Childhood Asthma Prevention Study (CAPS)

Model effectiveness research report last updated: 2012

Model overview

Theoretical approach

There are no definitive risk factors for the development of childhood asthma. Therefore, many asthma-related primary prevention programs focus on children whose parents have asthma. As children with asthmatic parents represent only a small proportion of the total population of children with asthma, the Childhood Asthma Prevention Study (CAPS) aimed to intervene with a broader range of children at risk of developing asthma, namely young children who had experienced wheezing episodes. In addition to the standard allergen-reduction efforts undertaken in other programs, the CAPS model also targeted the psychosocial factors that might affect successful illness management, such as parental knowledge of health promotion activities and caregiver mental health issues.
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Model services

CAPS provided home-based services that addressed allergen and environmental tobacco smoke reduction, illness management, parent-child relationships, and caregiver mental health. The home visitors guided and supported caregivers’ efforts to achieve health promotion goals through education, problem solving, and referrals for additional services.

Caregivers received videos addressing asthma prevention and management, and handouts on topics relevant to their needs (such as child care or interactions with medical care providers).
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Intended population

CAPS served young children living in low-income households, who were between 9 and 24 months and had at least three wheezing episodes that had been brought to the attention of a physician.
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Where to find out more

Mary D. Klinnert, Ph.D.
National Jewish Health
1400 Jackson St., G320
Denver, CO 80206
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Effects shown in research

Positive parenting practices

Findings rated high

Childhood Asthma Prevention Study (CAPS)
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
HOME score
FavorableUnfavorable or ambiguousNo Effect
 12 months Denver, Colorado sample 137 parents Mean = 36.66 Mean = 36.64 Mean difference = 0.02 Not available Not statistically significant, p = 0.94
Asthma knowledge score
FavorableUnfavorable or ambiguousNo Effect
 12 months Denver, Colorado sample 150 parents Mean = 5.20 Mean = 4.84 Mean difference = 0.36 Not available Statistically significant, p = 0.04
Cat dander
FavorableUnfavorable or ambiguousNo Effect
 12 months Denver, Colorado sample 140 parents = 0.33 = 0.26 Mean difference = 0.07 HomVEE calculated = 0.20 Not statistically significant, p = 0.25
Cockroach allergen
FavorableUnfavorable or ambiguousNo Effect
 12 months Denver, Colorado sample 140 parents = 0.01 = 0.13 Mean difference = -0.12 HomVEE calculated = -1.62 Statistically significant, p = 0.03
Collaborative relationship score
FavorableUnfavorable or ambiguousNo Effect
 12 months Denver, Colorado sample 146 parents Mean = 6.13 Mean = 5.81 Mean difference = 0.33 Not available Statistically significant, p = 0.04
Dog dander
FavorableUnfavorable or ambiguousNo Effect
 12 months Denver, Colorado sample 141 parents = 0.13 = 0.24 Mean difference = -0.11 HomVEE calculated = -0.45 Not statistically significant, p = -.07
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Child health

Findings rated high

Childhood Asthma Prevention Study (CAPS)
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Emergency Department Visits
FavorableUnfavorable or ambiguousNo Effect
 Between 24 and 34 months Denver, CO sample 144 children Unadjusted mean = 18.60 Unadjusted mean = 24.30 OR = 0.85 HomVEE calculated = 0.01 Not statistically significant, p = .72
Oral corticosteroid use
FavorableUnfavorable or ambiguousNo Effect
 Between 24 and 34 months Denver, CO sample 144 children Unadjusted mean = 18.60 Unadjusted mean = 24.30 OR = 0.69 HomVEE calculated = 0.01 Not statistically significant, p = .44
Childhood Asthma Prevention Study (CAPS)
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Cotinine level
FavorableUnfavorable or ambiguousNo Effect
 12 months Denver, Colorado sample 130 children = 0.66 = 0.56 Mean difference = 0.10 HomVEE calculated = 0.25 Not statistically significant, p = 0.28

footnote127

Submitted by user on

Cotinine level outcome based on logistic regression model. Outcome from logrnormal regression model had high attrition and is not included in this report.
Functional Severity Score
FavorableUnfavorable or ambiguousNo Effect
 12 months Denver, Colorado sample 150 children Mean = 1.03 Mean = 1.04 Mean difference = -0.01 Not available Not Statistically significant, p = 0.60
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Maternal health

