Reducing Older Adult Asthma Disparities (ROAAD) Study

Dates: 2017-2016

State: Massachusetts

Client(s): Massachusetts Department of Public Health (DPH)

Services: Applied Research & Evaluation, Health Systems Transformation

Technical Expertise: Aging, Chronic Disease Management, Environmental Health, Health Care Reform, Health Disparities, Integrated Care Models, Primary Care


In 2012, an estimated 21.1 million adults had asthma and 17.1% were aged 65 and older in US. In Massachusetts (MA), older adults have the highest mortality rate and the second highest hospitalization rate for asthma in the state. Black and Hispanic older adults have 3 times higher hospitalization rates for asthma than their White counterparts. In addition, Hispanic older adults have significantly higher asthma prevalence than Whites.

JSI is providing research services to support an innovative study that will be among the first in the nation to assess potential benefits of providing home visits conducted by a community health worker teamed with a visiting nurse, to help older adults address asthma. The long-term goal of this study is to identify home-based interventions that improve outcomes for older adults with high risk asthma and to secure sustainable funding for such interventions through insurers and/or accountable care organizations.

This study aims to improve asthma outcomes and quality of life for Black and Hispanic older adults with asthma by adding a team-based intervention that includes a home-visiting community health worker (CHW), visiting nurse, and pharmacist to the primary care team. JSI will assess whether this approach, which is evidence-based for children, is feasible when applied and adapted to the older adult population.

The pilot study will evaluate effectiveness of intervention design, methods, and protocols. In addition, ROAAD will track improvements in patient self-management and improved environmental triggers composite scores, with resultant reduction in emergent healthcare utilization and improvement in asthma control and quality of life.