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AsthmaCHICAGONCT02319967

Coordinated Healthcare Interventions for Childhood Asthma Gaps in Outcomes

A study testing CAPE and CHW home visits in people with Asthma, run by University of Illinois Chicago at 6 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Chicago is an epicenter for asthma health disparities in the U.S., with African-American children 5-11 yrs bearing a disproportionate share of the burden. Among the most visible of these disparities is the high rate of visits to the Emergency Department (ED) for uncontrolled asthma. Read more about this study

Who is it for?
Ages 5 to 11 years
Conditions the study is for
Asthma
What is being tested?
CAPE and CHW home visits
Could I receive a placebo?
No, everyone receives an active treatment
How many people
373 participants
Where
6 sitesUnited States
Study dates
Mar 2015to Mar 2017
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 5 to 11 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Child is 5-11 years of age (a population in whom a diagnosis of asthma is generally reliable, and in whom exacerbations are common);
  • Child is presenting to the ED, urgent care center, or observation unit at a participating clinical center (Anne and Robert H. Lurie Children's Hospital of Chicago, Sinai Health System's Mount Sinai Hospital, John H. Stroger Jr. Hospital of Cook County Health \& Hospitals System, Rush University Medical Center, University of Chicago Medicine Comer Children's Hospital, and the University of Illinois Hospital \& Health Sciences System);
  • Child is treated with at least 1 dose of an inhaled or nebulized short-acting bronchodilator (quick-relief medication);
  • Child received systemic corticosteroids in the ED OR the caregiver reported at least 1 additional acute care visit for asthma in the previous 6 months (defined as an asthma-related ED visit or urgent care visit, or course of systemic corticosteroids);
  • Child and caregiver approached at least 1 hour after receipt of the first dose of quick-relief medication or systemic corticosteroids, whichever occurred first;
  • Diagnosis of asthma exacerbation by treating clinician;
  • Treating ED clinician indicates the child is likely to be discharged to home; and
  • Caregiver reports that English or Spanish is the preferred language at home.

Who cannot join

  • Caregiver declines to provide informed consent, or the child declines to provide assent;
  • Child is admitted to an intensive care unit or transferred to another healthcare facility;
  • Child or another member of the child's primary household is a current or previous participant in the CHICAGO Plan;
  • Child is enrolled in another study involving a health-related intervention;
  • A CHW is already visiting the home as part of another program;
  • Child does not reside in Chicago.

Trial locations and contacts

6 sites in 1 country.

6 sites in 1 country

United States6 sites
  • Sinai Health System

    Chicago, Illinois, 60608

  • Ann & Robert H. Lurie Children's Hospital of Chicago

    Chicago, Illinois, 60611

  • Cook County Health & Hospitals System

    Chicago, Illinois, 60612

  • Rush University Medical Center

    Chicago, Illinois, 60612

  • University of Illinois at Chicago

    Chicago, Illinois, 60612

  • University of Chicago

    Chicago, Illinois, 60637

Other trials in United States

About this study

Official title: Coordinated Healthcare Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO Plan)

Chicago is an epicenter for asthma health disparities in the U.S., with African-American children 5-11 yrs bearing a disproportionate share of the burden. Among the most visible of these disparities is the high rate of visits to the Emergency Department (ED) for uncontrolled asthma. Clinical uncertainties regarding the real-world effectiveness of guideline recommendations for ED discharge and strategies to reduce environmental triggers at home contribute to practice variation and poor adherence to guidelines. The CHICAGO Plan tests both ED- and home-level interventions to improve clinically meaningful outcomes in a minority pediatric ED population with uncontrolled asthma.

Conditions
Asthma
Being tested
CAPE, CHW home visits
Keywords
community health worker, emergency, asthma
Medical subject headings
Asthma, Emergencies

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CAPEBehavioural

    Decision support and communication tool to promote guideline-recommended care by providers and use of such care by children/caregivers

  • CHW home visitsBehavioural

    Home visits by community health workers (CHW) to assist children and their caregivers to implement the CAPE and other guideline-recommended competencies.

Study groups in NCT02319967
Study groupRoleWhat they receive
Enhanced usual careNo interventionInhaler technique education and distribution of spacers to all participants.
ED-onlyExperimentalInhaler technique education and distribution of spacers to all participants. Structured patient-centered ED discharge template (CAPE) to be completed by ED coordinator.
Receives: Behavioral: CAPE
ED-plus-homeExperimentalInhaler technique education and distribution of spacers to all participants. Structured patient-centered ED discharge template (CAPE) to be completed by ED coordinator. Home visits by a community health worker (CHW).
Receives: Behavioral: CAPE; Behavioral: CHW home visits

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. PROMIS Asthma Impact Scale (v1.0, SF8a)

    Raw scores (0-32) were converted to T-scores to measure change from index visit to 6-month primary endpoint. Low scores indicate better asthma; high scores indicate worse asthma.