Findings rated high

Childhood Asthma Prevention Study (CAPS)
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Caregiver quality of life score
FavorableUnfavorable or ambiguousNo Effect
 12 months Denver, Colorado sample 143 parents Mean = 6.47 Mean = 6.34 Mean difference = 0.13 Not available Not statistically significant, p = 0.72
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In brief

Evidence of model effectiveness

Title General population Tribal population Domains with favorable effects
Childhood Asthma Prevention Study (CAPS) Does not meet HHS criteria because the findings from high- or moderate-rated effectiveness studies of the model do not meet all required criteria. Does not meet HHS criteria for tribal population because the model has not been evaluated with a tribal population.
  • Positive parenting practices,

Model description

The Childhood Asthma Prevention Study (CAPS) was designed to reduce children’s wheezing-related morbidity by reducing household allergens and increasing caregiver illness-management skills. CAPS participants were low-income families living in the Denver metropolitan area with children between 9 and 24 months old who had experienced at least three wheezing episodes. Nurses trained as home visitors addressed allergen and tobacco smoke reduction, as well as psychosocial factors of illness management, including parental knowledge, parent-child relationships, and caregiver mental health. Home visitors guided and supported caregivers’ efforts to achieve health-promotion goals through education, problem solving, and referrals for additional services. CAPS consisted of 18 home visits delivered over the course of a year.
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Extent of evidence

Results of search and review
Number of manuscripts
At least one finding was eligible for review…
2
  …and at least one finding rated high
2
  …and at least one finding rated moderate (but none rated high)
0
  …and all findings that were eligible for review rated low or indeterminate2
0
  …but manuscript is additional source3
0

1When an individual manuscript reports findings from multiple studies, HomVEE reviews each study as a distinct manuscript. In these rare instances, HomVEE counts that manuscript multiple times in this table, once for each study identified, screened, and reviewed by HomVEE.

2Manuscripts that receive a rating of indeterminate have findings that may rate moderate or high in response to additional information from the author. The indeterminate rating was applied to manuscripts beginning with the 2023 review.

3Additional sources have findings or details that perfectly overlap with another manuscript and are not rated.

For more information, see the research database. For more information on the criteria used to rate research, please see details of HomVEE’s methods and standards.
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Summary of findings

To see details on each finding HomVEE reviewed in well-designed research, click on the name of an outcome domain in the tables below. Findings rated low quality by HomVEE are not summarized here.

Outcomes
Findings

Outcome Child Development and School Readiness

Not measured

Outcome Child Health

Findings:
Favorable: 0
No effect: 4
Unfavorable or ambiguous: 0

Outcome Family Economic Self-Sufficiency

Not measured

Outcome Linkages and Referrals

Not measured

Outcome Maternal Health

Findings:
Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0

Outcome Positive Parenting Practices

Findings:
Favorable: 3
No effect: 3
Unfavorable or ambiguous: 0

Outcome Reductions in Child Maltreatment

Not measured

Outcome Reductions in Juvenile Delinquency, Family Violence, and Crime

Not measured

The section above focuses on findings from the full sample in a study. Subgroups that have been replicated in distinct samples also have findings reported above. HomVEE does not report the findings of non-replicated subgroups. Beginning with research reviewed in 2021, however, HomVEE lists those subgroups on the details page of each manuscript that had at least one finding that rated moderate or high.

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Criteria established by the U.S. Department of Health and Human Services

Information based on comprehensive review of all high- and moderate-rated manuscripts
CriterionCriterion descriptionCriterion met?
1High- or moderate-quality impact study?Yes
2Across high- or moderate-quality studies, favorable impacts in at least two outcome domains within one sample OR the same domain for at least two non-overlapping samples?No
3Favorable impacts on full sample?Yes
4Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?
Reported for all research but only required for RCTs.		Yes
5One or more favorable, statistically significant impact reported in a peer-reviewed journal?
Reported for all research but only required for RCTs.		Yes

Notes: If the model does not meet criterion 3 but meets criteria 1 and 2 based on findings from subgroups, the impacts must be replicated in the same domain in two or more studies using non-overlapping analytic study samples. HomVEE assesses and reports criteria 4 and 5 for all models that have well-designed research, but meeting those two criteria is only required of models for which all findings are from randomized controlled trials. Please read the HHS criteria for evidence-based models for more information.

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