We are 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.
In Massachusetts, 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.
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. In an initial feasibility study, JSI determined that this approach, which is evidence-based for children, is feasible when applied and adapted to the older adult population.
Building on the pilot study, the Housing and Urban Development Agency is supporting the Massachusetts Department of Public Health, and its research partners that include JSI, to conduct a follow-up study conducted in Lowell, MA, with patients of the Lowell Community Health Center. Using a delayed enrollment case-control design, the ROAAD-X study will be evaluated by JSI for the effectiveness of intervention design, methods, and protocols. In addition, ROAAD-X will track improvements in patient self-management and improved environmental triggers composite scores, with a resultant reduction in emergent healthcare utilization and improvement in asthma control and quality of life.