Previous Research Projects
Prompting Asthma Intervention in Rochester Uniting Parents and Providers (PAIR-UP)
The PAIR-UP study is a multifaceted prompting intervention designed to open the lines of communication between parents and healthcare providers about asthma. At the time of a healthcare visit, prompts are created for parents and providers to stimulate discussion about the child's asthma along with guideline-based recommendations for care. Participating practices also receive seminars and feedback on their performance. This study has now completed enrollment of more than 600 children in urban pediatric practices around Rochester, N.Y.
Asthma Education and Secondhand Smoke Reduction for Premature Infants
This program is designed to test whether comprehensive asthma education combined with a home-based secondhand smoke reduction program can reduce exposure to smoke and prevent respiratory illness among premature infants. We conducted a smoke reduction and education program with families at their homes. Regular follow-up assessments were then conducted to assess symptoms, smoke exposure and triggers, and to provide additional information.
Adolescent School-Based Asthma Program (Pilot Study/UR CTSI)
Adolescents often have poor adherence to preventive medications and few studies target this population. This pilot program was designed to enhance the delivery of preventive asthma medications to 12-15 year old children in school, and to provide support for the teens to independently manage their asthma. This study includes two components: The first component establishes a partnership with the school nurse who assures that the student receives his/her daily asthma medication through school-based directly observed therapy. The second component is a counseling intervention to help transition the teens to independently manage their asthma.
"Students are more controlled. It helped the students have more knowledge of their asthma and their triggers. It helped them be more responsible for their own health care and management."
– Nurse commenting on the benefits of the program
School-Based Asthma Therapy (SBAT) (ROI/NHLBI)
The School-Based Asthma Therapy (SBAT) trial built on our experience with a pilot study of 180 urban children in which we found that directly observed therapy using preventive medications in school reduced asthma symptoms. In partnership with the Rochester City School District, the SBAT study was a full-scale randomized trial focused on improving preventive care for urban children suffering from mild persistent to severe persistent asthma. From 2006-2009, we enrolled 530 children from 67 schools and preschools. We found that children who received preventive medications in school through directly observed therapy had improved outcomes across multiple measures including more symptom-free days, fewer exacerbations, and fewer school days missed.
- Halterman JS, Szilagyi PG, Fisher S, Fagnano M, Tremblay P, Conn K, Wang H, Borrelli B.
Randomized Controlled Trial to Improve Care for Urban Children with Asthma.
Archives of Pediatrics and Adolescent Medicine, 2011;165(3):262-268.
- Halterman JS, Borrelli B, Fisher S, Szilagyi PG, Yoos HL.
Improving Care for Urban Children with Asthma: Design and Methods of the School-Based Asthma Therapy (SBAT) Trial.
Journal of Asthma, 2008;45:279-286.
- Clinicaltrials.gov Identifier: NCT00296998
School-Based Preventive Asthma Care Technology (SB-PACT) (RC1/NHLBI)
The School-Based Preventive Asthma Care Technology study is a 100 subject pilot project funded by the American Recovery and Reinvestment Act and the National Institutes of Health, and developed in partnership with the Rochester City School District and School Nurse Program. This program utilized a novel, web-based communication system and assured that children received a daily preventive asthma medication in school. This system allowed school health staff to complete symptom assessments and electronically transmit asthma symptom reports to healthcare providers. The program built on the School-Based Asthma Therapy (SBAT) trial, conducted from 2006-2009 with more than 500 children, and was designed for dissemination and sustainability.
- Halterman JS, Fagnano M, Montes G, Fisher S, Tremblay P, Tajon R, Sauer J, Butz A.
The school-based preventive asthma care trial: results of a pilot study.
Journal of Pediatrics. 2012 Dec;161(6):1109-15.
- Halterman JS, Sauer J, Fagnano M, Montes G, Fisher S, Tremblay P, Tajon R, Butz A.
Working toward a sustainable system of asthma care: development of the School-Based Preventive Asthma Care Technology (SB-PACT) trial.
Journal of Asthma. 2012 May;49(4):395-400.
- Clinicaltrials.gov Identifier: NCT01175434
“Anything we can do to provide a continuous plan of care aimed at preventing hospitalizations and controlling symptoms is a benefit to our students, and it helps them stay in school.”
– Nurse commenting on the benefits of the SB-PACT program
School-Based Telemedicine Enhanced Asthma Management (SB-TEAM)
The SB-TEAM program builds on the School-Based Asthma Therapy (SBAT) Trial and the School-Based Preventive Asthma Care Technology (SB-PACT) study with a new focus on directly observed therapy of preventive medications, and ongoing monitoring and tailoring of therapy using telemedicine to facilitate guideline-based asthma care for children.
School-Based Asthma Care for Teens (SB-ACT)
In an attempt to ameliorate disproportionately high asthma morbidity and mortality rates among low income minority adolescents, the School-Based Asthma Care for Teens (SB-ACT) program partners with the Rochester City School District to provide Directly Observed Therapy (DOT) of preventive asthma medications and Motivational Interviewing (MI) counseling sessions in schools. These components, in combination, are designed to promote optimal medication adherence and enhance preventive asthma care for inner city teenagers.
Telemedicine Enhanced Asthma Management through the Emergency Department (TEAM-ED)
The TEAM-ED study focuses on reducing asthma-related pediatric emergency room visits by using telemedicine to link children back to their primary care provider for preventive asthma care.