An Asthma Collaboration to Reduce Childhood Asthma Disparities on the Navajo Nation

NCT03377647 | Active Not Recruiting

• 1 other identifier: HS2970
• Study Type: interventional
• Target: 300
• Locations: 1 country
• Sites: 2

Brief Summary

National Jewish Health and The University of Arizona worked with Navajo Nation organizations to develop this program to improve the health of children with asthma. The Navajo Community Asthma Program will have two main parts. One will train doctors and health care professionals to improve the diagnosis and treatment of asthma. The second part will work with area schools to provide education to school nurses, teachers, and children to help them better understand asthma. The project also works with families to help them know how to best take care of their child's asthma. A major project aim is to make sure that doctors, teachers, and families work together to manage asthma.

Conditions

Asthma in Children

Outcome Measures

Primary Outcomes (6)

• Rate of pediatric asthma exacerbations in Year 1

  The rate of asthma exacerbations among children living on the Navajo Nation during Year 1 of the project as measured by hospitalizations and urgent care visits. This rate will be assessed by review of Indian Health Service (IHS) data.

  Data will be collected once during Year 1 of the project.

• Rate of pediatric asthma exacerbations in Year 2

  The rate of asthma exacerbations among children living on the Navajo Nation during Year 2 of the project as measured by hospitalizations and urgent care visits. This rate will be assessed by review of Indian Health Service (IHS) data.

  Data will be collected once during Year 2 of the project.

• Rate of pediatric asthma exacerbations in Year 3

  The rate of asthma exacerbations among children living on the Navajo Nation during Year 3 of the project as measured by hospitalizations and urgent care visits. This rate will be assessed by review of Indian Health Service (IHS) data.

  Data will be collected once during Year 3 of the project.

• Rate of pediatric asthma exacerbation in Year 4

  The rate of asthma exacerbations among children living on the Navajo Nation during Year 4 of the project as measured by hospitalizations and urgent care visits. This rate will be assessed by review of Indian Health Service (IHS) data.

  Data will be collected once during Year 4 of the project.

• Rate of pediatric asthma exacerbations in Year 5

  The rate of asthma exacerbations among children living on the Navajo Nation during Year 5 of the project as measured by hospitalizations and urgent care visits. This rate will be assessed by review of Indian Health Service (IHS) data.

  Data will be collected once during Year 5 of the project.

• Rate of pediatric asthma exacerbations in Year 6

  The rate of asthma exacerbations among children living on the Navajo Nation during Year 6 of the project as measured by hospitalizations and urgent care visits. This rate will be assessed by review of Indian Health Service (IHS) data.

  Data will be collected once during Year 6 of the project.

Secondary Outcomes (5)

• Community reports of asthma-related events Year 1

  In-person interviews will be conducted with families during year one of the project.

• Community reports of asthma-related events Year 2

  In-person interviews will be conducted with families during year two of the project.

• Community reports of asthma-related events Year 3

  In-person interviews will be conducted with families during year three of the project.

• Community reports of asthma-related events Year 4

  In-person interviews will be conducted with families during year four of the project.

• Community reports of asthma-related events Year 5

  In-person interviews will be conducted with families during year five of the project.

Study Arms (3)

Year two intervention

ACTIVE COMPARATOR

Both interventions will occur in the Tuba City Agency during year two.

Behavioral: Asthma Care Provider Training; Behavioral: School Staff Asthma Education

Year three intervention

ACTIVE COMPARATOR

Both interventions will occur in the Chinle Agency during year three.

Behavioral: Asthma Care Provider Training; Behavioral: School Staff Asthma Education

Year four intervention

ACTIVE COMPARATOR

Both interventions will occur in the Fort Defiance during year four.

Behavioral: Asthma Care Provider Training; Behavioral: School Staff Asthma Education

Interventions

Asthma Care Provider Training BEHAVIORAL

In this intervention, asthma care providers will be trained in current, evidence-based guidelines for care of children with asthma, and will be provided with tools that their practice may use to facilitate care improvements.

Year four intervention; Year three intervention; Year two intervention

School Staff Asthma Education BEHAVIORAL

In this intervention, teachers and other school staff will be provided current, evidence-based training in understanding asthma and will be provided tools to help schools address the special needs of children with asthma.

Year four intervention; Year three intervention; Year two intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \- The study will be conducted within three agencies on the Navajo Nation, each of which has its own IHS service unit. The three agencies are Chinle, Tuba City, and Fort Defiance.

You may not qualify if:

• \- This protocol pertains only to the three agencies listed above.
• Community interviewees will be interested candidates who meet the following eligibility criteria:
• Able and willing to provide informed consent
• Greater than or equal to 18 years of age
• Guardianship of a child younger than 18 years of age who has been diagnosed with asthma
• Able to read and/or understand English or Navajo
• Unable or unwilling to provide informed consent
• Younger than 18 years of age, without presence of guardian
• Unable to read and/or understand English or Navajo

Sponsors & Collaborators

• National Jewish Health: lead
• University of Arizona: collaborator

Study Sites (2)

University of Arizona

Tucson, Arizona, 85721, United States

Location

National Jewish Health

Denver, Colorado, 80206, United States

Location

Related Publications (1)

• Lowe AA, Ravi P, Hudson B, Begay E, Tso B, Liu AH, Bender BG, Gerald LB, King DK. Using document analysis methods and implementation science frameworks to conduct a process evaluation of the community asthma program on the Navajo Nation. Transl Behav Med. 2025 Jan 16;15(1):ibaf056. doi: 10.1093/tbm/ibaf056.

  PMID: 41027683 DERIVED

Study Officials

• Bruce Bender, PhD

  National Jewish Health

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 1, 2017
• First Posted: December 19, 2017
• Study Start: August 1, 2017
• Primary Completion: June 30, 2024
• Study Completion: June 30, 2025
• Last Updated: February 24, 2025

Record last verified: 2025-02

Locations

US (2)