Mobile CHESS Research on Emergency Medical Services for Children

描述(由申请人提供)：这是由威斯康星大学健康促进系统研究中心与威斯康星大学儿科哮喘临床研究计划和密尔沃基县五个管理护理组织(MCO)合作提交的关于儿童紧急医疗服务的移动国际象棋研究再次提交。这项随机对照试验的主要目的是测试支持患有严重哮喘的低收入青少年(12-18岁)的互动PDA和MCO护士病例管理人员是否可以改善：哮喘控制和减少与哮喘相关的紧急情况、紧急护理就诊和住院。次要目标包括测试该系统是否增加了哮喘控制药物的依从性，并减少了学校旷课。我们还将研究一个中介模型，以帮助解释该系统产生影响的机制。400名医疗补助受助者(年龄12-18岁)在过去12个月中接受过哮喘相关的紧急护理或急诊，将被招募到这项研究中。所有人都将接受密尔沃基县五名参与MCO的医疗补助服务接受者的护理(并通过电子索赔数据识别)。我们预计在12个月的干预期间，辍学率将达到20%。受试者将被随机分配到两个研究臂中的一个，并将参与为期12个月的干预和12个月的随访期。所有受试者都将收到掌上电脑。对照组PDA将提供有限的哮喘信息，并收集和传输后测数据。试验组的PDA还将：1-访问互联网，2-提供与哮喘相关的大量文本、音频和视频教育材料，3-提供自动提醒，4-允许与支持小组和病例经理进行沟通。

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.