Design of a community-based, Hybrid Type II effectiveness-implementation asthma intervention study: The Rhode Island Asthma Integrated Response (RI-AIR) program.

Contemp Clin Trials

Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; Bradley-Hasbro Children's Research Center, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI, USA; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA. Electronic address:

Published: June 2023

AI Article Synopsis

  • Pediatric asthma is a prevalent condition affecting many children, particularly Black and Latino communities, prompting the need for targeted interventions like the Rhode Island Asthma Integrated Response (RI-AIR) program to address care gaps.
  • The RI-AIR program's trial evaluates both its effectiveness on health outcomes and strategies for better implementation to improve participation among families and schools in Greater Providence, R.I.
  • From November 2018 to December 2021, the study screened 6,420 children, enrolling 433 eligible participants, highlighting the importance of addressing health inequities through comprehensive asthma management strategies.

Article Abstract

Background: Pediatric asthma is among the most common health conditions and disproportionately impacts Black and Latino children. Gaps in asthma care exist and may contribute to racial and ethnic inequities. The Rhode Island Asthma Integrated Response (RI-AIR) program was developed to address current limitations in care. The aims of the RI-AIR Hybrid Type II effectiveness-implementation trial were to: a) simultaneously evaluate the effectiveness of RI-AIR on individual-level and community-level outcomes; b) evaluate implementation strategies used to increase uptake of RI-AIR. In this manuscript, we outline the design and methods used to implement RI-AIR.

Methods: School-based areas (polygons) with the highest asthma-related urgent healthcare utilization in Greater Providence, R.I., were identified using geospatial mapping. Families with eligible children (2-12 years) living in one of the polygons received evidence-based school- and/or home-based asthma management interventions, based on asthma control level. School-based interventions included child and caregiver education programs and school staff trainings. Home-based interventions included individualized asthma education, home-environmental assessments, and strategies and supplies for trigger remediation. Implementation strategies included engaging school nurse teachers as champions, tailoring interventions to school preferences, and engaging families for input.

Results: A total of 6420 children were screened throughout the study period, 811 were identified as eligible, and 433 children were enrolled between November 2018 and December 2021.

Conclusions: Effective implementation of pediatric asthma interventions is essential to decrease health inequities and improve asthma management. The RI-AIR study serves as an example of a multi-level intervention to improve outcomes and reduce disparities in pediatric chronic disease.

Clinical Trials Registration Number: NCT03583814.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11157426PMC
http://dx.doi.org/10.1016/j.cct.2023.107204DOI Listing

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