An asthma collaboration to reduce childhood asthma disparities on the Navajo Nation: Trial protocol for the Community Asthma Program

Navajo children disproportionately experience poor asthma outcomes. Following a one-year community engagement period with key stakeholders from the Navajo Nation, the Community Asthma Program (CAP) was created using evidenced based programs with the goal of reducing asthma disparities among Navajo c...

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Bibliographic Details
Published in:Public Health in Practice
Main Authors: A.A. Lowe, B. Simmons, P. Nez, E. Begay, A. Liu, D. King, J.K. Gerald, Kobernick Aaron, Patrick Wightman, Teshia Solomon, Jim Crooks, H. Phan, W. Morgan, B. Bender, L.B. Gerald
Format: Article in Journal/Newspaper
Language:English
Published: Elsevier 2022
Subjects:
Asthma
Asthma-management
Children
Navajo Nation
First Nations
RE-AIM
Public aspects of medicine
RA1-1270
Online Access:https://doi.org/10.1016/j.puhip.2022.100289
https://doaj.org/article/d3a083adc7f44b90bb89249201d15d95
Description
Summary:Navajo children disproportionately experience poor asthma outcomes. Following a one-year community engagement period with key stakeholders from the Navajo Nation, the Community Asthma Program (CAP) was created using evidenced based programs with the goal of reducing asthma disparities among Navajo children. CAP is being evaluated with a six-year, multi-site step-wedge design in three Navajo communities: Tuba City, Chinle and Fort Defiance, Arizona. The primary outcome is asthma exacerbations defined as use of systemic oral corticosteroids, asthma hospitalizations, asthma related ED visits, and ICU admissions. Asthma exacerbations will be measured using data from the electronic medical records of the three community health care centers. Secondary outcomes include will changes in asthma-related events and asthma control. The RE-AIM (Reach and representativeness, 2) Effectiveness, 3) Adoption, 4) Implementation, and 5) Maintenance) framework is being used to guide the implementation evaluation which includes iterative collection and analysis of process data to identify facilitators and barriers, describe relevant organizational contexts, and inform strategies for dissemination. The CAP intervention requires community engagement and participation, building community capacity, incorporating evidenced-based guidelines and practices while ensuring program strategies actively involve Navajo community members during all steps of the intervention. The outcome of this trial will allow us to determine the effectiveness of a multi-component, community-focused intervention to improve asthma in a tribal community.

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