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Home-Based Asthma Support and Education for Adults (HomeBase)

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT01783028
First Posted: February 4, 2013
Last Update Posted: May 12, 2014
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Collaborator:
National Institute of Environmental Health Sciences (NIEHS)
Information provided by (Responsible Party):
James Krieger, Public Health - Seattle and King County
  Purpose
This study tests the hypothesis that community health workers providing home visits to provide education and support for self-management of asthma, assessment of the home for environmental triggers, resources for asthma control, and assistance in effective communication with medical providers over the course of one year would reduce asthma morbidity, asthma-related urgent health care use and exposure to indoor asthma triggers among low income adults with not well controlled asthma.

Condition Intervention
Asthma Behavioral: Community Health Worker support

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Home-Based Asthma Support and Education for Adults

Resource links provided by NLM:


Further study details as provided by James Krieger, Public Health - Seattle and King County:

Primary Outcome Measures:
  • asthma symptom-free days during the last two weeks [ Time Frame: baseline and 12 months after enrollment ]

    Asthma symptoms are evaluated using the following questions:

    1. During the past 14 days (that is, during the past fourteen 24 hour periods that include daytime and nighttime), on how many DAYS did you have any asthma symptoms, such as wheezing, coughing, tightness in the chest, shortness of breath, waking up at night because of asthma symptoms, or slowing down of usual activities because of asthma?
    2. During the DAYTIME in the past 14 days, how many DAYS did you have asthma symptoms, such as wheezing, cough, tightness in the chest, or shortness of breath?
    3. During the past 14 days, how many days did you have to slow down or stop your usual activities because of asthma, wheezing or tightness in the chest, or cough?
    4. During the NIGHTTIME in the past 14 nights, how many NIGHTS did you WAKE UP because of asthma, wheezing, cough, tightness in the chest, or shortness of breath?.


Secondary Outcome Measures:
  • Asthma-related quality of life score during the last two weeks [ Time Frame: baseline and 12 months after enrollment ]

    Asthma Quality of Life Questionnaire

    http://www.qoltech.co.uk/aqlq.html



Other Outcome Measures:
  • health care utilization [ Time Frame: baseline and 12 months after enrollment ]
    health care utilization includes asthma-related hospitalization, emergency department visit, and unscheduled clinic visit during the past 12 months


Enrollment: 366
Study Start Date: March 2008
Study Completion Date: November 2011
Primary Completion Date: November 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Community Health Worker support
home visits from community health workers providing education and support for self-management of asthma, assessment of the home for environmental triggers, resources for asthma control, and assistance in effective communication with medical providers
Behavioral: Community Health Worker support
For the intervention group, a trained Community Health Worker (CHW) provided education, support and service coordination through home visits. The CHW first made an in home assessment visit. At the assessment visit, the participant had the opportunity to ask questions and sign written consent. During this visit, the CHW assessed the participant's knowledge of asthma, current status of asthma control, challenges with controlling asthma, self-management practices and exposure to asthma triggers. After enrollment, the participant received up to four follow-up educational visits 0.5, 1.5, 3.5 and 7 months later. In addition to scheduled visits, the CHWs worked with their participants on an as-needed basis via telephone, email, or additional home visits.
Other Name: CHW intervention
No Intervention: the usual care control group
Usual care is defined as services received by participants in the absence of the intervention plus information about community resources that support asthma self-management (such as classes and support groups) and educational pamphlets

Detailed Description:

We used a randomized controlled parallel group design to compare the intervention to a usual-care control group. We attempted to evaluate the effectiveness of the intervention in the "real world," rather than its ideal efficacy.

The CHWs used protocols that specified education content, participant skill development and participant and CHW actions. The CHWs modified their approach to meet the priorities of participants using motivational interviewing techniques. They addressed asthma patho-physiology, reliever and controller medication use, self-monitoring, use of an asthma action plan, environmental assessment, trigger avoidance, effective use of the health care system, successful communication with health care providers, and weight control (obesity is associated with increased asthma symptoms). Participants also received low-literacy educational materials, in English or Spanish. The education concepts and environmental assessment activities were based on our prior healthy homes work modified for adults.

  Eligibility

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Ages Eligible for Study:   18 Years to 65 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • residence of King County Washington
  • household income below the 250% of the 2007 federal poverty level
  • had "not well controlled asthma" or "very poorly controlled asthma"

Exclusion Criteria:

  • speak a language other than English or Spanish
  • no permanent housing
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01783028


Locations
United States, Washington
Public Health - Seattle & King County
Seattle, Washington, United States, 98104
Sponsors and Collaborators
Public Health - Seattle and King County
National Institute of Environmental Health Sciences (NIEHS)
Investigators
Principal Investigator: James Krieger, MD Public Health - Seattle and King County
  More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: James Krieger, Chief of Chronic Disease and Injury Prevention, Public Health - Seattle and King County
ClinicalTrials.gov Identifier: NCT01783028     History of Changes
Other Study ID Numbers: PHSKC-AST-HomeBASE
1R01ES014583-01A1 ( U.S. NIH Grant/Contract )
First Submitted: January 31, 2013
First Posted: February 4, 2013
Last Update Posted: May 12, 2014
Last Verified: May 2014

Keywords provided by James Krieger, Public Health - Seattle and King County:
asthma

Additional relevant MeSH terms:
Asthma
Bronchial Diseases
Respiratory Tract Diseases
Lung Diseases, Obstructive
Lung Diseases
Respiratory Hypersensitivity
Hypersensitivity, Immediate
Hypersensitivity
Immune System Diseases