Ignite Creation Date:
2024-05-05 @ 4:43 PM
Last Modification Date:
2024-10-26 @ 9:23 AM
Study NCT ID:
NCT00304304
Status:
COMPLETED
Last Update Posted:
2016-02-17
First Post:
2006-03-16
Brief Title:
HealthSpark 2 Improving Asthma Care for Preschool Children
Sponsor:
University of Miami
Organization:
University of Miami
Study Overview
Official Title:
Community - Based Asthma Intervention in Subsidized Preschools
Status:
COMPLETED
Status Verified Date:
2016-02
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
From a previous community needs survey we determined that asthma was a particular problem in our community-based research network of child care centers This study will examine whether a moderate intervention can help these centers improve their asthma-friendly rating as per NHLBI guidelines We will both center directors and parents to establish baseline data on child health and the asthma-friendliness of each center We will use a wait-list control with all centers eventually receiving the intervention
Detailed Description:
Asthma is the most common chronic health problem affecting children in the US and it is getting worse Children under the age of 18 years account for one third of the nations asthma sufferers The percent of children with asthma has increased from 3 in 1981 to 6 in 2003 Asthma is a leading reason for hospitalizations of children under the age of 15 years and causes 14 million days of missed school each year Previous studies suggest particularly high asthma rates among Hispanic and African-American populations Poverty increased exposure to indoor allergens low education level poor access to healthcare and failure to take prescribed medicines increase the likelihood of having a severe asthma attack or dying of asthma
According to the results of HealthSpark I children in the target communities have rates of asthma that are more than three times the national average 293 of HealthSpark families with children ages 3 to 5 years responded yes to the question Did a doctor ever tell you that your child has asthma In a national survey in 2002 only 73 of parents with children ages 0 to 4 years responded yes to the same question The high rate of asthma among HealthSpark families is similar to recent reports of high prevalence in Harlem NY and other underserved minority communities
Of HealthSpark parents reporting that their child has asthma 387 also reported that their child was taking a medication regularly for more than a year It is reasonable to assume that most of these were asthma medications which suggests that approximately 113 of the total HealthSpark population has moderate to severe asthma These children also had high rates of comorbidity HealthSpark children with asthma were twice as likely as children without asthma to be limited in their daily activities and three times as likely to require increased medical educational and mental health services HealthSpark children with asthma were also two to three times as likely than children without asthma to have early signs of attention deficit hyperactivity disorder ADHD
Our analysis also revealed ethnic differences in asthma prevalence consistent with national patterns African American children were nearly twice as likely to have a diagnosis of asthma when compared with Hispanic children 406 vs 23 None of these findings were related to access to child health care Children with asthma in fact had better access to care than children without asthma as demonstrated by the following measures having a regular source of care 994 vs 91 having health insurance 925 vs 886 and having a regular doctor that their parents could name 940 vs 865 Children with moderatesevere asthma had even better access to care 984 of parents could name their physician and 97 had health insurance for their child
In 1989 the National Asthma Education and Prevention Program NAEPP was initiated by the National Heart Lung and Blood Institute part of the NIH to address the growing problem of asthma in the United States To accomplish these broad program goals the NAEPP works with intermediaries including major medical associations voluntary health organizations and community programs to educate patients health professionals and the public The ultimate goal of the NAEPP is to enhance the quality of life for patients with asthma and decrease asthma-related morbidity and mortality As part of this broad program the NHLBI released guidelines for CCCs to provide optimal care for children with asthma These asthma-friendly guidelines are at the core of this proposal
This project is a community-based intervention to begin to improve asthma care among these preschool children The target population is 2000 children aged 1-5 years who attend the 51 child care centers that remain as part of the SPARK network
The long-term goals of this project are to a improve the health of children by improving asthma care in the targeted underserved areas of Miami-Dade County and b to enhance readiness for school by reducing the burden of asthma and related conditions
The specific objectives for this project are
1 Document the prevalence severity and impact of asthma among preschool children attending the 51 SPARK child care centers CCCs in AllapatahModel City and HomesteadFlorida City
2 Identify barriers to optimal asthma care in these children
3 Determine how asthma-friendly each child care center is according to guidelines of the National Heart Lung and Blood Institute part of the NIH see Appendix I
