Sean M. Frey, MD

The Telehealth Education for Asthma Connecting Hospital and Home (TEACHH) study will evaluate the feasibility, acceptability, and preliminary effectiveness of an intervention providing patient-centered asthma education and management support. The pilot randomized trial, which will include 60 caregivers and children (5-13yrs) hospitalized with asthma in Rochester, NY, is funded by an R03 award from the Agency for Healthcare Research and Quality (AHRQ) and by the University of Rochester Medical Faculty Group. Process measures and structured surveys will provide important data on intervention delivery. However, quantitative methods are not designed to capture stakeholder insights about intervention components, or understand how TEACHH might be refined to better meet the management needs of children with asthma and their families. The Catalyst Award provides an opportunity to conduct essential qualitative research to compliment and extend the pilot study. We will conduct semi-structured interviews of caregivers randomized to each arm of the study (20 from TEACHH, 20 from Standard Care), and ask about experiences with asthma education, components of the TEACHH intervention, and preferences for digital management support. Enrollment into the pilot has been slower than expected, likely reflective of the national decrease in asthma-related hospitalizations for children during the COVID-9 pandemic. Nevertheless, we remain optimistic that enrollment goals can still be met. Key modifications to pilot study protocol include an extension of enrollment from 9- to 12-months and an increase in the age limit of eligibility. Despite delays, we have started to interview caregivers randomized to TEACHH; interviews of caregivers in the Standard Care group will begin in May 2022, with interviews with healthcare providers who manage childhood asthma to start in summer 2022. We will ask providers about barriers to education in their practices, unmet home management needs, and the potential for ongoing smartphone-based support modeled from TEACHH. We are currently preparing for transcription review and iterative data analysis as interviews are completed. Finally, while TEACHH provides printed resources to support home management, we recognize that families may benefit from regular access to digital management supports. Digital versions of these tools, formatted for easy viewing on standard smartphone screens, have been created for the asthma educator to show families in TEACHH during follow-up visits. Drawing on data from caregiver and provider interviews, the Catalyst Award will facilitate a targeted modification of digital materials into a format that can be downloaded onto smart devices, customized to patient care plans, and accessed by caregivers across settings. We anticipate that this qualitative work made possible by the Catalyst Award, in partnership with a quantitative assessment funded by AHRQ, will optimize digital support for families managing childhood asthma and establish a strong foundation for a full-scale trial of the TEACHH intervention.
 

Update: Enrollment into the TEACHH pilot study has been slower than expected. Dr. Frey has started to conduct qualitative in-depth interviews with caregivers, which will be transcribed and analyzed over the coming year. Dr. Frey is also preparing to interview local healthcare providers who manage childhood asthma starting in the summer of 2022. These qualitative data will facilitate the targeted modification of digital patient support materials from the TEACHH intervention that can be downloaded onto smartphones and accessed across settings, and will provide other important insights necessary to optimize the TEACHH intervention in advance of an application for a full-scale trial.