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NCT03514485: WPCA

West Philadelphia Controls Asthma

Completed NA Results posted Last updated 30 October 2024
What this trial tests

NA trial testing Yes We Can Children's Asthma Program in Childhood Asthma in 626 participants. Completed in 30 June 2022.

Timeline
17 May 2018
Primary endpoint
30 June 2022
30 June 2022

Quick facts

Lead sponsorChildren's Hospital of Philadelphia
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designfactorial
Maskingsingle
Primary purposetreatment
Enrollment626
Start date17 May 2018
Primary completion30 June 2022
Estimated completion30 June 2022
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Children's Hospital of Philadelphia

Who can join

Adults 5 to 13, any sex, with Childhood Asthma or Community Health Workers. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Change in Asthma Control Primary · Baseline and 12 months

Asthma Control Questionnaire (ACQ) developed by E.F. Juniper et al. is a 6-item recall of asthma control indicators over the past week. The 6-item recall includes awakening at night with asthma symptoms, asthma symptoms upon waking, activity limitations due to asthma symptoms, shortness of breath, wheezing, and administration of asthma rescue medications. The score range for the ACQ is 0 to 6, with lower numbers indicating greater asthma control and higher numbers indicating worse asthma control. Based on existing literature, the minimal clinically important difference (MCID) is 0.5. The range

Baseline
GroupValue95% CI
P+S+1.351.16 – 1.54
S+ Alone1.421.23 – 1.62
P+ Alone1.381.23 – 1.53
Control1.371.22 – 1.51
12 Months
GroupValue95% CI
P+S+0.740.56 – 0.92
S+ Alone0.850.67 – 1.03
P+ Alone0.850.72 – 0.99
Control0.970.84 – 1.03
Difference (Month 12 minus Baseline)
GroupValue95% CI
P+S+-0.61-0.82 – -0.40
S+ Alone-0.57-0.78 – -0.36
P+ Alone-0.53-0.69 – -0.37
Control-0.39-0.55 – -0.23
Change in Daytime Asthma Symptoms Secondary · Baseline and 12 months

Comparison of the change in daytime symptoms from baseline to 12 months for each intervention group. This data was collected at 3 month intervals with a 2 week recall for number of days with symptoms. This question asks how many days the child has had daytime asthma symptoms in the last 2 weeks and the number of days with asthma symptoms is the answer value (0-14 days). P+ Alone group includes children randomized to receive only the primary care intervention. This group combines two arms P+S- and P+S0 (participants who attended a partner school (P+S-) and those who did not attend a partner sc

Baseline
GroupValue95% CI
P+S+10 – 3
S+ Alone1.50 – 3
P+ Alone10 – 4
Control10 – 3
12 Months
GroupValue95% CI
P+S+00 – 1
S+ Alone10 – 2
P+ Alone00 – 2
Control10 – 2
Change in Nighttime Symptoms Secondary · Baseline and 12 months

Comparison of the change in nighttime symptoms from baseline to 12 months for each intervention group. This question asks how many days the child has had nighttime asthma symptoms in the last 2 weeks and the number of days with asthma symptoms is the answer value (0-14 days). P+ Alone group includes children randomized to receive only the primary care intervention. This group combines two arms P+S- and P+S0 (participants who attended a partner school (P+S-) and those who did not attend a partner school (P+S0). Similarly, the control group combines P-S- and P-S0 (participants in both groups d

Baseline
GroupValue95% CI
P+S+00 – 2
S+ Alone00 – 2
P+ Alone00 – 2
Control00 – 2
12 Months
GroupValue95% CI
P+S+00 – 1
S+ Alone00 – 1
P+ Alone00 – 1
Control00 – 2
Change in School Absences Secondary · Baseline and 12 months

School report of child's school absences pre and post study enrollment

Baseline
GroupValue95% CI
P+S+113 – 20
S+ Alone104 – 23
P+ Alone177 – 24
Control137 – 20
12 Months
GroupValue95% CI
P+S+126 – 26
S+ Alone137 – 28
P+ Alone167 – 24
Control127 – 23
Change in Emergency Department (ED) Visits Secondary · Baseline and 12 months

Comparison of the change in asthma-related Emergency Department visits from baseline to 12 months for each intervention group

baseline
GroupValue95% CI
P+S+10 – 1
S+ Alone10 – 2
P+ Alone11 – 2
Control10 – 2
12 months
GroupValue95% CI
P+S+00 – 1
S+ Alone00 – 1
P+ Alone00 – 1
Control00 – 1
Change in Hospitalizations Secondary · Baseline and 12 months

Comparison of the change in asthma-related hospitalizations from baseline to 12 months for each intervention group

baseline
GroupValue95% CI
P+S+00 – 1
S+ Alone00 – 1
P+ Alone00 – 1
Control00 – 1
12 months
GroupValue95% CI
P+S+00 – 0
S+ Alone00 – 0
P+ Alone00 – 0
Control00 – 0
Change in Asthma Emotional Functioning Domain Secondary · Baseline and 12 months

Comparison of the change in caregivers' self-reported quality of life from baseline to 12 months for each intervention group. Data was collected using Juniper's Pediatric Asthma Caregiver's Quality of Life Questionnaire designed for children aged 7 to 17 years of age. The PAQLQ has 23 questions in 3 domains, including emotional function. The questions ask about a 1 week recall. The range for answer choices is 1-7, with the higher number indicating a better quality of life. The score for the subscale is the mean of the answers for that subscale.

Baseline
GroupValue95% CI
P+S+5.72± 1.26
S+ Alone5.79± 1.18
P+ Alone5.55± 1.32
Control5.63± 1.25
12 Months
GroupValue95% CI
P+S+6.47± 0.78
S+ Alone6.21± 1.00
P+ Alone6.15± 1.08
Control6.16± 1.10
Change in Activity Limitations Domain Secondary · Baseline and 12 months

Comparison of the change in caregivers' self-reported quality of life from baseline to 12 months for each intervention group. he Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ) by Juniper et al. is a 13-item measure of asthma caregiver's quality of life in two domains, including activity limitation. The score for the subscale is the mean of the answers for the subscale. All items are weighted equally and the score range is 1 - 7, with lower numbers indicating poor quality of life and higher numbers indicating better quality of life around caring for a child with asthma.

Baseline
GroupValue95% CI
P+S+5.13± 1.51
S+ Alone5.18± 1.53
P+ Alone5.00± 1.67
Control5.09± 1.69
12 Months
GroupValue95% CI
P+S+6.09± 1.13
S+ Alone5.89± 1.25
P+ Alone5.79± 1.47
Control5.91± 1.43
Baseline School Organizational Climate Index Secondary · At start of school intervention

The Standardized Organizational Climate Index (SOCI) is a 30-item descriptive measure for schools. The index has four dimensions: principal leadership, teacher professionalism, achievement press for students to perform academically, and vulnerability to the community. The score range for each questionnaire item is 1 - 4. The answers assign the value of 1 to "rarely occurs," 2 to "sometimes occurs," 3 to "often occurs," and 4 to "very frequently occurs. For the subscores, ninety-nine percent of the scores range from 200 to 800 with a population mean of 500 and a population standard deviation of

GroupValue95% CI
SOCI Collegial Leadership538.83± 110.95
SOCI Professional Teacher Behavior528.8± 144.88
SOCI Achievement Press471.46± 121.64
SOCI Institutional Vulnerability441.59± 86.28
Baseline School Leadership Secondary · At start of school intervention

The Implementation Leadership Scale (ILS) is comprised of 12 items assessing the degree to which a leader is Proactive, Knowledgeable, Supportive, and shows Perseverance in implementing evidence-based practice. The range for total score and each subscale score is 0 - 4. Higher scores represent better implementation leadership. The mean of the subscale scores yields the total score.

GroupValue95% CI
ILS Total1.76± 1.16
ILS Proactive Leadership1.82± 1.24
ILS Knowledgeable Leadership1.57± 1.2
ILS Supportive Leadership1.7± 1.2
ILS Perseverant Leadership2.03± 1.27
Baseline School Staff Attitudes Secondary · At start of school intervention

The Evidence-Based Practice Attitude Scale (EBPAS) is a 15-item self-report measure of attitudes toward adoption of EBPs. It consists of four subscales: Appeal (is EBP intuitively appealing), Requirements (would an EBP be used if required), Openness (general openness to innovation), and Divergence (perceived divergence between EBP and current practice). Total score range is 0 - 60. The Appeal, Openness, and Divergence subscales have a range of 0 - 16. The Requirements subscale has a range of 0 - 12. Higher scores indicate more positive attitudes. Subscales are summed to compute a total score.

GroupValue95% CI
EBPAS Total2.53± 0.65
EBPAS Requirements2.31± 1.2
EBPAS Appeal2.42± 0.91
EBPAS Openness2.56± 0.87
EBPAS Divergence1.01± 0.86

Sponsor's own description

This project uses community health workers (CHW) or lay health educators to implement asthma interventions that have been proven to work in the primary care setting and in schools. The objective is to integrate the home, school, healthcare system, and community for 600 school-aged asthmatic children in West Philadelphia through use of CHWs. The children enrolled in the study will be randomized to one of four groups including: primary care CHW, school CHW, primary care and school CHW or the control group (no CHW).

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

  1. Community Health Workers Linking Clinics and Schools and Asthma Control: A Randomized Clinical Trial.
    Bryant-Stephens T, Kenyon CC, Tingey C, Apter A, et al · · 2024 · cited 13× · PMID 39432292 · DOI 10.1001/jamapediatrics.2024.3967

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