Trial Outcomes & Findings for Assessing Inflammatory and Behavioral Pathways Linking PTSD to Increased Asthma Morbidity in WTC Workers (NCT NCT04552301)

NCT ID: NCT04552301

Last Updated: 2024-09-19

Results Overview

The PTSD Checklist for DSM-5 (PCL-5), is a 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD. The PCL-5 has a variety of purposes, including monitoring symptom change during and after treatment, screening individuals for PTSD, and making a provisional PTSD diagnosis. Full range from 0-80, higher score indicates more symptoms.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

361 participants

Primary outcome timeframe

Baseline; 1 week post-intervention, up to 11 weeks; 3 months post-intervention, up to 5.5 months

Results posted on

2024-09-19

Participant Flow

10 participants did not have their baseline demographic info because they were added later on in the pilot study

Participant milestones

Participant milestones
Measure
Cognitive Processing Therapy and Targeted Asthma Education
Intervention group - Cognitive Processing Therapy and Targeted Asthma Education Cognitive Processing Therapy: Integrated CPT. CPT is based on a social cognitive theory of PTSD that focuses on how the traumatic event is construed and coped with by a person who is trying to regain a sense of mastery and control in his or her life. The asthma components that will be integrated into the intervention include psychoeducation about asthma, barriers to asthma self-care, asthma medication education, inhaler technique, and asthma self-management behaviors. Targeted Asthma Education: The manualized 10-session program of asthma self-management
Psychotherapy and General Asthma Education
Psychotherapy and General Asthma Education Psychotherapy: The Study Interventionist will conduct generalized supportive psychotherapy with the participants to provide emotional support for both PTSD and general education for asthma. General Asthma Education: A 10-session program of similar time
Overall Study
STARTED
19
19
Overall Study
COMPLETED
19
19
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Assessing Inflammatory and Behavioral Pathways Linking PTSD to Increased Asthma Morbidity in WTC Workers

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Cognitive Processing Therapy and Targeted Asthma Education
n=12 Participants
Intervention group - Cognitive Processing Therapy and Targeted Asthma Education Cognitive Processing Therapy: Integrated CPT. CPT is based on a social cognitive theory of PTSD that focuses on how the traumatic event is construed and coped with by a person who is trying to regain a sense of mastery and control in his or her life. The asthma components that will be integrated into the intervention include psychoeducation about asthma, barriers to asthma self-care, asthma medication education, inhaler technique, and asthma self-management behaviors. Targeted Asthma Education: The manualized 10-session program of asthma self-management
Psychotherapy and General Asthma Education
n=16 Participants
Psychotherapy and General Asthma Education Psychotherapy: The Study Interventionist will conduct generalized supportive psychotherapy with the participants to provide emotional support for both PTSD and general education for asthma. General Asthma Education: A 10-session program of similar time
Total
n=28 Participants
Total of all reporting groups
Age, Continuous
57.3 years
STANDARD_DEVIATION 7.7 • n=5 Participants
51.9 years
STANDARD_DEVIATION 8.3 • n=7 Participants
54.2 years
STANDARD_DEVIATION 8.4 • n=5 Participants
Sex: Female, Male
Female
7 Participants
n=5 Participants
10 Participants
n=7 Participants
17 Participants
n=5 Participants
Sex: Female, Male
Male
5 Participants
n=5 Participants
6 Participants
n=7 Participants
11 Participants
n=5 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
Black or African American
5 Participants
n=5 Participants
2 Participants
n=7 Participants
7 Participants
n=5 Participants
Race/Ethnicity, Customized
White or Caucasian
3 Participants
n=5 Participants
4 Participants
n=7 Participants
7 Participants
n=5 Participants
Race/Ethnicity, Customized
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
Unknown or Not Reported or Other
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic or Latino
2 Participants
n=5 Participants
8 Participants
n=7 Participants
10 Participants
n=5 Participants
Education
8th grade or less
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Education
Some high school
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
Education
High school or GED
2 Participants
n=5 Participants
3 Participants
n=7 Participants
5 Participants
n=5 Participants
Education
1 to 3 years of college
7 Participants
n=5 Participants
8 Participants
n=7 Participants
15 Participants
n=5 Participants
Education
4-year college graduate
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
Education
Higher degree
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
Education
Missing information
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Monthly income
Less than $3000
6 Participants
n=5 Participants
8 Participants
n=7 Participants
14 Participants
n=5 Participants
Monthly income
More than $3000
6 Participants
n=5 Participants
7 Participants
n=7 Participants
13 Participants
n=5 Participants
Monthly income
Missing Information
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Marital status
Unmarried
9 Participants
n=5 Participants
5 Participants
n=7 Participants
14 Participants
n=5 Participants
Marital status
Married
3 Participants
n=5 Participants
11 Participants
n=7 Participants
14 Participants
n=5 Participants
Language
Mostly English
11 Participants
n=5 Participants
10 Participants
n=7 Participants
21 Participants
n=5 Participants
Language
Mostly Spanish
1 Participants
n=5 Participants
4 Participants
n=7 Participants
5 Participants
n=5 Participants
Language
About the same
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
Smoking status
Current/former smoker
4 Participants
n=5 Participants
3 Participants
n=7 Participants
7 Participants
n=5 Participants
Smoking status
Never smoker
6 Participants
n=5 Participants
12 Participants
n=7 Participants
18 Participants
n=5 Participants
Smoking status
Missing Information
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
Insurance
Medicare
4 Participants
n=5 Participants
3 Participants
n=7 Participants
7 Participants
n=5 Participants
Insurance
Medicaid
2 Participants
n=5 Participants
3 Participants
n=7 Participants
5 Participants
n=5 Participants
Insurance
Medicare and Medicaid
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Insurance
Private
3 Participants
n=5 Participants
7 Participants
n=7 Participants
10 Participants
n=5 Participants
Insurance
Other
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Insurance
Unknown or Not Reported
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline; 1 week post-intervention, up to 11 weeks; 3 months post-intervention, up to 5.5 months

