Uncontrolled asthma continues to be a leading cause of pediatric hospitalization in the U.S., especially among children from low-income and racial/ethnic minority populations.
Guidelines recommend that daily controller therapy can reduce the likelihood of severe exacerbations in children with persistent asthma. However, nonadherence to this therapy is common. Effective support for home asthma management can increase adherence, promote a successful transition from hospital to home, and reduce future morbidity.
To deal with these issues facing children with asthma, the Agency for Health Research and Quality’s (AHRQ) in their Small Research Grant Program funded the University of Rochester with $100,000 to develop the pilot study called the Telehealth Education for Asthma Connecting Hospital and Home (TEACHH) project. The project started September 2021 and is due to end August 31, 2023.
TEACHH is designed to provide an effective educational platform appropriate for all health literacy levels, beginning with initial instruction in the hospital and reinforcement at home by using virtual visits to circumvent common barriers to self-management support in clinical settings.
By incorporating evidence-based educational strategies with telemedicine enhanced communication, TEACHH will deliver high quality self-management support across care settings for underserved children that are at the greatest risk of asthma morbidity.
In a previous study, the researchers demonstrated the feasibility of implementing a health literacy informed asthma education toolkit for children and caregivers in an ambulatory care setting. For the current study, they will extend the use of this toolkit to inpatient and home telehealth settings.
This study will entail doing a randomized controlled trial, by enrolling 80 children 5-11 over a 9 month period to the TEACHH intervention as compared to a Standard Care Comparison group.
The TEACHH group will receive health literacy informed asthma education including color and shape labels for home medications to improve controller identification in the hospital and at home.
This group will also receive two home-based virtual visits to reinforce teaching and self-management support using smartphone accessible teleconferencing software. Both the intervention and the standard care comparison group will watch inpatient teaching videos and provide routine follow up after discharge.
If successful, this model can be applied broadly to reach children with asthma in other care settings. It could also be applied to other chronic childhood diseases, such as diabetes and sickle cell anemia since they require well informed home management to decease preventable morbidity.
The PI is Sean Frey, MD, Assistant Professor in the Department of Pediatrics. For more information on the AHRQ funded project, Telehealth Education for Asthma Connecting Hospital and Home (TEACHH, go to https://digital.ahrq.gov.