4 Work with CCCs and community health clinics to improve clinical outcomes for children with asthma
Outcomes
1 We will better understand the prevalence severity and impact of asthma among preschool children in underserved communities parent surveys
2 We will identify barriers to optimal community-based asthma care projects parent surveys and CCC survey
3 We will increase the number of CCCs that are asthma-friendly CCC surveys site visit
4 We will improve clinical outcomes for children with asthma parent survey
5 We will increase the number of children with written asthma plans from an estimated 10 to greater than 50
Other outcomes
Baseline correlations to identify significant relationships among individual characteristics including asthma severity healthcare utilization healthcare access comorbidity quality of life environmental exposures maternal health literacy and maternal education
According to the results of HealthSpark I children in the target communities have rates of asthma that are more than three times the national average 293 of HealthSpark families with children ages 3 to 5 years responded yes to the question Did a doctor ever tell you that your child has asthma In a national survey in 2002 only 73 of parents with children ages 0 to 4 years responded yes to the same question The high rate of asthma among HealthSpark families is similar to recent reports of high prevalence in Harlem NY and other underserved minority communities
Of HealthSpark parents reporting that their child has asthma 387 also reported that their child was taking a medication regularly for more than a year It is reasonable to assume that most of these were asthma medications which suggests that approximately 113 of the total HealthSpark population has moderate to severe asthma These children also had high rates of comorbidity HealthSpark children with asthma were twice as likely as children without asthma to be limited in their daily activities and three times as likely to require increased medical educational and mental health services HealthSpark children with asthma were also two to three times as likely than children without asthma to have early signs of attention deficit hyperactivity disorder ADHD
Our analysis also revealed ethnic differences in asthma prevalence consistent with national patterns African American children were nearly twice as likely to have a diagnosis of asthma when compared with Hispanic children 406 vs 23 None of these findings were related to access to child health care Children with asthma in fact had better access to care than children without asthma as demonstrated by the following measures having a regular source of care 994 vs 91 having health insurance 925 vs 886 and having a regular doctor that their parents could name 940 vs 865 Children with moderatesevere asthma had even better access to care 984 of parents could name their physician and 97 had health insurance for their child
In 1989 the National Asthma Education and Prevention Program NAEPP was initiated by the National Heart Lung and Blood Institute part of the NIH to address the growing problem of asthma in the United States To accomplish these broad program goals the NAEPP works with intermediaries including major medical associations voluntary health organizations and community programs to educate patients health professionals and the public The ultimate goal of the NAEPP is to enhance the quality of life for patients with asthma and decrease asthma-related morbidity and mortality As part of this broad program the NHLBI released guidelines for CCCs to provide optimal care for children with asthma These asthma-friendly guidelines are at the core of this proposal
This project is a community-based intervention to begin to improve asthma care among these preschool children The target population is 2000 children aged 1-5 years who attend the 51 child care centers that remain as part of the SPARK network
The long-term goals of this project are to a improve the health of children by improving asthma care in the targeted underserved areas of Miami-Dade County and b to enhance readiness for school by reducing the burden of asthma and related conditions
The specific objectives for this project are
1 Document the prevalence severity and impact of asthma among preschool children attending the 51 SPARK child care centers CCCs in AllapatahModel City and HomesteadFlorida City
2 Identify barriers to optimal asthma care in these children
3 Determine how asthma-friendly each child care center is according to guidelines of the National Heart Lung and Blood Institute part of the NIH see Appendix I
4 Work with CCCs and community health clinics to improve clinical outcomes for children with asthma
Outcomes
1 We will better understand the prevalence severity and impact of asthma among preschool children in underserved communities parent surveys
2 We will identify barriers to optimal community-based asthma care projects parent surveys and CCC survey
3 We will increase the number of CCCs that are asthma-friendly CCC surveys site visit
4 We will improve clinical outcomes for children with asthma parent survey
5 We will increase the number of children with written asthma plans from an estimated 10 to greater than 50
Other outcomes
Baseline correlations to identify significant relationships among individual characteristics including asthma severity healthcare utilization healthcare access comorbidity quality of life environmental exposures maternal health literacy and maternal education
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None