Population: Data available for participants who completed instrument.

The PTSD Checklist for DSM-5 (PCL-5), is a 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD. The PCL-5 has a variety of purposes, including monitoring symptom change during and after treatment, screening individuals for PTSD, and making a provisional PTSD diagnosis. Full range from 0-80, higher score indicates more symptoms.

Outcome measures

Outcome measures
Measure
Cognitive Processing Therapy and Targeted Asthma Education
n=19 Participants
Intervention group - Cognitive Processing Therapy and Targeted Asthma Education Cognitive Processing Therapy: Integrated CPT. CPT is based on a social cognitive theory of PTSD that focuses on how the traumatic event is construed and coped with by a person who is trying to regain a sense of mastery and control in his or her life. The asthma components that will be integrated into the intervention include psychoeducation about asthma, barriers to asthma self-care, asthma medication education, inhaler technique, and asthma self-management behaviors. Targeted Asthma Education: The manualized 10-session program of asthma self-management
Psychotherapy and General Asthma Education
n=19 Participants
Psychotherapy and General Asthma Education Psychotherapy: The Study Interventionist will conduct generalized supportive psychotherapy with the participants to provide emotional support for both PTSD and general education for asthma. General Asthma Education: A 10-session program of similar time
PTSD Checklist for DSM-5 (PCL-5)
Pilot Baseline Pre-Intervention
39.2 score on a scale
Standard Deviation 10.3
36.4 score on a scale
Standard Deviation 9.6
PTSD Checklist for DSM-5 (PCL-5)
1 Week Post-Intervention
32.9 score on a scale
Standard Deviation 14.7
34.3 score on a scale
Standard Deviation 11.3
PTSD Checklist for DSM-5 (PCL-5)
3 Months Post-Intervention
29.8 score on a scale
Standard Deviation 17.4
30.9 score on a scale
Standard Deviation 9.1

SECONDARY outcome

Timeframe: Baseline; 1 week post-intervention, up to 11 weeks; 3 months post-intervention, up to 5.5 months

Population: Data available for participants who completed instrument.

The ACQ assess asthma beliefs about asthma control. The ACQ is a 7-item instrument, full scale from 0-6, higher score indicates more impairment.

Outcome measures

Outcome measures
Measure
Cognitive Processing Therapy and Targeted Asthma Education
n=19 Participants
Intervention group - Cognitive Processing Therapy and Targeted Asthma Education Cognitive Processing Therapy: Integrated CPT. CPT is based on a social cognitive theory of PTSD that focuses on how the traumatic event is construed and coped with by a person who is trying to regain a sense of mastery and control in his or her life. The asthma components that will be integrated into the intervention include psychoeducation about asthma, barriers to asthma self-care, asthma medication education, inhaler technique, and asthma self-management behaviors. Targeted Asthma Education: The manualized 10-session program of asthma self-management
Psychotherapy and General Asthma Education
n=19 Participants
Psychotherapy and General Asthma Education Psychotherapy: The Study Interventionist will conduct generalized supportive psychotherapy with the participants to provide emotional support for both PTSD and general education for asthma. General Asthma Education: A 10-session program of similar time
Asthma Control Questionnaire (ACQ)
Pilot Baseline Pre-Intervention
2.1 score on a scale
Standard Deviation 1.1
2.1 score on a scale
Standard Deviation 0.4
Asthma Control Questionnaire (ACQ)
1 Week Post-Intervention
1.7 score on a scale
Standard Deviation 1.0
2.0 score on a scale
Standard Deviation 2.1
Asthma Control Questionnaire (ACQ)
3 Months Post-Intervention
1.9 score on a scale
Standard Deviation 1.5
2.1 score on a scale
Standard Deviation 0.9

