Mobile CHESS Research on Emergency Medical Services for Children

描述（由申请人提供）：这是威斯康星州大学健康增强系统研究中心与威斯康星州大学儿童哮喘临床研究项目和密尔沃基县的五个管理式护理组织（MCO）合作进行的儿童紧急医疗服务移动的CHESS研究的重新提交。这项随机对照试验的主要目的是测试交互式PDA支持低收入青少年（年龄12-18岁）的显着哮喘和MCO护士病例管理器是否可以改善：哮喘控制和减少哮喘相关的紧急情况，紧急护理访问和住院。次要目的包括测试该系统是否增加了对哮喘控制药物的依从性并减少了旷课。我们还将研究一个中介模型，以帮助解释该系统的影响机制。本研究将招募400名在过去12个月内接受过哮喘相关紧急护理或紧急就诊的医疗补助接受者（年龄12-18岁）。所有人都将从密尔沃基县的五名参与MCO的医疗补助接受者那里得到他们的照顾（并通过电子索赔数据进行识别）。我们预计在12个月的干预期间，辍学率为20%。受试者将被随机分配至两个研究组之一，并将参加12个月的干预加12个月的随访期。所有受试者将接受PDA。对照组PDA将提供有限的哮喘信息，并收集和传输测试后数据。实验组的PDA还将：1-访问互联网，2-提供大量的文本、音频和视频哮喘相关的教育材料，3-提供自动提醒，以及4-允许与支持小组和病例管理员进行通信。

DESCRIPTION (provided by applicant): This is a resubmission of Mobile CHESS Research on Emergency Medical Services for Children by the University of Wisconsin's Center for Health Enhancement Systems Studies in collaboration with the University of Wisconsin Pediatric Asthma Clinical Research Program and five managed care organizations (MCO's) in Milwaukee County. This randomized control trial's primary aims are to test whether an interactive PDA supporting low income teenagers (ages 12-18) with significant asthma and MCO nurse case managers can improve: asthma control and reduce asthma-related emergency, urgent care visits, and hospitalizations. Secondary aims include testing whether this system increases adherence to asthma control medication and reduces school absenteeism. We will also examine a mediational model to help explain mechanisms by which this system has its effects. Four hundred Medicaid recipients (ages 12-18) with an asthma related urgent care or emergency visit in the last 12-months will be recruited into this study. All will receive their care (and be identified through electronic claims data) from the five participating MCO's serving Medicaid recipients in Milwaukee County. We anticipate a 20% dropout rate during the 12 month intervention. Subjects will be randomly assigned to one of two study arms and will participate in a 12-month intervention plus a 12-month follow-up period. All subjects will receive PDAs. Control group PDAs will offer limited asthma information, and collect and transmit posttest data. The experimental group's PDA will also: 1-access the internet, 2-deliver extensive text, audio and video asthma-related educational material, 3-deliver automated reminders and 4-allow communication with support groups and case manager.