The overall goal of this SBIR Fast-Track application is to develop a web-based program to train peer mentors to guide parents of children with asthma on methods to reduce ED visits and hospitalizations. There are 7.1 million children with asthma. Asthma is the cause of 10.5 million missed days of school, 7.5 million outpatient visits, 640,000 ED visits, and 157,000 hospitalization visits in 2008. Recent work by Fisher et al. (2009) has shown in a 2-year randomized clinical trial that trained peers mentors (lay individuals from the community) can be effective in reducing hospitalizations for asthmatic children from 59.1 percent to 36.5 percent (p<0.01). The training protocol used in the clinical trial involved 3 months of in-person training. In-person training is too slow and expensive to allow for general dissemination of this effective method for reducing hospitalizations in children with asthma. To overcome this barrier to dissemination, we are developing a web-based training program. In Phase I, our Specific Aim is to develop a web-based tool for training peer mentors such that the mentors meet the same qualification standards achieved in the study. Following training, we will use Mentor1to1" (developed by InquisitHealth) to allow the peer mentors to coach parents of children with asthma. Mentor1to1" allows for HIPAA-compliant phone conversations between a parent and a peer mentor that are easily managed, tracked, and integrated into clinical workflow. The proposed platform (web-training plus Mentor1to1") should allow for the creation of a scalable, cost-effective peer mentor workforce to meet the challenge of reducing asthma-related hospitalizations. In Phase II, our Specific Aim is to test this software with a health plan and a health system in a randomized clinical trial. To achieve our Phase I Specific Aim, we will carry out the following three Tasks: Task 1: Conduct Focus Groups. Task 2: Iterative Development of our Web-based Training Program Prototype for Peer Mentors. Task 3. Evaluate Peer Training Efficacy with 40 Peer Mentor-Trainees. Phase I Test of Feasibility: (1) 70 percent+ of mentors should meet the threshold set for both passing the written (80 percent correct) and simulated patient exams (80 percent of objectives met). (2) 70 percent+ of mentors should be satisfied with the Process Measure Tests (score at 3 or 4 on a 0-4 Likert scale, with 4 being completely satisfied). To achieve our Phase II Specific Aim, we will carry out the following four Tasks: Task 1. Gather and Utilize Feedback to Improve Training System. Task 2. Develop Easy-Access Material for Peer Mentors. Task 3. Develop Systems and Automation to Support Peer Mentoring Deployment. Task 4. Evaluate Efficacy of our Web-Trained Peer Mentors. Phase II Criteria for Success: Reduce hospitalizations by at least 30 percent, as in Fisher et al. (2009).
There are 7.1 million children (9.6 percent of US children) under the age of 18 with asthma. Asthma is the cause of 157,000 hospitalization visits in 2008. This is an application to develop a method to greatly reduce such hospitalizations.