SECONDARY outcome

Timeframe: Baseline, 1 week post-intervention, 3 months post-intervention

Population: Data available for participants who completed instrument.

The AQLQ assess asthma beliefs about asthma quality of life. The AQLQ is a 32-item instrument, full scale from 1-7, higher score indicates better health outcomes

Outcome measures

Outcome measures
Measure
Cognitive Processing Therapy and Targeted Asthma Education
n=19 Participants
Intervention group - Cognitive Processing Therapy and Targeted Asthma Education Cognitive Processing Therapy: Integrated CPT. CPT is based on a social cognitive theory of PTSD that focuses on how the traumatic event is construed and coped with by a person who is trying to regain a sense of mastery and control in his or her life. The asthma components that will be integrated into the intervention include psychoeducation about asthma, barriers to asthma self-care, asthma medication education, inhaler technique, and asthma self-management behaviors. Targeted Asthma Education: The manualized 10-session program of asthma self-management
Psychotherapy and General Asthma Education
n=19 Participants
Psychotherapy and General Asthma Education Psychotherapy: The Study Interventionist will conduct generalized supportive psychotherapy with the participants to provide emotional support for both PTSD and general education for asthma. General Asthma Education: A 10-session program of similar time
Asthma Quality of Life Questionnaire (AQLQ)
Pilot Baseline Pre-Intervention
3.7 score on a scale
Standard Deviation 1.1
3.7 score on a scale
Standard Deviation 0.8
Asthma Quality of Life Questionnaire (AQLQ)
1 Week Post-Intervention
4.3 score on a scale
Standard Deviation 1.2
3.9 score on a scale
Standard Deviation 1.0
Asthma Quality of Life Questionnaire (AQLQ)
3 Months Post-Intervention
4.4 score on a scale
Standard Deviation 1.6
3.8 score on a scale
Standard Deviation 1.0

SECONDARY outcome

Timeframe: Baseline; 1 week post-intervention, up to 11 weeks; 3 months post-intervention, up to 5.5 months

Population: Data available for participants who completed instrument.

The MARS assess asthma beliefs about asthma medication adherence. The MARS is a 10-item instrument, full range from 0-10, higher score indicates higher likelihood of medication adherence.

Outcome measures

Outcome measures
Measure
Cognitive Processing Therapy and Targeted Asthma Education
n=19 Participants
Intervention group - Cognitive Processing Therapy and Targeted Asthma Education Cognitive Processing Therapy: Integrated CPT. CPT is based on a social cognitive theory of PTSD that focuses on how the traumatic event is construed and coped with by a person who is trying to regain a sense of mastery and control in his or her life. The asthma components that will be integrated into the intervention include psychoeducation about asthma, barriers to asthma self-care, asthma medication education, inhaler technique, and asthma self-management behaviors. Targeted Asthma Education: The manualized 10-session program of asthma self-management
Psychotherapy and General Asthma Education
n=19 Participants
Psychotherapy and General Asthma Education Psychotherapy: The Study Interventionist will conduct generalized supportive psychotherapy with the participants to provide emotional support for both PTSD and general education for asthma. General Asthma Education: A 10-session program of similar time
Medication Adherence Report Scale (MARS)
Pilot Baseline Pre-Intervention
4.4 score on a scale
Standard Deviation 0.8
4.5 score on a scale
Standard Deviation 0.7
Medication Adherence Report Scale (MARS)
1 Week Post-Intervention
4.5 score on a scale
Standard Deviation 0.6
4.5 score on a scale
Standard Deviation 1.1
Medication Adherence Report Scale (MARS)
3 Months Post-Intervention
4.6 score on a scale
Standard Deviation 0.6
4.5 score on a scale
Standard Deviation 0.8

SECONDARY outcome

Timeframe: Baseline; 1 week post-intervention, up to 11 weeks; 3 months post-intervention, up to 5.5 months

Population: Data available for participants who completed instrument.

