This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This research, with the University of Wisconsin's Pediatric Asthma Clinical Research Program, will test whether and how a Web-based telehealth nursing care support system can increase asthma symptom-free days and adherence to asthma controller medication of children, age 4-12, with moderate persistent or severe persistent asthma. CHESS (Comprehensive Health Enhancement Support System), the proposed intervention, will integrate monthly telephone nurse case management through several healthcare organizations into its existing services. This will allow families to share asthma data with the nurse and the nurse to create educational links within CHESS to help pediatric patients and families gain mastery in asthma self care. Secondary aims include testing whether CHESS (with the case management feature) improves lung function and parent and child quality of life, and reduces unplanned asthma-related healthcare utilization. This study is community-wide and will include (a) Madison's four managed care organizations, Deancare, Physicians Plus, Group Health Cooperative, and Unity, (b) Milwaukee County managed care organization Managed Health Services, and (c) The Wisconsin Department of Health and Family Services Medicaid division. Four-hundred (400) children with asthma and primary parent will be recruited; one-third of the sample will be ethnic minorities. Subjects will be randomized to receive Standard Care or CHESS (with case management). Data Collection includes: (1) Claims data for pharmacy refills, (2) spirometry readings, (3) 5 survey questionnaires, (4) 5 two-week symptom diaries, (5) 2 interviews (one at intake and one at exit), and (6) CHESS usage data. Diary and survey data will be collected at 0, 3, 6, 9 and 12 months. Nursing case management and CHESS have both been shown to have positive outcomes in chronic disease management, however this is the first opportunity to study them in combination.
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