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  • 1
    Online Resource
    Online Resource
    American Academy of Pediatrics (AAP) ; 2017
    In:  Pediatrics Vol. 139, No. 6 ( 2017-06-01)
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 139, No. 6 ( 2017-06-01)
    Abstract: Researchers often struggle with the gap between efficacy and effectiveness in clinical research. To bridge this gap, the Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS) study adapted an efficacious, randomized controlled trial that resulted in evidence-based asthma interventions in community health centers. METHODS: Children (aged 5–12 years; N = 590) with moderate to severe asthma were enrolled from 3 intervention and 3 geographically/capacity-matched control sites in high-risk, low-income communities located in Arizona, Michigan, and Puerto Rico. The asthma intervention was tailored to the participant’s allergen sensitivity and exposure, and it comprised 4 visits over the course of 1 year. Study visits were documented and monitored prospectively via electronic data capture. Asthma symptoms and health care utilization were evaluated at baseline, and at 6 and 12 months. RESULTS: A total of 314 intervention children and 276 control children were enrolled in the study. Allergen sensitivity testing (96%) and home environmental assessments (89%) were performed on the majority of intervention children. Overall study activity completion (eg, intervention visits, clinical assessments) was 70%. Overall and individual site participant symptom days in the previous 4 weeks were significantly reduced compared with control findings (control, change of −2.28; intervention, change of −3.27; difference, −0.99; P & lt; .001), and this result was consistent with changes found in the rigorous evidence-based interventions. CONCLUSIONS: Evidence-based interventions can be successfully adapted into primary care settings that serve impoverished, high-risk populations, reducing the morbidity of asthma in these high-need populations.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2017
    detail.hit.zdb_id: 1477004-0
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  • 2
    In: Health Promotion Practice, SAGE Publications, Vol. 12, No. 6_suppl_1 ( 2011-11), p. 82S-90S
    Abstract: Successful chronic disease project management, especially of multiyear initiatives using evidence-based interventions (EBIs), is of great importance to funders, health care decision makers, and researchers, particularly in light of limited funding. However, a gap in knowledge may exist regarding which attributes and skills are most desirable in a program manager to help him or her ensure successful implementation of EBIs. Although some literature examines the dynamics contributing to the success of community coalitions, public health leadership, and community health education, there is minimal literature exploring the significance of a program manager’s role in the conceptualization, implementation, and sustainability of initiatives to improve patient and community health. The authors present their experiences as participants in a large-scale asthma initiative implemented in priority communities, as well as results of a survey distributed among all personnel of the program sites. The survey aimed to assess the key skills and attributes, in addition to contextual factors, that contribute to the strength of a program manager overseeing EBIs in asthma initiatives. The results suggest that certain attributes and skills are desirable in recruiting and hiring of a program manager, especially when augmented by ongoing skill-building training, and can help ensure program and research success.
    Type of Medium: Online Resource
    ISSN: 1524-8399 , 1552-6372
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2036801-X
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  • 3
    In: Health Promotion Practice, SAGE Publications, Vol. 12, No. 6_suppl_1 ( 2011-11), p. 9S-19S
    Abstract: Pediatric asthma is a multifactorial disease, requiring complex, interrelated interventions addressing children, families, schools, and communities. The Merck Childhood Asthma Network, Inc. (MCAN) is a nonprofit organization that provides support to translate evidence-based interventions from research to practice. MCAN developed the rationale and vision for the program through a phased approach, including an extensive literature review, stakeholder engagement, and evaluation of funding gaps. The analysis pointed to the need to identify pediatric asthma interventions implemented in urban U.S. settings that have demonstrated efficacy and materials for replication and to translate the interventions into wider practice. In addition to this overall MCAN objective, specific goals included service and system integration through linkages among health care providers, schools, community-based organizations, patients, parents, and other caregivers. MCAN selected sites based on demonstrated ability to implement effective interventions and to address multiple contexts of pediatric asthma prevention and management. Selected MCAN program sites were mature institutions or organizations with significant infrastructure, existing funding, and the ability to provide services without requiring a lengthy planning period. Program sites were located in communities with high asthma morbidity and intended to integrate new elements into existing programs to create comprehensive care approaches.