The IPQ assess asthma beliefs about illness perception. The IPQ is an 80-item instrument, total scale from 0-80, with higher score indicating higher perception of effects on illness.

Outcome measures

Outcome measures
Measure
Cognitive Processing Therapy and Targeted Asthma Education
n=19 Participants
Intervention group - Cognitive Processing Therapy and Targeted Asthma Education Cognitive Processing Therapy: Integrated CPT. CPT is based on a social cognitive theory of PTSD that focuses on how the traumatic event is construed and coped with by a person who is trying to regain a sense of mastery and control in his or her life. The asthma components that will be integrated into the intervention include psychoeducation about asthma, barriers to asthma self-care, asthma medication education, inhaler technique, and asthma self-management behaviors. Targeted Asthma Education: The manualized 10-session program of asthma self-management
Psychotherapy and General Asthma Education
n=19 Participants
Psychotherapy and General Asthma Education Psychotherapy: The Study Interventionist will conduct generalized supportive psychotherapy with the participants to provide emotional support for both PTSD and general education for asthma. General Asthma Education: A 10-session program of similar time
Illness Perception Questionnaire (IPQ)
Pilot Baseline Pre-Intervention
47.0 score on a scale
Standard Deviation 14.3
46.8 score on a scale
Standard Deviation 12.3
Illness Perception Questionnaire (IPQ)
1 Week Post-Intervention
41.4 score on a scale
Standard Deviation 10.3
44.0 score on a scale
Standard Deviation 12.3
Illness Perception Questionnaire (IPQ)
3 Months Post-Intervention
42.7 score on a scale
Standard Deviation 13.1
44.6 score on a scale
Standard Deviation 12.9

SECONDARY outcome

Timeframe: Baseline; 1 week post-intervention, up to 11 weeks; 3 months post-intervention, up to 5.5 months

Population: Data available for participants who completed instrument.

Beliefs About Medicines Questionnaire (BMQ), a 10-item validated tool assessing medication necessity and concerns. The BMQ consists of two five-item scales assessing patients' beliefs about the necessity of medication and their concerns about taking it. Each item scored on a five-point Likert scale, ranging from 1 = strongly disagree to 5 = strongly agree. Total subscale scores for the Necessity and Concerns Scales range from 5 to 25. Higher scores indicate stronger beliefs.

Outcome measures

Outcome measures
Measure
Cognitive Processing Therapy and Targeted Asthma Education
n=19 Participants
Intervention group - Cognitive Processing Therapy and Targeted Asthma Education Cognitive Processing Therapy: Integrated CPT. CPT is based on a social cognitive theory of PTSD that focuses on how the traumatic event is construed and coped with by a person who is trying to regain a sense of mastery and control in his or her life. The asthma components that will be integrated into the intervention include psychoeducation about asthma, barriers to asthma self-care, asthma medication education, inhaler technique, and asthma self-management behaviors. Targeted Asthma Education: The manualized 10-session program of asthma self-management
Psychotherapy and General Asthma Education
n=19 Participants
Psychotherapy and General Asthma Education Psychotherapy: The Study Interventionist will conduct generalized supportive psychotherapy with the participants to provide emotional support for both PTSD and general education for asthma. General Asthma Education: A 10-session program of similar time
Beliefs About Medicines Questionnaire (BMQ)
Pilot Baseline Pre-Intervention Concerns Score
16.3 score on a scale
Standard Deviation 2.7
17.2 score on a scale
Standard Deviation 4.0
Beliefs About Medicines Questionnaire (BMQ)
Pilot Baseline Pre-Intervention Necessity Score
20.1 score on a scale
Standard Deviation 2.8
19.5 score on a scale
Standard Deviation 3.2
Beliefs About Medicines Questionnaire (BMQ)
1 Week Post-Intervention Necessity Score
20.7 score on a scale
Standard Deviation 1.8
19.4 score on a scale
Standard Deviation 4.1
Beliefs About Medicines Questionnaire (BMQ)
3 Months Post-Intervention Necessity Score
19.5 score on a scale
Standard Deviation 3.5
18.8 score on a scale
Standard Deviation 3.7
Beliefs About Medicines Questionnaire (BMQ)
1 Week Post-Intervention Concerns Score
16.0 score on a scale
Standard Deviation 3.7
16.9 score on a scale
Standard Deviation 4.4
Beliefs About Medicines Questionnaire (BMQ)
3 Months Post-Intervention Concerns Score
17.1 score on a scale
Standard Deviation 4.6
16.0 score on a scale
Standard Deviation 4.3

SECONDARY outcome

Timeframe: Baseline; 1 week post-intervention, up to 11 weeks; 3 months post-intervention, up to 5.5 months

Population: Data available for participants who completed instrument.

