A Multicomponent, Multi-Trigger Intervention to Enhance Asthma Control in High-Risk African American Children

Abstract

Introduction We evaluated the effectiveness and feasibility of implementation of a multicomponent, multi-trigger (MCMT) intervention through a public health department in a high risk population of African American children. Methods This was a pragmatic quasi-experimental pretest–posttest study. The population consisted of African American children enrolled in Medicaid and Children’s Medical Services who had poorly controlled asthma. The MCMT intervention included 4 educational sessions and home asthma trigger reduction. Parents reported outcomes at baseline and at 1 to 3 months, 6 months, and 12 months after the MCMT intervention. Analysis used the McNemar χ 2 test and Student t test for paired observations. Data were collected during 2014 through 2016 in Augusta, Georgia. Results The number of children with asthma that was assessed as well controlled increased from 4 to 17 out of 20 ( P < .001). Compared with baseline, at 12 months parents reported fewer days of school missed (6.4 vs 4.2, P = .01), fewer emergency department visits (1.7 vs 0.6, P = .02) and fewer hospitalizations (0.59 vs 0.18, P = .05). The most common environmental interventions were dust mitigation, getting a mattress or pillow protector, and cockroach mitigation. Conclusion An MCMT intervention in high risk African American children with poorly controlled asthma administered through the health department was associated with significant improvements in asthma control, days of school missed, and emergency department visits. Broader implementation of these strategies is warranted.

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“…Intervention settings included the physical locations where the intervention was conducted. These 29,32,[44][45][46][47]54,57 (2) community setting, 22,23,26,28,31,[33][34][35]39,40,42,43,48,51,52,55 (3) correctional facility, 30 (4) home-based delivery, 24,27,60 (5) mobile clinics, 36,37,49,50 (6) not-reported, 53,56 and (8) virtual setting. 25,38,41,58,59 Intervention delivery agent…”

“…Intervention components were strategies and tactics that interventions used to reach populations and effect change. These included: (1) health education training,22-29 (2) free/affordable care,30-36 (3) social media/social networks,37-42 (4) training providers,43-48 (5) data-driven strategy,49-52 (6) structural/policy change,53-56(7) phone-based interventions,57-59 and (8) environmental change 60. Some articles used multiple tactics to reach populations.…”

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