Internet Telehealth for Pediatric Asthma Case Management

Overview

The original and primary aim of this study is to evaluate the effects of CHESS with Nurse Case Management on asthma control (symptom-free days), and adherence factors of children aged 4-12. The investigators have expanded the scope of the specific aims. The criteria for their expanded aim is to also interview low-income African-American caregivers to gain an understanding of how they conceptualize their child's asthma, and what they consider to be barriers or facilitators to managing their child's asthma. There is no change in the investigators' original aim.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: August 2007

Interventions

  • Behavioral: CHESS Internet telehealth
    • CHESS Internet telehealth

Arms, Groups and Cohorts

  • Experimental: CHESS + Case Mgt
    • Case Management (with monthly support calls) and CHESS services were available for a 12 month intervention period. Support calls refer to check in calls by a nurse to the parents to see how the child is doing. CHESS services include access to a website with information on asthma management, discussion groups and a case manager. The website also include a management tool for asthma symptoms check in, and the case manager used the information entered to tailor the homepage to individual clients.
  • No Intervention: Control
    • Control-usual care. Usual care refers to the manner in which clients generally manage their asthma.

Clinical Trial Outcome Measures

Primary Measures

  • Percentage Changed in Adherence Score
    • Time Frame: Baseline compared to the mean of the combined 3, 6, 9, and 12 month scores
    • A baseline number of participants less dropouts was gauged against the weighted average of the number of participants in study period. The percentage change in adherence from baseline through the study was measured and is reported below, together with confidence intervals.
  • Number of Symptom-free Days
    • Time Frame: Baseline compared to the mean of the combined 3, 6, 9, and 12 month scores
    • A comparison in the average number of days that a child goes without asthma symptoms between experimental and control groups are shown below.

Secondary Measures

  • Improvement in Asthma Control
    • Time Frame: Baseline compared to the mean of the combined 3, 6, 9, and 12 month scores
    • A six item survey on a seven point Likert scale measuring daytime and nocturnal asthma symptoms, missed school days and rescue medication use in the previous seven days. Lower scores signal better asthma control.

Participating in This Clinical Trial

Inclusion Criteria

  • Parents of children, aged 4-12 with moderate to severe asthma

Gender Eligibility: All

Minimum Age: 4 Years

Maximum Age: 12 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Wisconsin, Madison
  • Collaborator
    • National Institutes of Health (NIH)
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • David Gustafson, PhD, Principal Investigator, University of Wisconsin, Madison

References

Wise M, Gustafson DH, Sorkness CA, Molfenter T, Staresinic A, Meis T, Hawkins RP, Shanovich KK, Walker NP. Internet telehealth for pediatric asthma case management: integrating computerized and case manager features for tailoring a Web-based asthma education program. Health Promot Pract. 2007 Jul;8(3):282-91. Epub 2006 Aug 23.

Citations Reporting on Results

Wise M, Pulvermacher A, Shanovich KK, Gustafson DH, Sorkness C, Bhattacharya A. Using action research to implement an integrated pediatric asthma case management and eHealth intervention for low-income families. Health Promot Pract. 2010 Nov;11(6):798-806. doi: 10.1177/1524839909334621. Epub 2009 Jun 10.

Gustafson D, Wise M, Bhattacharya A, Pulvermacher A, Shanovich K, Phillips B, Lehman E, Chinchilli V, Hawkins R, Kim JS. The effects of combining Web-based eHealth with telephone nurse case management for pediatric asthma control: a randomized controlled trial. J Med Internet Res. 2012 Jul 26;14(4):e101. doi: 10.2196/jmir.1964.

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