervention: Intervention clinics will implement a multicomponent intervention that will include decision support, audit and feedback, provider and staff education, asthma champions, team-based care, and spirometry, all supported by EMR enhancements and clinic systems redesign.
CHW Home Visit Only
Patients in study arm will receive:
* CHW Home Visit
* Usual clinic care with enhanced health plan
CHW Home Visit Only
-Home visit intervention: Community health workers will provide in-home tailored asthma support: assess asthma self-management knowledge and skills, conduct a home environmental assessment focused on asthma triggers, and conduct follow-up visits to support patient actions to improve asthma control based on unified asthma management plan.
Enhanced Clinic+ Unified Plan+ CHW
Patients in study arm will receive:
* CHW Home Visit
* Enhanced Clinic intervention
* Enhanced health plan
* Unified asthma management plan
Enhanced Clinic+ Unified Plan + CHW
* Unified asthma management plan and asthma support team coordination: A support team will partner with each patient to develop a single asthma management plan. An EMR will provide a web-based platform for sharing the unified asthma management plan.
* Home visit intervention: Community health workers will provide in-home tailored asthma support and conduct follow-up to support patient actions to improve asthma control based on unified asthma management plan.
* Enhanced clinic intervention: Intervention clinics will implement a multicomponent intervention that will include decision support, audit and feedback, provider and staff education, asthma champions, team-based care, and spirometry, all supported by EMR enhancements and clinic systems redesign.
Usual Care
-Usual clinic care with enhanced healthplan
No interventions assigned to this group
Interventions
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Enhanced Clinic+ Unified Plan + CHW
* Unified asthma management plan and asthma support team coordination: A support team will partner with each patient to develop a single asthma management plan. An EMR will provide a web-based platform for sharing the unified asthma management plan.
* Home visit intervention: Community health workers will provide in-home tailored asthma support and conduct follow-up to support patient actions to improve asthma control based on unified asthma management plan.
* Enhanced clinic intervention: Intervention clinics will implement a multicomponent intervention that will include decision support, audit and feedback, provider and staff education, asthma champions, team-based care, and spirometry, all supported by EMR enhancements and clinic systems redesign.
Enhanced Clinic+ Unified Management Plan
* Unified asthma management plan and asthma support team coordination: A support team (clinicians, CHWs and plan care managers) will partner with each patient to develop a single asthma management plan. An EMR will provide a web-based platform for sharing the unified asthma management plan and enhancing communications among care team.
* Enhanced clinic intervention: Intervention clinics will implement a multicomponent intervention that will include decision support, audit and feedback, provider and staff education, asthma champions, team-based care, and spirometry, all supported by EMR enhancements and clinic systems redesign.
CHW Home Visit Only
-Home visit intervention: Community health workers will provide in-home tailored asthma support: assess asthma self-management knowledge and skills, conduct a home environmental assessment focused on asthma triggers, and conduct follow-up visits to support patient actions to improve asthma control based on unified asthma management plan.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Provider-verified diagnosis of asthma
* Have uncontrolled asthma
* Primary language of English,Spanish or Vietnamese
* Patient of Neighborcare or HealthPoint Health
* Insured by Molina Healthcare or Community Health Plan of Washington
Exclusion Criteria
* Household appearing to be unsafe for a visit by a community health worker
* Co-existing medical conditions that make asthma control a low priority for patient management or that confound outcome measurement or that preclude participation in self-management
* Participation in another asthma research study
5 Years
75 Years
ALL
No
Sponsors
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Patient-Centered Outcomes Research Institute
OTHER
Public Health - Seattle and King County
OTHER_GOV
Responsible Party
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Principal Investigators
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James Stout, MD
Role: PRINCIPAL_INVESTIGATOR
University of Washington
Locations
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Public Health -- Seattle & King County
Seattle, Washington, United States
Countries
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Other Identifiers
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AS1307-05498
Identifier Type: -
Identifier Source: org_study_id
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