    PROMIS Asthma Impact Scale, Pediatric: Min possible T-score: 31.5; Max possible T-score: 76.2 Possible range for change in T-score is [-44.7 to 44.7]

    PROMIS Asthma Impact Scale, Parent proxy: Min possible T-score: 32; Max possible T-score: 80 Possible range for change in T-score is [-48 to 48]

    The reported value represents a change in T-score from baseline to 6 months after index ED discharge.

    A negative change in score indicates improvement in asthma. A positive change in score indicates worsening of asthma. A score of 0 indicates no change.

    Measured: Baseline and 6 months after index ED discharge

  2. PROMIS Satisfaction With Participation in Social Roles (v1.0, SF4a)

    Raw scores (4-20) were converted to T-scores to measure change from index visit to 6-month primary endpoint. Low scores indicate less satisfaction among caregivers; high scores indicate more satisfaction among caregivers.

    PROMIS Satisfaction With Participation in Social Roles: Min possible T-score: 29.0; Max possible T-score: 64.1 Possible range for change in T-score is [-35.1 to 35.1]

    The reported value represents a change in T-score from baseline to 6 months after index ED discharge.

    A negative change in score indicates less satisfaction among caregivers. A positive change in score indicates a more satisfaction among caregivers. A score of 0 indicates no change.

    Measured: Baseline and 6 months after index ED discharge

Secondary outcomes (15)
  1. Childhood Asthma Control Test (cACT)

    The scores of each item were summed for a total score (0-27) to measure change from index to 6-month primary endpoint. Low scores indicate worse asthma; high scores indicate better asthma.

    Childhood Asthma Control Test (cACT): Min possible score: 0; Max possible score: 27 Possible range for change in score is [-27 to 27]

    The reported value represents a change in score from baseline to 6 months after index ED discharge.

    A negative change in score indicates improvement in asthma. A positive change in score indicates worsening of asthma. A score of 0 indicates no change.

    Measured: Baseline and 6 months after index ED discharge

  2. PROMIS Anxiety (v1.0, SF4a)

    Raw scores (4-20) were converted to T-scores to measure change from index visit to 6-month primary endpoint. Low scores indicate less anxiety; high scores indicate more anxiety.

    PROMIS Anxiety: Min possible T-score: 40.3; Max possible T-score: 81.6 Possible range for change in T-score is [-41.3 to 41.3]

    The reported value represents a change in T-score from baseline to 6 months after index ED discharge.

    A negative change in score indicates improvement in anxiety. A positive change in score indicates worsening of anxiety. A score of 0 indicates no change.

    Measured: Baseline and 6 months after index ED discharge

  3. PROMIS Depression (v1.0, SF4a)

    Raw scores (4-20) were converted to T-scores to measure change from index visit to 6-month primary endpoint. Low scores indicate less depression; high scores indicate more depression.

    PROMIS Depression: Min possible T-score: 41.0; Max possible T-score: 79.4 Possible range for change in T-score is [-38.4 to 38.4]

    The reported value represents a change in T-score from baseline to 6 months after index ED discharge.

    A negative change in score indicates improvement in depression. A positive change in score indicates worsening of depression. A score of 0 indicates no change.

    Measured: Baseline and 6 months after index ED discharge

  4. PROMIS Fatigue (v1.0, SF4a)

    Raw scores (4-20) were converted to T-scores to measure change from index visit to 6-month primary endpoint. Low scores indicate less fatigue; high scores indicate more fatigue.

    PROMIS Fatigue: Min possible T-score: 33.7; Max possible T-score: 75.8 Possible range for change in T-score is [-42.1 to 42.1]

    The reported value represents a change in T-score from baseline to 6 months after index ED discharge.

    A negative change in score indicates improvement in fatigue (i.e., less fatigue). A positive change in score indicates worsening of fatigue (i.e., more fatigue). A score of 0 indicates no change.

    Measured: Baseline and 6 months after index ED discharge

  5. PROMIS Sleep Disturbance (v1.0, SF4a)

    Raw scores (4-20) were converted to T-scores to measure change from index visit to 6-month primary endpoint. Low scores indicate less sleep disturbance; high scores indicate more sleep disturbance.

    PROMIS Sleep Disturbance (v1.0, SF4a): Min possible T-score: 32.0; Max possible T-score: 73.3 Possible range for change in T-score is [-41.3 to 41.3]

    The reported value represents a change in T-score from baseline to 6 months after index ED discharge.

