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Translating an Efficacious Illness Management Intervention for African American Youth with Poorly Controlled Asthma to Real World Settings

Award Number: R01HL138633
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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There is a critical need to develop interventions to reduce barriers to optimal asthma management and reduce the significant risk for asthma-related morbidity experienced by minority children, especially African- American adolescents with poorly controlled asthma. There are few clinical trials focusing on African-American adolescents with poorly controlled asthma, and intervention studies targeting African-American adolescents with asthma in general or African-American children with poorly controlled asthma in particular are characterized by methodological limitations and/or limited effects on objective health outcomes. Multisystemic Therapy-Health Care (MST-HC) is an intensive, multi-component, home-based psychotherapy that targets the multiple causes of poor adolescent asthma management across individual, family and community systems. In a randomized clinical trial, we showed that MST-HC was significantly more effective than home-based family support in improving adherence to controller medications and improving lung functioning among African- American adolescents with moderate to severe, poorly controlled asthma up to six months after the completion of the intervention. In addition, MST-HC reduced asthma-related hospitalizations and associated ED visits. The primary purpose of the proposed study is to adapt MST-HC for use in real world, public healthcare settings and test it in a T3 translational trial. The new intervention, Reach for Control (RFC), will be housed in a pediatric emergency department (ED) at Children's Hospital of Michigan (CHM)and will be adapted for delivery by community health workers (CHWs). The design is an effectiveness-implementation “Hybrid 1” design where the primary aims are to determine the effectiveness of an evidence-based intervention in a real-world setting, and the secondary aims are to gather information about the context for implementation and barriers/ facilitators to implementation. For our effectiveness aim, we will conduct a randomized effectiveness trial with 170 high risk adolescents with poorly controlled asthma seen in the ED for an asthma exacerbation. RFC will be delivered by Wayne Children's Healthcare Access Program, a community agency providing health care services to underserved children in the Detroit area and will be compared to the agency's standard care intervention for youth with poorly controlled asthma. For our implementation aims, we will evaluate the effectiveness of identification, screening and referral to RFC by ED clinical staff via a clinical pathway. We will study barriers and facilitators to the implementation of RFC (both its integration within the ED and delivery by CHWs) using a mixed methods approach. We will also develop and evaluate an efficient and effective method of measuring CHW fidelity to RFC and conduct a cost analysis that will inform decisions such as treatment dose and CHW caseload in future real-world implementations. If successful, the study has the potential to improve quality of life for a vulnerable population while reducing healthcare costs.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$146,101 )
2025	2021	WAYNE STATE UNIVERSITY	5700 CASS AVE STE 4900	DETROIT	MI	48202	WAYNE	USA	Lung Diseases Research	000	5	11/23/2024	NON-COMPETING CONTINUATION	-$146,101
														Subtotal = -$146,101

Issue Date FY: 2023 ( Subtotal = $0 )
2023	2021	WAYNE STATE UNIVERSITY	5700 CASS AVE STE 4900	DETROIT	MI	48202	WAYNE	USA	Lung Diseases Research	000	5	6/23/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $0 )
2022	2021	WAYNE STATE UNIVERSITY	5057 WOODWARD STE 13001	DETROIT	MI	48202	WAYNE	USA	Lung Diseases Research	000	5	11/18/2021	NON-COMPETING CONTINUATION	$0
2022	2021	WAYNE STATE UNIVERSITY	5057 WOODWARD STE 13001	DETROIT	MI	48202	WAYNE	USA	Lung Diseases Research	001	5	7/19/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2021 ( Subtotal = $600,589 )
2021	2021	WAYNE STATE UNIVERSITY	5057 WOODWARD STE 13001	DETROIT	MI	48202	WAYNE	USA	Lung Diseases Research	000	5	8/19/2021	NON-COMPETING CONTINUATION	$600,589
														Subtotal = $600,589

Issue Date FY: 2020 ( Subtotal = $620,803 )
2020	2020	WAYNE STATE UNIVERSITY	5057 WOODWARD STE 13001	DETROIT	MI	48202	WAYNE	USA	Lung Diseases Research	000	4	7/31/2020	NON-COMPETING CONTINUATION	$620,803
														Subtotal = $620,803

Issue Date FY: 2019 ( Subtotal = $640,919 )
2019	2019	WAYNE STATE UNIVERSITY	5057 WOODWARD 13 FLOOR	DETROIT	MI	48202	WAYNE	USA	Lung Diseases Research	000	3	8/27/2019	NON-COMPETING CONTINUATION	$640,919
														Subtotal = $640,919

Issue Date FY: 2018 ( Subtotal = $664,145 )
2018	2018	WAYNE STATE UNIVERSITY	5057 WOODWARD 13 FLOOR	DETROIT	MI	48202	WAYNE	USA	Lung Diseases Research	000	2	7/20/2018	NON-COMPETING CONTINUATION	$664,145
														Subtotal = $664,145

Issue Date FY: 2017 ( Subtotal = $697,427 )
2017	2017	WAYNE STATE UNIVERSITY	5057 WOODWARD 13 FLOOR	DETROIT	MI	48202	WAYNE	USA	Lung Diseases Research	000	1	8/18/2017	NEW	$697,427
														Subtotal = $697,427

Grand Total All Awards = $3,077,782

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Translating an Efficacious Illness Management Intervention for African American Youth with Poorly Controlled Asthma to Real World Settings

Award Number: R01HL138633

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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