Journal of Allergy and Clinical Immunology: Global (Aug 2023)
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan
- Jerry A. Krishnan, MD, PhD,
- Helen Margellos-Anast, MPH,
- Rajesh Kumar, MD,
- Joel J. Africk, JD,
- Michael Berbaum, PhD,
- Nina Bracken, MSN, NP,
- Yi-Fan Chen, PhD,
- Julie DeLisa, MA,
- Kim Erwin, MDes,
- Stacy Ignoffo, MSW,
- Sai Dheeraj Illendula, MS,
- Hajwa Kim, MS,
- Cortland Lohff, MD, MPH,
- Tom MacTavish, MLIS,
- Molly A. Martin, MD, MAPP,
- Giselle S. Mosnaim, MD, MS,
- Hannah Nguyen, MPH,
- Sarah Norell, MDes, MFA,
- Sharmilee M. Nyenhuis, MD,
- S. Margaret Paik, MD,
- Zachary Pittsenbarger, MD,
- Valerie G. Press, MD, MPH,
- Jennifer Sculley, MDes,
- Trevonne M. Thompson, MD,
- Leslie Zun, MD, MBA,
- Lynn B. Gerald, PhD, MSPH,
- Michael McDermott, MD,
- Sana Ali,
- Janet Flores,
- Shahina Gantiwala,
- Carmen Goralski,
- Rajesh Kumar,
- Jacqueline Ortega,
- Zachary Pittsenbarger,
- Isabelle Wilson,
- Cortland Lohff,
- Michael McDermott,
- Kim Erwin,
- Thomas MacTavish,
- Sarah Norell,
- Maureen Damitz,
- David Massaquoi,
- Kenneth Soyemi,
- Thomas Senko,
- Trevonne Thompson,
- Kate McMahon,
- Joel Africk,
- Amy O’Rourke,
- Christopher Codispoti,
- Jane Kramer,
- Rabia Malik,
- Pamela Manning,
- Giselle Mosnaim,
- Jeanette Avila,
- Helen Margellos-Anast,
- Fatima Padron,
- Jessica Ramsay,
- Nazia Saiyed,
- Tala Schwindt,
- Gloria Seals,
- Leslie Zun,
- Susannah Butters,
- Ashley Hull,
- John Kim,
- S. Margaret Paik,
- Valerie Press,
- Crystal Stevenson,
- Nicole Twu,
- Nicole Woodrick,
- Michael Berbaum,
- Nina Bracken,
- Jennifer Buenrostro,
- Lauren Castro,
- Yi-Fan Chen,
- Julie DeLisa,
- David De La Torre-Dorado,
- Dameka Edwards,
- Alexander Frye,
- Maciej Grabarek,
- Sai Dheeraj Illendula,
- Hajwa Kim,
- Jerry Krishnan,
- Molly Martin,
- Melissa Morales- Perez,
- Hannah Nguyen,
- Sharmilee Nyenhuis,
- Jennifer Sculley,
- Bruce Bender, PhD,
- Francine Ducharme, MD,
- Sheri Hurdle,
- Xue Li, PhD,
- Sande Okelo, MD, PhD
Affiliations
- Jerry A. Krishnan, MD, PhD
- Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Ill; Department of Medicine, University of Illinois Chicago, Chicago, Ill
- Helen Margellos-Anast, MPH
- Sinai Urban Health Institute, Sinai Health System, Chicago, Ill
- Rajesh Kumar, MD
- Department of Pediatrics, Northwestern University and Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
- Joel J. Africk, JD
- Respiratory Health Association, Chicago, Ill
- Michael Berbaum, PhD
- Center for Clinical and Translational Science, University of Illinois Chicago, Chicago, Ill
- Nina Bracken, MSN, NP
- Department of Medicine, University of Illinois Chicago, Chicago, Ill
- Yi-Fan Chen, PhD
- Center for Clinical and Translational Science, University of Illinois Chicago, Chicago, Ill
- Julie DeLisa, MA
- Department of Medicine, University of Illinois Chicago, Chicago, Ill
- Kim Erwin, MDes
- Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Ill
- Stacy Ignoffo, MSW
- Sinai Urban Health Institute, Sinai Health System, Chicago, Ill
- Sai Dheeraj Illendula, MS
- Department of Medicine, University of Illinois Chicago, Chicago, Ill
- Hajwa Kim, MS
- Center for Clinical and Translational Science, University of Illinois Chicago, Chicago, Ill
- Cortland Lohff, MD, MPH
- Chicago Department of Public Health, Chicago, Ill
- Tom MacTavish, MLIS
- Institute of Design, Illinois Institute of Technology, Chicago, Ill
- Molly A. Martin, MD, MAPP
- Department of Pediatrics, University of Illinois Chicago, Chicago, Ill
- Giselle S. Mosnaim, MD, MS
- Department of Medicine, NorthShore University Health System, Chicago, Ill
- Hannah Nguyen, MPH
- Department of Medicine, University of Illinois Chicago, Chicago, Ill
- Sarah Norell, MDes, MFA
- Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Ill
- Sharmilee M. Nyenhuis, MD
- Department of Pediatrics, University of Chicago Medicine Comer Children's Hospital, Chicago, Ill
- S. Margaret Paik, MD
- Department of Pediatrics, University of Chicago Medicine Comer Children's Hospital, Chicago, Ill
- Zachary Pittsenbarger, MD
