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Rhode Island Asthma Integrated Response Program (RI-AIR)

罗德岛州哮喘综合应对计划 (RI-AIR)

基本信息

批准号：
9768560
负责人：
Daphne Koinis Mitchell
金额：
$ 182.8万
依托单位：
RHODE ISLAND HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-15 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9768560
关键词：
Address Algorithms Area Asthma Care given by nurses Caregivers Caring Child Child Care Child Health Childhood Asthma Cities Clinical Communities Contracts Cost Savings Data Databases Disease Management Disease Outcome Dose Education Effectiveness Emergency department visit Evaluation Family Family Characteristics Family health status Focus Groups Funding Goals Guidelines Health Health Personnel Healthcare Home environment Hospitalization Individual Information Systems Inhalators Insurance Intervention Investments Knowledge Latino Medical Methods Minority Modeling Needs Assessment Outcome Participant Penetration Pharmaceutical Preparations Poverty Prevalence Process Program Evaluation Provider Public Health Quality of life Randomized Recommendation Research Rhode Island Risk School Nursing Schools Secure Self Efficacy Services Stratification Surveys Symptoms System Techniques Technology Visit Work aged base care systems community involvement design ethnic diversity evidence base health care service utilization health care settings high risk improved programs racial and ethnic reduce symptoms remediation response school district screening

项目摘要

Project Summary/Abstract: Greater Providence, Rhode Island is comprised of several urban “core” cities of high poverty and significant pediatric asthma disparity. The RI-Asthma Integrated Response (RI-AIR) Asthma Care Implementation Program (ACIP) is a comprehensive system of identification, screening and intervention for pediatric asthma. Core components include: a 1) state of the art technology platform (the RI-AIR information data system, or RI-AIR IDS) to integrate data from LifeChart (EHR), REDCap (research data system), and KIDSNet (state-based database of child health information), 2) algorithm for stratification of asthma management services based on level of asthma control/risk, 3) multilevel school-based education (CASE) to family/child/school system for children whose asthma is not well-controlled, 4) intensive home-based intervention (HARP) for children with poorly controlled asthma, and 5) enhanced coordination between caregiver, school nurse, and health care provider to promote integration across sectors of care. The first aim of the proposed work is to evaluate the effectiveness of the RI-AIR ACIP using a randomized, stepped wedge design. During Years 2-4, we will provide our intervention sequentially to sixteen high-risk communities involving approximately 1500 urban, ethnically diverse children (aged 2-12) with asthma and their families. We will evaluate both individual-level (e.g., asthma control) and community-specific outcomes (i.e., rates of ED a multi-level process evaluation of the RI-AIR ACIP during implementation (Years 2-5). We will assess penetration within identified communities and school districts, and evaluate characteristics of families that accept and complete the intervention vs. those who do not. We will determine fidelity of the RI-AIR IDS technology platform in assigning interventions according to asthma control/risk, and treatment fidelity and dose delivered of the HARP and CASE programs. We will use focus groups and provider surveys to determine facilitators of and barriers to visits) for children with asthma. The second aim of this application involves conducting effective implementation. The third aim involves conducting a mixed-methods evaluation of the sustainability of the RI-AIR ACIP, with ongoing input from our community stakeholders during Years 5-6. We define sustainability as continued capacity, continued activities, and continued benefits. We expect over 1 year, participants receiving the RI-AIR ACIP will have improved asthma control and fewer symptom free days relative to baseline. We expect over 1 year, relative to baseline, caregivers will have improved asthma knowledge, self-efficacy, asthma QOL, and indicators of effective disease management. We expect over 1 year, communities receiving the RI-AIR ACIP will have reduced ED visits and hospitalizations relative to their baseline year, and relative to targeted communities that have not yet received RI-AIR. We plan to demonstrate that RI-AIR ACIP is a replicable, evidence-based and cost-saving model that improves asthma outcomes for children at most risk, and can be disseminated to other urban communities to address asthma disparities.

项目总结/文摘: