TY - JOUR
T1 - Rationale and design of a comparative effectiveness trial of home- and clinic-based self-management support coaching for older adults with asthma
AU - the SAMBA Investigators, The SAMBA investigators and development team
AU - Federman, Alex D.
AU - Martynenko, Melissa
AU - O'Conor, Rachel
AU - Kannry, Joseph
AU - Karp, Adam
AU - Lurio, Joseph
AU - Hoy-Rosas, Jamillah
AU - Lopez, Ray
AU - Obiapi, Rosemary
AU - Young, Edwin
AU - Wolf, Michael S.
AU - Wisnivesky, Juan P.
AU - Dendy, Cleo
AU - Donadelle, Archibald
AU - Santiago, Marsha
AU - Torres, Eduarda
AU - Walton, Dorothy
AU - Busse, Paula
AU - Caday, Fernando
AU - Federman, Alex D.
AU - Saperstein, Melissa
AU - Skloot, Gwen
AU - Russell, Allison L.
AU - Hauser, Diane
AU - Little, Virna
AU - Nelson, Carla
AU - Anarella, Joseph
AU - Mane, Jennifer
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Older adults with asthma face numerous barriers to effective self-management and asthma control, and experience worse outcomes than younger asthmatics. Yet, there have been no controlled trials of interventions specifically designed to improve their care and outcomes. Through a multi-stakeholder collaboration (patients, academia, community-based organizations, a state department of health, and an advocacy organization) we developed a multi-component asthma self-management support intervention to address the myriad psychosocial, functional, health status, and cognitive barriers to effective asthma self-management in adults ages 60 and older. We are recruiting 425 New Yorkers in Manhattan and the Bronx for a pragmatic randomized controlled trial with 3 arms: the intervention delivered in primary care settings or in their home, or usual care. In the intervention, care coaches use a novel screening tool to identify the specific barriers to asthma control and self-management they experience. Once identified, the coach and patient choose from a menu of actions to address it. The intervention emphasizes efficiency, flexibility, shared decision making and goal setting, communication strategies appropriate for individuals with limited cognition and literacy skills, and ongoing reinforcement and support. Additionally, we introduced asthma-specific enhancements to the electronic health records of all participating clinical practices, including an asthma severity assessment, clinical decision support, and a patient-tailored asthma action plan. Patients will be followed for 12. months and interviewed at baseline, 3, 6, and 12. months and data on emergency department visits and hospitalizations will be obtained through the New York State Statewide Planning and Research Cooperative System.
AB - Older adults with asthma face numerous barriers to effective self-management and asthma control, and experience worse outcomes than younger asthmatics. Yet, there have been no controlled trials of interventions specifically designed to improve their care and outcomes. Through a multi-stakeholder collaboration (patients, academia, community-based organizations, a state department of health, and an advocacy organization) we developed a multi-component asthma self-management support intervention to address the myriad psychosocial, functional, health status, and cognitive barriers to effective asthma self-management in adults ages 60 and older. We are recruiting 425 New Yorkers in Manhattan and the Bronx for a pragmatic randomized controlled trial with 3 arms: the intervention delivered in primary care settings or in their home, or usual care. In the intervention, care coaches use a novel screening tool to identify the specific barriers to asthma control and self-management they experience. Once identified, the coach and patient choose from a menu of actions to address it. The intervention emphasizes efficiency, flexibility, shared decision making and goal setting, communication strategies appropriate for individuals with limited cognition and literacy skills, and ongoing reinforcement and support. Additionally, we introduced asthma-specific enhancements to the electronic health records of all participating clinical practices, including an asthma severity assessment, clinical decision support, and a patient-tailored asthma action plan. Patients will be followed for 12. months and interviewed at baseline, 3, 6, and 12. months and data on emergency department visits and hospitalizations will be obtained through the New York State Statewide Planning and Research Cooperative System.
KW - Asthma
KW - Community health workers
KW - Elderly
KW - Pragmatic trial
KW - Randomized controlled trial
KW - Self-management
UR - http://www.scopus.com/inward/record.url?scp=84939513816&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84939513816&partnerID=8YFLogxK
U2 - 10.1016/j.cct.2015.07.018
DO - 10.1016/j.cct.2015.07.018
M3 - Article
C2 - 26238181
AN - SCOPUS:84939513816
SN - 1551-7144
VL - 44
SP - 103
EP - 111
JO - Contemporary Clinical Trials
JF - Contemporary Clinical Trials
ER -