    Type of Medium: Online Resource
    ISSN: 1524-8399 , 1552-6372
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2036801-X
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  • 4
    Online Resource
    Online Resource
    Mary Ann Liebert Inc ; 2015
    In:  Pediatric Allergy, Immunology, and Pulmonology Vol. 28, No. 2 ( 2015-06), p. 80-86
    In: Pediatric Allergy, Immunology, and Pulmonology, Mary Ann Liebert Inc, Vol. 28, No. 2 ( 2015-06), p. 80-86
    Type of Medium: Online Resource
    ISSN: 2151-321X , 2151-3228
    Language: English
    Publisher: Mary Ann Liebert Inc
    Publication Date: 2015
    detail.hit.zdb_id: 2566342-2
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  • 5
    In: Journal of General Internal Medicine, Springer Science and Business Media LLC, Vol. 37, No. S1 ( 2022-04), p. 6-13
    Abstract: Engaging patients and other stakeholders as partners in research offers promise in improving the relevance and usefulness of research findings. Objective To explore the influence and impact of patient and other stakeholder engagement on the planning and conduct of comparative effectiveness research studies. Design Qualitative study with virtual, hour-long semi-structured interviews. Participants Fifty-eight researchers and fifty-one partners from a diverse purposeful sample of fifty-eight studies funded by the Patient-Centered Outcomes Research Institute (PCORI). Approach Content and thematic analysis of interview data. Key Results Described as an integral, long-term part of the research process, engagement influenced all aspects of the design and execution of studies. Partner influence was also dynamic and iterative, taking different forms over the course of the study. Across studies, we identified 387 discrete examples of influence and classified each as one of five types of influence, derived inductively from the interview data: co-producing, redirecting, refining, confirming, and limited. Most projects exhibited multiple types of influence, with 50 researchers and 41 partners reporting two or more types of influence within a project. Of the 387 examples of stakeholder influence, 306 had at least one reported impact on the study. Such impacts included changes to reflect the needs and preferences of patients or clinicians, as well as impacts on study feasibility, study quality, engagement scope or quality, and study relevance. Both researchers and partners identified multiple types of impact within projects, with 42 researchers and 38 partners reporting two or more types within a project. Because of these observable impacts, researchers and partners described engagement as worthwhile. Conclusions Findings provide insights for funders and institutions supporting engagement, measurement efforts, and clinical researchers aiming to conduct engaged research and observe similar influences and impacts in their own studies.
    Type of Medium: Online Resource
    ISSN: 0884-8734 , 1525-1497
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2006784-7
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  • 6
    In: Research Involvement and Engagement, Springer Science and Business Media LLC, Vol. 6, No. 1 ( 2020-12)
    Abstract: There is growing interest in patient and stakeholder engagement in research, yet limited evidence about effective methods. Since 2012, the Patient-Centered Outcomes Research Institute (PCORI) has funded patient-centered comparative effectiveness research with a requirement for engaging patients and other stakeholders as research partners in study planning, conduct, and dissemination. This requirement, unique among large healthcare research funders in the US, provides an opportunity to learn about challenges encountered and specific strategies used by PCORI-funded study teams. The primary objective of this study is to describe -- from the perspective of PCORI investigators and research partners—the most common engagement challenges encountered in the first two years of the projects and promising strategies to prevent and overcome these challenges. Methods Descriptive information about investigators, partners, and their engagement was collected from investigators via annual ( N  = 235) and mid-year ( N  = 40) project progress reporting to PCORI, and from their partners ( N  = 260) via voluntary survey. Qualitative data were analyzed using content and thematic analyses. Results Investigators and partners most often described engagement challenges in three domains: (1) infrastructure to support engagement, (2) building relationships, and (3) maintaining relationships. Infrastructure challenges related to financial and human resources, including funding support and dedicated staff, identifying diverse groups of partners, and partners’ logistical needs. Challenges for both building and maintaining relationships encompass a variety of aspects of authentic, positive interactions that facilitate mutual understanding, full participation, and genuine influence on the projects. Strategies to prevent or mitigate engagement challenges also corresponded overall to the same three domains. Both groups typically described strategies more generally, with applicability to a range of challenges rather than specific actions to address only particular challenges. Conclusion Meaningful engagement of patients and other stakeholders comes with challenges, as does any innovation in the research process. The challenges and promising practices identified by these investigators and partners, related to engagement infrastructure and the building and maintenance of relationships, reveal actionable areas to improve engagement, including organizational policies and resources, training, new engagement models, and supporting engagement by viewing it as an investment in research uptake and impact.