- Department of Pediatrics, Northwestern University and Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
- Valerie G. Press, MD, MPH
- Department of Pediatrics, University of Chicago Medicine Comer Children's Hospital, Chicago, Ill; Department of Medicine, University of Chicago Medicine, Chicago, Ill
- Jennifer Sculley, MDes
- Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Ill
- Trevonne M. Thompson, MD
- Department of Emergency Medicine, Cook County Health and Hospitals System, Chicago, Ill; Department of Emergency Medicine, University of Illinois Chicago, Chicago, Ill
- Leslie Zun, MD, MBA
- Department of Emergency Medicine and Psychiatry, Rosalind Franklin University of Medicine and Science, Chicago Medical School, Chicago, Ill
- Lynn B. Gerald, PhD, MSPH
- Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Ill; Department of Medicine, University of Illinois Chicago, Chicago, Ill; Corresponding author: Lynn B. Gerald, PhD, MSPH, University of Illinois Chicago,1220 S Wood Street, Chicago, IL 60608.
- Michael McDermott, MD
- Illinois Emergency Department Asthma Surveillance Project, Chicago, Ill
- Sana Ali
- Janet Flores
- Shahina Gantiwala
- Carmen Goralski
- Rajesh Kumar
- Jacqueline Ortega
- Zachary Pittsenbarger
- Isabelle Wilson
- Cortland Lohff
- Michael McDermott
- Kim Erwin
- Thomas MacTavish
- Sarah Norell
- Maureen Damitz
- David Massaquoi
- Kenneth Soyemi
- Thomas Senko
- Trevonne Thompson
- Kate McMahon
- Joel Africk
- Amy O’Rourke
- Christopher Codispoti
- Jane Kramer
- Rabia Malik
- Pamela Manning
- Giselle Mosnaim
- Jeanette Avila
- Helen Margellos-Anast
- Fatima Padron
- Jessica Ramsay
- Nazia Saiyed
- Tala Schwindt
- Gloria Seals
- Leslie Zun
- Susannah Butters
- Ashley Hull
- John Kim
- S. Margaret Paik
- Valerie Press
- Crystal Stevenson
- Nicole Twu
- Nicole Woodrick
- Michael Berbaum
- Nina Bracken
- Jennifer Buenrostro
- Lauren Castro
- Yi-Fan Chen
- Julie DeLisa
- David De La Torre-Dorado
- Dameka Edwards
- Alexander Frye
- Maciej Grabarek
- Sai Dheeraj Illendula
- Hajwa Kim
- Jerry Krishnan
- Molly Martin
- Melissa Morales- Perez
- Hannah Nguyen
- Sharmilee Nyenhuis
- Jennifer Sculley
- Bruce Bender, PhD
- Francine Ducharme, MD
- Sheri Hurdle
- Xue Li, PhD
- Sande Okelo, MD, PhD
- Journal volume & issue
-
Vol. 2,
no. 3
p. 100100
Abstract
Background: Evidence-based strategies to improve outcomes in minority children with uncontrolled asthma discharged from the emergency department (ED) are needed. Objectives: This multicenter pragmatic clinical trial was designed to compare an ED-only intervention (decision support tool), an ED-only intervention and home visits by community health workers for 6 months (ED-plus-home), and enhanced usual care (UC). Methods: Children aged 5 to 11 years with uncontrolled asthma were enrolled. The change over 6 months in the Patient-Reported Outcomes Measurement Information System Asthma Impact Scale score in children and Satisfaction with Participation in Social Roles score in caregivers were the primary outcomes. The secondary outcomes included guideline-recommended ED discharge care and self-management. Results: Recruitment was significantly lower than expected (373 vs 640 expected). Of the 373 children (64% Black and 31% Latino children), only 63% completed the 6-month follow-up visit. In multivariable analyses that accounted for missing data, the adjusted odds ratios and 98% CIs for differences in Asthma Impact Scores or caregivers’ Satisfaction with Participation in Social Roles scores were not significant. However, guideline-recommended ED discharge care was significantly improved in the intervention groups versus in the UC group, and self-management behaviors were significantly improved in the ED-plus-home group versus in the ED-only and UC groups. Conclusions: The ED-based interventions did not significantly improve the primary clinical outcomes, although the study was likely underpowered. Although guideline-recommended ED discharge care and self-management did improve, their effect on clinical outcomes needs further study.