Chronic Obstructive Pulmonary Disease and Community Health Worker Home-visits

NCT ID: NCT06350799

Last Updated: 2024-04-05

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 9 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2019-03-14
• Study Completion Date: 2023-04-28

Brief Summary

We examined a Community Health Worker (CHW) program for Chronic Obstructive Pulmonary Disease (COPD) in Veteran Participants. The goal of this study was to assess participants' perceived acceptability, appropriateness, and feasibility of the intervention, explore participants' COPD health outcomes, and gather insights from participants and CHWs to inform potential improvements.

Veteran participants enrolled in the 12-week intervention and received a series of 9 CHW home, phone, or video visits. These visits provided education and chronic disease self-management practices to improve COPD health.

Researchers examined the participant and CHW perception of the intervention through qualitative interviews and surveys.

Detailed Description

Background: One-third of Veterans live in rural areas, and rural patients are more likely to have chronic obstructive pulmonary disease (COPD) and rural Veterans with COPD have lower health status than urban Veterans. COPD patients often have exacerbations that can lead to emergency room visits and hospitalizations. Since COPD exacerbations and hospitalizations can be prevented by interventions such as appropriate use of inhaled COPD medications, focusing efforts to improve COPD management for these high-risk rural Veterans with COPD is essential.

Objectives: The proposed project will test the feasibility and potential effectiveness of a Community Health Worker (CHW) intervention to help reduce risk of COPD exacerbations among Veterans. The overall goal of this pilot study is to determine the feasibility and acceptability of a community health worker intervention to promote health behavior change among Veterans with COPD. To target a high risk population, we will focus on Veterans with moderate-severe exacerbations in the past year.

Methods: Participants at VA Puget Sound will be enrolled in the study. We will develop a program to serve rural Veterans, though we will also serve all Veterans meeting the criteria particularly in these initial stages at the VA Puget Sound in Seattle. Participants will be scheduled for 9 education visits over 12 weeks that will be delivered either in-person, though a Clinical Video Telehealth into the home (CVT-to-Home), or by phone. Participants will be offered to have additional phone calls in between visits to check-in on their COPD self-management goals and confirm their upcoming appointments. Participants will be followed for a total of 3 months in this pilot study. Data on proportion of eligible patients who enroll in the study, number of intervention visits completed, and completion of study questionnaires will be collected. Data analysis will examine whether any changes in outcomes such as quality of life or physical activity between baseline and follow-up are associated with the intervention. Semi-structured exit interviews will be conducted at the end of the study to assess the design of intervention components, use of technology, appropriateness, and feasibility.

Conditions

COPD

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: PROSPECTIVE

Eligibility Criteria

Inclusion Criteria

• Clinical diagnosis of COPD
• Enrolled in VA primary care
• English speaking
• Access to a telephone
• Clinically stable breathing for at least 1 month prior to enrollment
• If available, post-bronchodilator spirometry with FEV1/FVC < 0.70 in the last 5 years
• ≥ 1 exacerbation in the past year treated with prednisone and/or antibiotics or treated in the ED or stay in the hospital
• Ability to connect to CVT-to-Home

Exclusion Criteria

• Nursing home resident or institutionalized
• Pregnancy
• Pulmonary rehabilitation program in the last year
• Uncontrolled hypertension, angina, or heart failure
• Life expectancy < 1 year or terminal illness.
• Dementia or uncontrolled psychiatric illness
• Other safety concerns with participating in physical activity

• Minimum Eligible Age: 45 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Public Health - Seattle and King County

OTHER_GOV

Sponsor Role: collaborator

University of Washington

OTHER

Sponsor Role: collaborator

VA Puget Sound Health Care System

FED

Sponsor Role: lead

Responsible Party

Vincent S. Fan

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

VA Puget Sound Health Care System

Seattle, Washington, United States

Countries

United States

Other Identifiers

01741

Identifier Type: -

Identifier Source: org_study_id