The Coordinated Healthcare Interventions for
Childhood Asthma Gaps in Outcomes (CHICAGO Trial)
Valerie Press, MD, MPH
Assistant Professor, Section of
Hospital Medicine
January 20, 2015
1
2
The CHICAGO Trial
Ann & Robert Lurie Children’s Hospital of Chicago. Rush University Medical Center. Sinai Health System. Cook County
Health & Hospital System (Stroger). University of Illinois Hospital & Health Sciences System (UI-Health). University of
Illinois – Chicago (UIC). Chicago Asthma Consortium (CAC). Respiratory Health Association (RHA). NorthShore University
HealthSystem (NSUHS). Northwestern University (NWU). Illinois Emergency Department Asthma Surveillance Project
(IEDASP). Chicago Department of Public Health (CDPH). Illinois Institute of Technology (IIT).
8 PCORI awards: Treatment options for African American
and Latinos / Hispanics with uncontrolled asthma
Alex Federman, Icahn
SOM at Mt. Sinai
James Krieger,
Seattle-King County
Pub Health Dept
Kaharu Sumino,
WashU
Andrea Apter,
UPenn
Stephen Teach, Children’s
Research Institute
John Elder, San Diego
State Univ
Winifred Hamilton,
BCM
December 17, 2013 - PCORI Announces Research Awards: Congratulations!
AIM 1
Complete planning activities, including
qualitative interviews with caregivers,
clinicians and community health workers
(CHWs), to finalize the study design and
protocol, and obtain clearances from all
institutional and community partners for the
CHICAGO Trial.
Asthma Care Action Plan
CAPE
Design Implications
• Decided on patient-centered outcomes
• Modified ED-delivery of CAPE
– Initially intended to be delivered by ED staff
– Changed to be delivered by ED Coordinator
funded by project
– Testing not just tool, but also the impact of adding
a designated ED discharge person
Aim 2
Conduct a 3-arm multicenter pragmatic trial
comparing the effectiveness of an enhanced
ED-discharge intervention (CAPE-ED) v.
enhanced ED-discharge combined with a
patient-level CHW-led intervention that
includes a focus on reducing environmental
triggers at home (CAPE-ED plus PatientHome) v. Usual Care.
Outcomes
– 2 Co-primary outcomes
• PROMIS: Asthma Impact Scale (child)
• PROMIS: Satisfaction with social roles (caregiver)
– Secondary outcomes will examine adherence to selfmanagement skills:
• Child: cACT (childhood Asthma Control Test)
• Caregiver: PACQLQ (pediatric asthma caregiver quality of life
questionnaire)
• Acute care visits (all-cause urgent care visits, ED visits,
hospitalizations)
• Adherence to meds prescribed in ED (prescriptions filled within 7
days)
• Inhaler technique for meds prescribed in ED
• Trigger reduction behavior (primary targets: smoking, roach, mice)
CHICAGO Trial Design
Home visits
(days since ED discharge)
CAPE
+ Patient-Home
N= 640 children
age 5-11 years
Usual Care
Rz
Structure, tailored ED discharge
Template (CAPE)
Assessment  By phone
 In-home
CAPE (CHICAGO trial Action
Plan after Emergency
department discharge )
CHW Home visit
CAPE only
0
30

90

180

360

Assessments (days since ED discharge)
Next Steps
• Recruitment starts March 1, 2015