The Breathe Easy Telehealth Program: A Project-Based Grant Proposal Thesis to Improve Asthma Management among Elementary and Middle School Children in Louisiana Pubblico
Padgett, Kia Renee (2017)
Abstract
Asthma has emerged as a significant health and economic burden to patients, families, health systems, payors, and society. It is one of the most common chronic childhood conditions in the United States, affecting approximately nine million children under the age of eighteen. Researchers have identified a broad range of genetic, behavioral, and environmental triggers associated with symptoms and exacerbation. Asthma disproportionately affects low-income and minority populations with higher morbidity and mortality rates. Although the etiology of asthma is unknown and currently there is no cure, asthma can be effectively controlled through prevention activities and symptom management. Louisiana has a unique set of demographic, socioeconomic, environmental, and geographical factors that contribute to the state's childhood asthma burden. Under the application guidelines for NIH funding opportunity announcement PA-16-161, I propose a project-based thesis to create opportunities for children and families living in low-income communities to receive specialty health services in the school setting, using a telehealth care delivery model. The proposed research program entitled "The Breathe Easy Telehealth Program" aims to increase access to specialty healthcare; utilize evidence-based prevention strategies; create essential clinical, public health, academic, and community partnerships; improve population health; and demonstrate sustainability.
After obtaining IRB approval, a pilot program will be conducted in eight elementary and middle schools; across four USDA-designated, persistent poverty parishes in Louisiana. Students with signed consent forms and completed asthma impact assessment forms will be eligible for participation in the program. Using encrypted health information technology, audio-visual equipment, and telehealth medical devices, students enrolled in the program will receive HIPAA-compliant health services. Participating students will receive a respiratory focused physical examination, patient education, and individualized asthma action plan. A registered nurse will perform the physical assessment at the presenting site, the school nurse office, while virtually connected with a pediatric pulmonologist who will facilitate the visit, from a hospital setting. Quantitative and qualitative data collected from the asthma impact assessment form, and the telehealth consultations will be entered into IBM SPSS 22.0 and NVivo 11, respectively. Results of data analysis will be used to identify knowledge gaps; evaluate medication adherence; assess the impact of high trigger burden on the frequency of severe asthma exacerbations, hospitalizations, days lost at school; and the impact on overall quality of life. Proven effectiveness of the Breathe Easy Telehealth Program will allow for reproducibility of the program, as a viable healthcare delivery model, that can be expanded to other school-based telehealth specialty services including diabetes management and behavioral health consultations.
Table of Contents
Table of Contents
Abstract vi
Acknowledgement vii
Table of contents vii
List of tables viii
List of figures viii
Chapter 1: Introduction
Introduction and rationale 1
Problem statement 1
Purpose statement 1
Project addressed by the proposal 2
Significance statement 2
Theoretical framework 2
Detailed description of proposed program 3
Definition of terms 5
Chapter 2: Review of literature 6
Overview of childhood asthma 6
Global burden of asthma 8
Healthy People 2020 - Respiratory Disease 10
Social determinants of childhood asthma 12
Economic impact of asthma 14
Environmental health and asthma 17
Application of a theoretical framework to asthma management 20
Patient Centered Medical Home and Telehealth 24
Evaluation of School-Based Telehealth asthma Programs 26
Chapter 3: Methodology 29
Review funding agencies that address asthma 29
Summary of the request for proposal 31
Rationale for choosing funding source 32
Program aims and objectives 32
Target population 33
Research design 39
Protection of Human Subjects and Vulnerable Population 40
Data collection and procedures 43
Budget 47
Evaluation 51
Sustainability plan 53
Statistical analysis and reporting of results 54
Public health implications 55
Chapter 4: Incorporation of Grant Proposal Reviewer Comments 56
Acknowledgement of thesis committee 56
Grant reviewers comments on request for proposal 57
Chapter 5: PA--16--161 NIH Exploratory/Developmental Research Grant Proposal 59
References 88
Appendix 92
Appendix A: Assent and consent form 92
Appendix B: Asthma impact assessment form 96
Appendix C: Asthma action plan 104
Appendix D: Telehealth evaluation form 105
Appendix E: Modular budget 107
Appendix F: Logic model 108
Appendix G: Gantt chart 109
Appendix H: Letter of commitment 110
Appendix I: Subaward agreement 111
List of Tables
Table 1. Asthma Severity among Children with Current Asthma by U.S. State 8
Table 2. Projected Medicare Savings from Telehealth 25
Table 3. Equipment budget justifications 49
Table 4. Travel budget justifications 50
List of Figures
Figure 1. Global Prevalence of Asthma 9
Figure 2. U.S. Asthma Prevalence by Age, Sex, and Race 11
Figure 3: BenMAP-CE Economic Estimates of Health Impacts related to Changes in Air Quality 17
Figure 4: Social Ecological Model 20
Figure 5: Persistent Poverty Parishes in Louisiana 34
Figure 6: Percentage of Population Enrolled in Medicaid by Parish 35
Figure 7: Quality Counts 2016: State of Louisiana Report Card 36
About this Master's Thesis
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Primary PDF
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The Breathe Easy Telehealth Program: A Project-Based Grant Proposal Thesis to Improve Asthma Management among Elementary and Middle School Children in Louisiana () | 2018-08-28 16:20:47 -0400 |
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Supplemental Files
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Padgett_Thesis_budget_template.xls () | 2018-08-28 16:21:01 -0400 |
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Padgett_Thesis_LogicModel.docx () | 2018-08-28 16:21:06 -0400 |
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Padgett_Thesis_GANTT chart.xlsx () | 2018-08-28 16:21:10 -0400 |
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