Registry and Screening Tool to Identify Children With Asthma Likely to Benefit From Home Assessment and Remediation

Summary

Recognizing a decline in pediatric primary care visits and immunizations rates, an increase in utilization of the emergency room and stagnating academic achievement, leaders of MetroHealth Medical Center and the Cleveland Metropolitan School District understood that an innovative delivery option would be required to meet the needs of their pediatric urban population. In the fall of 2013, with support from local and regional funders, they collaborated to open the first School Based Health Center in Cleveland. During its first year, the MetroHealth School Health Program provided primary care services to children in 98 clinical care visits. Through an emphasis on population health and care coordination, the School Health Program has grew dramatically, completing over 2,400 visits in the 2017-2018 school year at clinical sites in over 13 schools. The School Health Program has been successful in developing a care management model to improve the percentage of students who complete recommended preventive services including immunization and preventive visits. The investigators intend to apply and expand upon lessons learned to develop an effective multi component asthma care management model that includes (1) registry utilization (2) evidence based clinical care protocols (3) implementation of an Environmental Screening Tool (4) effective utilization of a Medical Legal Partnership (5) effective partnership with an environmental health justice community organization, Environmental Health Watch, for home assessment and remediation (6) utilization of a unique data sharing partnership between a large health system and school district to document health and educational outcomes.

Conditions

• Asthma
• Pediatric ALL
• School Health Services
• Registries
• Medical Informatics
• Home Visits
• Housing Problems
• Social Determinants of Health
• Healthcare Disparity
• Health Status Disparity

Interventions

OTHER

Home assessment

Home assessment for environmental hazards according to protocol established by Environmental Health Watch (Healthy Home Audit https://www.ehw.org/healthy-home-audit/)

OTHER

Home remediation

Low level home remediation according to previously established protocol (Kercsmar CM, Dearborn DG, Schluchter M, et al. Reduction in asthma morbidity in children as a result of home remediation aimed at moisture sources. Environ Health Perspect. 2006;114(10):1574-80)

OTHER

Referral to Medical Legal Partnership

Medical Legal Partnership referral as described by the National Center for Medical Legal partnerships and others (Beck AF, Identifying and treating a substandard housing cluster using a medical-legal partnership. Pediatrics. 2012;130(5):831-838)

OTHER

Regular School Based Health Asthma Care

Regular care in the School Health Program

Sponsors & Collaborators

• Cleveland Metropolitan School District

  collaborator UNKNOWN

• Environmental Health Watch

  collaborator UNKNOWN

• Legal Aid Society of Cleveland

  collaborator UNKNOWN

• MetroHealth Medical Center

  lead OTHER

Principal Investigators

• Vanessa Maier, MD, MPH · MetroHealth Medical Center

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

5 Years

Max Age

17 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-12-01

Primary Completion

2023-01-01

Completion

2023-06-01

Countries

• United States

Study Locations