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Klinnert, M. D., Liu, A. H., Pearson, M. R., Tong, S., Strand, M, Luckow, A., & Robinson, J. L. (2007). Outcome of a randomized multifaceted intervention with low-income families of wheezing infants. Archives of Pediatrics & Adolescent Medicine, 161(8), 783-790.

Model(s) Reviewed: Childhood Asthma Prevention Study (CAPS)
Manuscript screening details
Screening decision Screening conclusion
Passes screens Eligible for review
Study design details
Rating Design Attrition Baseline equivalence Reassignment Confounding factors
High Randomized controlled trial Low Not applicable None None
Notes:

footnote130

Submitted by user on Fri, 03/15/2019 - 14:29

High rating applies to oral corticosteroid and emergency department visit outcomes. All other outcomes receive a low rating because of high attrition and failure to demonstrate baseline equivalence.

Study characteristics
Study participants Participants (infants and their families) were recruited from local hospitals and clinics in the Denver, Colorado, area and assigned randomly to either the intervention or the comparison group. Initially 181 infants were randomly assigned, 90 to the treatment group and 91 to the comparison group. At the four-year-old follow-up that is the focus of the paper, 72 children remained in the intervention group and 77 in the control group. This follow-up sample included European Americans (21 percent treatment, 21 percent control), African American (22 percent treatment, 25 percent control), U.S.-born Hispanic (35 percent treatment, 29 percent control) and foreign-born Hispanic (22 percent treatment, 22 percent control). Approximately half of each group had incomes less than $12,000 per year.
Setting The study was conducted in Denver, Colorado.
Intervention services The intervention included home visits conducted by specially trained nurses. The intervention began when infants were from 9 to 24 months old and continued for 12 months. Participants received approximately 15 visits (or telephone calls) by a public health nurse. Each visit lasted an average of 53 minutes.
Comparison conditions Comparison group members received an educational video at the baseline interview that described risk factors for developing asthma and actions that caregivers can take to mediate the risks.
Staff characteristics and training The nurses in this study had bachelor’s of science degrees in nursing and had experience in community outreach.
Funding sources National Institute of Allergy and Infectious Diseases; National Institute of Health/National Center for Research Resources.
Author affiliation Mary D. Klinnert, a study author, is a developer of this model.

Findings details

Child health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Emergency Department Visits
FavorableUnfavorable or ambiguousNo Effect
Denver, CO sample Between 24 and 34 months 144 children Unadjusted mean 18. 6 = 18.60 Unadjusted mean = 24.30 OR = 0.85 HomeVEE calculated = 0.01 Not statistically significant, p = .72
High Oral corticosteroid use
FavorableUnfavorable or ambiguousNo Effect
Denver, CO sample Between 24 and 34 months 144 children Unadjusted mean 18. 6 = 18.60 Unadjusted mean = 24.30 OR = 0.69 HomeVEE calculated = 0.01 Not statistically significant, p = .44

Outcome measure summary

Child health
Outcome measure Description of measure Data collection method Properties of measure

Emergency Department Visits

Percentage of child emergency department visits between three and four years of age Review of medical records

Not applicable

Oral corticosteroid use

Percentage of children who had a course of oral corticosteroids during the previous year. Review of medical records

Not applicable