A Multifaceted Prompting Intervention for Urban Children With Asthma

A Multifaceted Prompting Intervention for Urban Children With Asthma

The overall goal of this project is to evaluate whether a multifaceted prompting intervention, administered in the urban primary care office setting, reduces morbidity among urban children with asthma. This study builds on our experience with a pilot study in two urban continuity clinics, in which we found that prompting clinicians about asthma severity and care guidelines at the time of an office visit resulted in improved preventive care delivery to inner-city children. This type of prompting program has the potential to substantially improve care for impoverished children with asthma, and we propose to establish: 1) whether these findings can be replicated in a similar study including a larger sample of urban children from different types of practices, and 2) whether the positive effects can be enhanced by more specific prompting directed towards both the provider and the caregiver and by providing practice-level supports and feedback. We hypothesize that children receiving a multifaceted prompting intervention (MPI) will experience less asthma-related morbidity (defined by symptom-free days at the 2-month follow-up) compared to children receiving usual care. Our secondary hypothesis is that children receiving the MPI will receive improved preventive asthma care (defined by guideline-based corrective actions taken at the index visit) compared to children receiving usual care.

Inclusion Criteria:

• Physician-diagnosed asthma
• Mild persistent or more severe asthma severity, or poor asthma control
• Age >2 and <12 years.
• Parent or caregiver must give permission to the study, and children >7 will must provide assent.

Exclusion Criteria:

• Inability to speak and understand English or Spanish
• No access to a working phone for follow-up surveys
• The child having other significant medical conditions,
• Children in foster care or other situations in which consent cannot be obtained from a guardian.
• Prior enrollment in the study.
• Child will not be seen by a physician or nurse practitioner during their visit