    A negative change in score indicates improvement in sleep disturbance (i.e., less sleep disturbance). A positive change in score indicates worsening of sleep disturbance (i.e., more sleep disturbance). A score of 0 indicates no change.

    Measured: Baseline and 6 months after index ED discharge

  6. Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ)

    The overall score is the mean score across all 13 items. Each item is scored on a 7-point Likert scale with 1 indicating severe impairment and 7 indicating no impairment. Higher scores indicate better quality of life; lower scores indicate worse quality of life.

    Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ): Min possible score: 1; Max possible score: 7 Possible range for change in score is [-6 to 6]

    The reported value represents a change in overall score from baseline to 6 months after index ED discharge.

    A negative change in score indicates worsening quality of life. A positive change in score indicates improvement in quality of life. A score of 0 indicates no change.

    Measured: Baseline and 6 months after index ED discharge

  7. Number of Participants With All-cause Emergency Department (ED) or Urgent Care Visits

    Count of participants (children) with at least one all-cause ED or urgent care visit at 6 months

    Measured: 6 months post index ED discharge

  8. Number of Participants With All-cause Hospitalizations

    Count of participants (children) with at least one all-cause hospitalization at 6 months

    Measured: 6 months post index ED discharge

  9. Self-management Practices After ED Discharge: Number of Participants Who Filled Prescriptions for Systemic Corticosteroids

    Count of participants who filled a prescription for systemic corticosteroids within 7 days of discharge

    Measured: 7 days post index ED discharge

  10. Self-management Practices After ED Discharge: Number of Participants Who Filled Prescriptions for Inhaled Corticosteroids or Other Controller

    Count of participants who filled prescription for inhaled corticosteroids or other controller within 7 days of discharge

    Measured: 7 days post index ED discharge

  11. Self-management Practices After ED Discharge: Number of Participants Who Attended an Outpatient Appointment With Patient-identified Asthma Provider

    Count of participants who attended follow-up appointment with patient-identifier asthma provider within 4 weeks of discharge

    Measured: 4 weeks post index ED discharge

  12. Indicator of Guideline-consistent Care Provided on ED Discharge: Number of Participants Who Received Instructions to Use Systemic Corticosteroids

    Count of participants who were provided documented discharge instructions to use systemic corticosteroids

    Measured: At index ED discharge

  13. Indicator of Guideline-consistent Care Provided on ED Discharge: Number of Participants Who Received Instructions to Use Inhaled Corticosteroids or Other Controller

    Count of participants who were provided documented discharge instructions to use inhaled corticosteroids or other controller

    Measured: At index ED discharge

  14. Indicator of Guideline-consistent Care Provided on ED Discharge: Number of Participants Who Received Instructions to Use Inhaled Rescue Medication

    Count of participants who were provided documented discharge instructions to use an inhaled rescue medication

    Measured: At index ED discharge

  15. Indicator of Guideline-consistent Care Provided on ED Discharge: Number of Participants Who Received a Follow-up Appointment Scheduled by ED Staff

    Count of participants who were provided documented discharge instructions for a follow-up appointment scheduled within 4 weeks of discharge

    Measured: At index ED discharge

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Dec 2014 (estimated)
  2. Study startMar 2015
  3. Primary completionMar 2017
  4. Study completionMar 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
373 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02319967
Sponsor's protocol ID
2014-1214
Other IDs
AS-1307-05420
Acronym
CHICAGO
Status last verified
Jun 2019
First submitted
15 Dec 2014
Last updated
19 Jun 2019
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Krishnan JA, Martin MA, Lohff C, Mosnaim GS, Margellos-Anast H, DeLisa JA, McMahon K, Erwin K, Zun LS, Berbaum ML, McDermott M, Bracken NE, Kumar R, Margaret Paik S, Nyenhuis SM, Ignoffo S, Press VG, Pittsenbarger ZE, Thompson TM; CHICAGO Plan consortium. Design of a pragmatic trial in minority children presenting to the emergency department with uncontrolled asthma: The CHICAGO Plan. Contemp Clin Trials. 2017 Jun;57:10-22. doi: 10.1016/j.cct.2017.03.015. Epub 2017 Mar 31.

    PubMed 28366780

Questions about this trial

What is this clinical trial studying?

A study testing CAPE and CHW home visits in people with Asthma, run by University of Illinois Chicago at 6 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Jun 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 22 Apr 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

PROMIS Asthma Impact Scale (v1.0, SF8a) (time frame: Baseline and 6 months after index ED discharge). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02319967, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Jun 2019.

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