The primary goal of this award is to support the research career development of Dr. Joseph J. Zorc. During fellowship training in pediatric emergency medicine and early work as an investigator, Dr. Zorc has focused his research career on improving outcomes for inner-city children with asthma who are seen in the emergency department (ED). With the support of Dr. Kathy Shaw, Dr. Julian Allen and other mentors and colleagues, Dr Zorc has developed a program of formal coursework, seminars, and individual mentoring to be completed over a 5-year period. The program, which is structured around a formal Master's of Science degree in Clinical Epidemiology, focuses on improving skills in interventional research and understanding the principles of patient adherence to therapy. Prevalence and morbidity from childhood asthma have increased substantially in recent decades. Inner-city children are particularly at risk for poor outcomes and frequently obtain their asthma care in the ED. Prior studies have had limited success in improving primary care follow-up, quality of care, and long-term outcomes after a pediatric ED visit for asthma. Prior ED-based interventions by this and other investigators have been designed to address barriers to follow-up with a primary care provider such as an inability to obtain a follow-up appointment or lack of transportation. Focus groups and surveys of inner-city families have found that beliefs about the benefits of follow-up care and the role of preventive asthma medications have a strong impact on adherence to therapy. In the research projects outlined in this proposal, Dr. Zorc will develop a brief educational video about the benefits of follow-up asthma care using a multi-disciplinary panel of experts at the Children's Hospital of Philadelphia and focus groups of parents of children with asthma. This educational video will then be combined into an intervention along with symptom screening and a reminder phone call that has been demonstrated to improve follow-up rates in a previous study. The combined intervention will be tested using a randomized trial design to determine its efficacy on healthcare utilization, asthma controller medication use, symptoms, and quality of life during the 6 months following an ED visit. The expected goal of the project will be to develop an intervention that can subsequently be tested in a newly developed, federally-funded research network of pediatric EDs.
| Zorc, Joseph J; Chew, Amber; Allen, Julian L et al. (2009) Beliefs and barriers to follow-up after an emergency department asthma visit: a randomized trial. Pediatrics 124:1135-42 |
| Zorc, Joseph J; Pawlowski, Nicholas A; Allen, Julian L et al. (2006) Development and validation of an instrument to measure asthma symptom control in children. J Asthma 43:753-8 |
