Asthma morbidity and mortality rates are high among young inner-city children. Lack of routine primary care provider (PCP) visits, poor access to care, and poor patient-physician communication may be contributing factors.
This study evaluated the effects of providing Breathmobile services only, a Facilitated Asthma Communication Intervention (FACI) only, or both Breathmobile+FACI on asthma outcomes, relative to standard care.
Children with asthma (n=322, mean age=4 years, 53% male, 97% African American) were recruited from Head Start programs in Baltimore City and randomized into four groups. Outcome measures included symptom-free days, urgent care use (emergency department visits and hospitalizations) and medication use (courses of oral steroids and proportion on an asthma controller medication) as reported by caregivers at baseline, 6-, and 12-month assessments. Generalized Estimating Equations models were conducted to examine the differential treatment effects of Breathmobile and FACI compared to standard care.
Children in the combined treatment group (Breathmobile+FACI) had an increase of 1.7 (6.6%) symptom-free days (SFD) that was not maintained at 12 months. In intent-to-treat analyses, the FACI-only group had an increase in the number of ED visits at 6 months, which was not present at 12 months or in the post hoc as-treated analyses. No significant differences were found between the intervention groups as compared to standard care on all other outcome measures.
Other than a slight improvement in SFD at 6 months in the Breatmobile+FACI group, the intervention components did not result in any significant improvements in asthma management or asthma morbidity.