As a severity measure, the PHQ-9 score can range from 0 to 27, since each of the 9 items can be scored from 0 (not at all) to 3 (nearly every day). Total scores of 5, 10, 15, and 20 represent cutpoints for mild, moderate, moderately severe and severe depression, respectively.

Outcome measures

Outcome measures
Measure
Cognitive Processing Therapy and Targeted Asthma Education
n=19 Participants
Intervention group - Cognitive Processing Therapy and Targeted Asthma Education Cognitive Processing Therapy: Integrated CPT. CPT is based on a social cognitive theory of PTSD that focuses on how the traumatic event is construed and coped with by a person who is trying to regain a sense of mastery and control in his or her life. The asthma components that will be integrated into the intervention include psychoeducation about asthma, barriers to asthma self-care, asthma medication education, inhaler technique, and asthma self-management behaviors. Targeted Asthma Education: The manualized 10-session program of asthma self-management
Psychotherapy and General Asthma Education
n=19 Participants
Psychotherapy and General Asthma Education Psychotherapy: The Study Interventionist will conduct generalized supportive psychotherapy with the participants to provide emotional support for both PTSD and general education for asthma. General Asthma Education: A 10-session program of similar time
Patient Health Questionnaire-9 (PHQ-9) Depression Severity
Pilot Baseline Pre-Intervention
12.9 score on a scale
Standard Deviation 5.4
10.9 score on a scale
Standard Deviation 4.9
Patient Health Questionnaire-9 (PHQ-9) Depression Severity
1 Week Post-Intervention
9.7 score on a scale
Standard Deviation 4.6
10.4 score on a scale
Standard Deviation 6.4
Patient Health Questionnaire-9 (PHQ-9) Depression Severity
3 Months Post-Intervention
10.1 score on a scale
Standard Deviation 7.5
9.7 score on a scale
Standard Deviation 5.8

SECONDARY outcome

Timeframe: Baseline; 1 week post-intervention, up to 11 weeks; 3 months post-intervention, up to 5.5 months

Population: Data available for participants who completed instrument.

The GAD-7 score is calculated by assigning scores of 0, 1, 2, and 3, to the response categories of 'not at all', 'several days', 'more than half the days', and 'nearly every day', respectively, and adding together the scores for the seven questions. Scores of 5, 10, and 15 are taken as the cut-off points for mild, moderate and severe anxiety, respectively. When used as a screening tool, further evaluation is recommended when the score is 10 or greater. Full scale from 0-21, with higher score indicating poorer health outcomes.

Outcome measures

Outcome measures
Measure
Cognitive Processing Therapy and Targeted Asthma Education
n=19 Participants
Intervention group - Cognitive Processing Therapy and Targeted Asthma Education Cognitive Processing Therapy: Integrated CPT. CPT is based on a social cognitive theory of PTSD that focuses on how the traumatic event is construed and coped with by a person who is trying to regain a sense of mastery and control in his or her life. The asthma components that will be integrated into the intervention include psychoeducation about asthma, barriers to asthma self-care, asthma medication education, inhaler technique, and asthma self-management behaviors. Targeted Asthma Education: The manualized 10-session program of asthma self-management
Psychotherapy and General Asthma Education
n=19 Participants
Psychotherapy and General Asthma Education Psychotherapy: The Study Interventionist will conduct generalized supportive psychotherapy with the participants to provide emotional support for both PTSD and general education for asthma. General Asthma Education: A 10-session program of similar time
Generalized Anxiety Disorder-7
Pilot Baseline Pre-Intervention
11.1 score on a scale
Standard Deviation 5.1
9.4 score on a scale
Standard Deviation 4.6
Generalized Anxiety Disorder-7
1 Week Post-Intervention
10.1 score on a scale
Standard Deviation 5.6
8.9 score on a scale
Standard Deviation 5.7
Generalized Anxiety Disorder-7
3 Months Post-Intervention
9.3 score on a scale
Standard Deviation 7.8
8.1 score on a scale
Standard Deviation 5.2

Adverse Events

Cognitive Processing Therapy and Targeted Asthma Education

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Psychotherapy and General Asthma Education

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Juan Wisnivesky

Icahn School of Medicine at Mount Sinai

Phone: (212) 241-2125

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place