# Translating an Efficacious Illness Management Intervention for African American Youth with Poorly Controlled Asthma to Real World Settings

> **NIH NIH R01** · WAYNE STATE UNIVERSITY · 2020 · $620,803

## Abstract

There is a critical need to develop interventions to reduce barriers to optimal asthma management and
reduce the significant risk for asthma-related morbidity experienced by minority children, especially African-
American adolescents with poorly controlled asthma. There are few clinical trials focusing on African-American
adolescents with poorly controlled asthma, and intervention studies targeting African-American adolescents
with asthma in general or African-American children with poorly controlled asthma in particular are
characterized by methodological limitations and/or limited effects on objective health outcomes. Multisystemic
Therapy-Health Care (MST-HC) is an intensive, multi-component, home-based psychotherapy that targets the
multiple causes of poor adolescent asthma management across individual, family and community systems. In
a randomized clinical trial, we showed that MST-HC was significantly more effective than home-based family
support in improving adherence to controller medications and improving lung functioning among African-
American adolescents with moderate to severe, poorly controlled asthma up to six months after the completion
of the intervention. In addition, MST-HC reduced asthma-related hospitalizations and associated ED visits.
The primary purpose of the proposed study is to adapt MST-HC for use in real world, public healthcare settings
and test it in a T3 translational trial. The new intervention, Reach for Control (RFC), will be housed in a
pediatric emergency department (ED) at Children's Hospital of Michigan (CHM)and will be adapted for delivery
by community health workers (CHWs). The design is an effectiveness-implementation “Hybrid 1” design where
the primary aims are to determine the effectiveness of an evidence-based intervention in a real-world setting,
and the secondary aims are to gather information about the context for implementation and barriers/ facilitators
to implementation. For our effectiveness aim, we will conduct a randomized effectiveness trial with 170 high
risk adolescents with poorly controlled asthma seen in the ED for an asthma exacerbation. RFC will be
delivered by Wayne Children's Healthcare Access Program, a community agency providing health care
services to underserved children in the Detroit area and will be compared to the agency's standard care
intervention for youth with poorly controlled asthma. For our implementation aims, we will evaluate the
effectiveness of identification, screening and referral to RFC by ED clinical staff via a clinical pathway. We will
study barriers and facilitators to the implementation of RFC (both its integration within the ED and delivery by
CHWs) using a mixed methods approach. We will also develop and evaluate an efficient and effective method
of measuring CHW fidelity to RFC and conduct a cost analysis that will inform decisions such as treatment
dose and CHW caseload in future real-world implementations. If successful, the study has the potential to
...

## Key facts

- **NIH application ID:** 10003384
- **Project number:** 5R01HL138633-04
- **Recipient organization:** WAYNE STATE UNIVERSITY
- **Principal Investigator:** DEBORAH A. ELLIS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $620,803
- **Award type:** 5
- **Project period:** 2017-08-20 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10003384

## Citation

> US National Institutes of Health, RePORTER application 10003384, Translating an Efficacious Illness Management Intervention for African American Youth with Poorly Controlled Asthma to Real World Settings (5R01HL138633-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10003384. Licensed CC0.

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