Initiating an online asthma management program in urban emergency departments: the recruitment experience

Joseph, Christine L.M.; Lü, Mei; Stokes-Bruzzelli, Stephanie; Johnson, Dayna A.; Duffy, Elizabeth; Demers, Michele; Zhang, Talan; Ownby, Dennis R.; Zoratti, Edward M.; Mahajan, Prashant

doi:10.1016/j.anai.2015.10.021

Cited by 4 publications

(7 citation statements)

References 11 publications

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“…The details of the Puff City intervention have been previously published. 27,28 The present study focuses on the caregiver of the teenager enrolled in Puff City. The caregiver (legal guardian) accompanying the teenager at the index Emergency Department visit was recruited to participate in the caregiver baseline survey conducted during the recruitment period of October 2012 – October 2013.…”

Section: Methodsmentioning

confidence: 99%

The influence of psychosocial stressors and socioeconomic status on sleep among caregivers of teenagers with asthma, the Puff City study

et al. 2018

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Section: Methodsmentioning

confidence: 99%

The influence of psychosocial stressors and socioeconomic status on sleep among caregivers of teenagers with asthma, the Puff City study

et al. 2018

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“…Emergency departments at two health care systems (Henry Ford Health System and Children’s Hospital of Michigan at the Detroit Medical Center) were used for this study, as were two methods of recruitment described briefly, here, and with more detail in a previous publication [ 11 ]. Children’s Hospital of Michigan (CHOM) is a for-profit, tertiary care hospital in urban Detroit, caring for most of the city’s children of indigent parents.…”

Section: Methodsmentioning

confidence: 99%

“…An awareness campaign for the study included fliers posted in the ED, informational letters emailed to ED physicians, Puff City as an agenda item in nursing “huddles,” and description and updates provided during divisional and practice council meetings. More detail is provided in a previous publication [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

Pilot study of a randomized trial to evaluate a Web-based intervention targeting adolescents presenting to the emergency department with acute asthma

Joseph

Mahajan

Stokes‐Buzzelli

et al. 2017

Pilot Feasibility Stud

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BackgroundLow-income African-American adolescents use preventive medical services less frequently than their White counterparts, indicating a need for effective interventions targeting this group. Puff City is a Web-based, asthma management program for urban adolescents that has been evaluated in high school settings with promising results. The objective of this pilot was to assess the feasibility of initiating Puff City (treatment) in an emergency department setting, thereby informing the conduct of an individual randomized trial to evaluate its effectiveness compared to a generic, Web-based program (control) in preventing subsequent emergency department (ED) visits.MethodsTeens aged 13–19 years presenting with acute asthma to two urban EDs within the study period were eligible. Subsequent ED visits were collected using the electronic medical record. A priori indication of a potential intervention effect was p < 0.20.ResultsOf the 121 teens randomized (65 treatment, 56 control), 86.0% were African-American and 44.6% male, with the mean age = 15.4 years. Computer ownership was reported by 76.8% of teens. Overall, 64.5% of teens completed >3 of 4 sessions and 90% completed the 12-month survey. At 12 months, the treatment group showed a trend toward fewer ED visits than controls (33.8 versus 46.4%), p = 0.15.ConclusionsResults indicate the feasibility of enrolling at-risk adolescents in ED settings and set the stage for a large, pragmatic trial using a technology-based intervention to reduce the burden of pediatric asthma.Trial registrationClinicalTrials.gov, NCT01695031

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“…Previous trials of Puff City were conducted in populations that could be considered more vulnerable (urban high schools and emergency departments) than the present clinic population and consisted of a higher percentage of African-American patients (90%, 88.4%, and 69.9% for schools, ED, and clinic, respectively), of which fewer had access to a computer (74.1%, 71.1%, and 93.6%, for schools, ED, and clinic, respectively). [2,4,11] Missing data (e.g., 30% of data missing for "missed school or work" variable) and extreme values for the ACT scores among controls (which are not taken into account when comparing medians) could also account for this trial's departure from results of the previous school-based Puff City trials, in which Puff City results were more positive.…”

Section: Discussionmentioning

confidence: 99%

“…Pragmatic e-initiatives were used for trial conduct including application of HEDIS criteria to administrative data to identify patients with persistent asthma, a systemwide e-scheduling appointment system to identify the upcoming appointments of potential participants at our primary care locations, and e-tracking and EMR monitoring for patient follow-up. Our experience in using the EMR for trial recruitment and retention is detailed in a previous publication [4]. The purpose of this study is to report the Phase II trial results based on CONSORT guidelines [5] and to assess intervention benefit overall, as well as to describe the enriched population identified through the marker-positive analysis.…”

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Phase II trial of web-based tailored asthma management intervention in adolescents at clinics

Lü

Zhang

Ownby

et al. 2019

Contemporary Clinical Trials

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Clinical trials are critical for medical decision-making; however, conduct is costly and labor intensive. Traditionally, clinical trials are conducted in a controlled environment with a restricted patient population. In addition to the use of electronic initiatives (e-initiatives) such as the use of electronic medical records (EMR) for patient identification, recruitment and data collection, pragmatic clinical trials promote patient enrollment in a "real world" setting with fewer exclusion criteria and less need for research infrastructure. The pragmatic trial also uses comparative adaptive methods and approaches to ensure results provide realworld evidence, i.e., evidence that study execution and data analysis are translatable to practice. Puff City, a web-based, asthma management program for urban adolescents with asthma, has been evaluated in Detroit Public High Schools [1] [2], and results of these school-based randomized trials were promising for potential dissemination beyond schools [1] [2]. To demonstrate pragmatic approaches to conduct of a randomized trial, we extended the Puff City program to a clinical setting and conducted a seamless Phase II/III pragmatic trial of the program in a group of urban, primary care clinics.

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Initiating an online asthma management program in urban emergency departments: the recruitment experience

Cited by 4 publications

References 11 publications

The influence of psychosocial stressors and socioeconomic status on sleep among caregivers of teenagers with asthma, the Puff City study

The influence of psychosocial stressors and socioeconomic status on sleep among caregivers of teenagers with asthma, the Puff City study

Pilot study of a randomized trial to evaluate a Web-based intervention targeting adolescents presenting to the emergency department with acute asthma

Phase II trial of web-based tailored asthma management intervention in adolescents at clinics

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