    Type of Medium: Online Resource
    ISSN: 2056-7529
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2834246-X
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  • 7
    In: American Journal of Public Health, American Public Health Association, Vol. 106, No. 11 ( 2016-11), p. 2012-2018
    Abstract: Objectives. To assess the effect of care coordination on asthma outcomes among children in underserved urban communities. Methods. We enrolled children, most of whom had very poorly or not well-controlled asthma, in medical–social care coordination programs in Los Angeles, California; Chicago, Illinois; Philadelphia, Pennsylvania; and San Juan, Puerto Rico in 2011 to 2014. Participants (n = 805; mean age = 7 years) were 60% male, 50% African American, and 42% Latino. We assessed asthma symptoms and health care utilization via parent interview at baseline and 12 months. To prevent overestimation of intervention effects, we constructed a comparison group using bootstrap resampling of matched control cases from previous pediatric asthma trials. Results. At follow-up, intervention participants had 2.2 fewer symptom days per month (SD = 0.3; P  〈  .01) and 1.9 fewer symptom nights per month (SD = 0.35; P  〈  .01) than did the comparison group. The relative risk in the past year associated with the intervention was 0.63 (95% confidence interval [CI] = 0.45, 0.89) for an emergency department visit and 0.69 (95% CI = 0.47, 1.01) for hospitalization. Conclusions. Care coordination may improve pediatric asthma symptom control and reduce emergency department visits. Policy Implications. Expanding third-party reimbursement for care coordination services may help reduce pediatric asthma disparities.
    Type of Medium: Online Resource
    ISSN: 0090-0036 , 1541-0048
    RVK:
    Language: English
    Publisher: American Public Health Association
    Publication Date: 2016
    detail.hit.zdb_id: 2054583-6
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  • 8
    In: Health Promotion Practice, SAGE Publications, Vol. 12, No. 6_suppl_1 ( 2011-11), p. 73S-81S
    Abstract: Partnerships have taken on added importance in recent years because of their critical role in addressing complex public health problems and translating evidence-based practices to real-world settings. The Merck Childhood Asthma Network, Inc. initiative recognized the importance of partnerships in achieving the program’s goals. In this article, case studies of the five Merck Childhood Asthma Network program sites describe the role of partnerships in the development and evolution of the program and its interventions. Three key factors contributed to the success of the partnerships: having common organizational goals, considering context in the selection and engagement of partners, and ensuring that each partnership benefited from the alliance. Over the 4-year program period, all five partnerships evolved, matured, and had an established goal to maintain collaboration.
    Type of Medium: Online Resource
    ISSN: 1524-8399 , 1552-6372
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2036801-X
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  • 9
    In: Health Promotion Practice, SAGE Publications, Vol. 12, No. 6_suppl_1 ( 2011-11), p. 20S-33S
    Abstract: The Merck Childhood Asthma Network, Inc. (MCAN) initiative selected five sites that had high asthma burden and established asthma programs but were ready for greater program integration across schools, health care systems, and communities. MCAN supported a community-based approach that was tailored to the needs of each program site. As a result, each site was unique in its combination of interventions, but all sites served common goals of integration of care, incorporation of evidence-based programs, and improvement in knowledge, self-management, health, and quality of life. This case study of the MCAN cross-site evaluation discusses the challenges associated with evaluating interventions involving multiple stakeholders that have been adjusted to fit the unique needs of specific communities. The evaluation triangulates data from site-specific monitoring and evaluation data; site documents, site visits, and cross-site meetings; qualitative assessments of families, organizational partners, and other stakeholders; and quantitative data from a common instrument on health indicators before and after the intervention. The evaluation employs the RE-AIM framework—reach, effectiveness, adoption, implementation, and maintenance—to assess the barriers and facilitators of translation from theory into practice. Our experience suggests trade-offs between rigor of evaluation and burden of assessment that have applicability for other community-based translational efforts.
    Type of Medium: Online Resource
    ISSN: 1524-8399 , 1552-6372
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2036801-X
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  • 10
    In: Journal of Palliative Medicine, Mary Ann Liebert Inc, Vol. 22, No. S1 ( 2019-09-01), p. S-2-S-6
    Type of Medium: Online Resource
    ISSN: 1096-6218 , 1557-7740
    Language: English
    Publisher: Mary Ann Liebert Inc
    Publication Date: 2019
    detail.hit.zdb_id: 2030890-5
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