Translating an Efficacious Illness Management Intervention for Youth With Asthma
Translating an Efficacious Illness Management Intervention for Youth With Asthma
The propose of the study is to test the effectiveness of Reach for Control (RFC) as compared
 to Michigan MATCH to improve asthma symptoms, asthma management and lung functioning and to
 decrease ED visits and admissions for youth with poorly controlled asthma when integrated
 into hospital emergency departments and delivered by community health workers. The study is a
 hybrid implementation-effectiveness design and will test RFC for use in real world, public
 healthcare settings.
The study will be conducted in the emergency department at Children's Hospital of Michigan;
 CHM). 170 adolescents with poorly controlled asthma and their primary caregivers will be
 enrolled. Families will be randomly assigned to six months of home-based family treatment
 consisting of either RFC or Michigan MATCH , a model program endorsed by the State of
 Michigan for treatment of poorly controlled asthma. Treatment content of RFC consists of
 weekly sessions focusing on asthma education, asthma management skills, improving home-school
 community for asthma, access to care and case management. MATCH includes asthma education but
 is less intensive and does not focus on family management skills. Treatment will be provided
 by community health workers (CHWs) employed by a community agency providing MATCH as their
 standard of care. Consent and data collection will be completed in the home at baseline with
 additional data collection visits at 6, 12 and 18 months after baseline. Data collection is
 completed by project research assistants and consists of questionnaires and interviews with
 the adolescent and parent to assess asthma management, asthma symptoms and hospital
 utilization. The adolescent also completes a pulmonary function test on a portable spirometer
 and is observed using medication devices to assess asthma care skills objectively.The data
 analyses will be intent-to-treat, meaning that all randomized participants are included
 regardless of the intervention dose received. Trial data will analyzed using the linear mixed
 effect models.
Inclusion Criteria:

 Adolescent/Parent:

 1. Child aged 12 years, 0 months to 16 years, 11 months

 2. Moderate to severe persistent asthma

 3. Child seen in the CHM emergency department for treatment of asthma exacerbation

 4. Child has experienced 2 or more ED visits and/ or inpatient admissions in prior 12
 months (i.e. poorly controlled asthma)

 5. Parent/ legal guardian willing to participate in home-based family treatment

 6. Child and family resides within 20 miles of CHM (allows for home-based data collection
 and intervention)

 Exclusion Criteria:

 Adolescent/Parent:

 1. Child is currently in an out-of-home placement

 2. Schizophrenia or other psychosis on the part of the youth or parent

 3. Current suicidality or homicidality on the part of the youth or parent

 4. Cognitive impairment or learning disability that prevents comprehension of research
 measures on the part of parent or youth