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Objective This study tested a randomized controlled trial of RVA Breathes, a community asthma program, in reducing asthma-related healthcare utilization among children living in an area with a high poverty rate. Methods Participants included 250 caregivers (78% African American/Black; 73.3% household income<$25,000/year) and their children with asthma (5–11 years). Inclusion criteria included an asthma-related emergency department (ED) visit, hospitalization, unscheduled doctor's visit, or systemic steroids in the past 2 years. Families were randomized to a full active intervention (asthma education with community health workers [CHWs], home remediation with home assessors, and a school nurse component; n  = 118), partial active intervention (asthma education and home remediation; n  = 69), or a control group (n  = 63) for 9 months. Measures on healthcare utilization and asthma-related factors were collected. Follow-up assessments occurred across a 9-month period. Results Although we did not find any significant effects, there was a trend toward significance for a group by time effect with objective healthcare utilization as the outcome (F 4,365   =   2.28, p  =  .061). The full intervention group experienced a significant decrease from baseline to 9-month follow-up compared with the other groups (p  <  .001). Only the full intervention group experienced a significant increase in reported asthma action plans across time (no significant group effect). Conclusions In the context of the unprecedented COVID-19 pandemic, which led to a substantial global decrease in healthcare utilization, the study's main hypotheses were not supported. Nevertheless, findings support the benefit of community asthma programs that integrate care across multiple settings and connect families with CHWs. [ABSTRACT FROM AUTHOR]

This study evaluated caregivers' stress and depressive symptoms, and children's asthma control, before COVID-19 began and after its onset among families in the RVA Breathes program. The RVA Breathes intervention, which took place in an urban city in the United States, includes asthma education delivered by a community health worker (CHW), a home assessment, and school nurse components. Participants included 125 children (5–11 years) with asthma and their caregivers (48% household income <$25,000) enrolled prior to the pandemic. Families were randomized to an active intervention arm (full intervention or intervention without school nurse component) or the control group. Caregivers completed the Center for Epidemiological Studies Depression Scale (CES-D) and the Perceived Stress Scale (PSS); children and caregivers completed the Childhood Asthma Control Test (cACT). Assessments pre-COVID-19 were compared to those completed after the pandemic's onset. Children in both intervention groups had better cACT scores after the start of COVID-19 compared to before (t(55) = −2.131, p =.019; t(28) = −2.893, p =.004). Caregivers in the intervention groups had lower PSS scores after the start of COVID-19 compared to pre-COVID-19 (t(53) = 3.928, p <.001; t(28) = 2.568, p =.008). Furthermore, CES-D scores improved among caregivers in the full intervention (t(48) = 1.789, p =.040). Caregivers in the control condition did not report significant changes in stress or depressive symptoms. Findings suggest that support from interventionists, including CHWs, might have alleviated stress and depressive symptoms during COVID-19, as well as improved asthma control during the pandemic. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the associations between child health, parent racial regard, and parent physical health in 87 African American and Black parents/caregivers of children with and without asthma from a low-income, under-resourced urban area. Participants completed the Private and Public Regard subscales of the Multidimensional Inventory of Black Identity (MIBI) and 12-item Short Form Health Survey (SF-12). Parents of children with asthma reported having poorer physical health, while those with higher public and private racial regard reported better physical health. The association between public regard and physical health was surpassed by an interaction of child asthma status and public regard: as public regard decreased, so did physical health, but only for parents raising a child with asthma. Findings suggest that the stresses associated with raising a child with chronic illness and perceiving lower public racial regard may together confer additional risk for poor physical health in African American and Black parents. [ABSTRACT FROM AUTHOR]

Compared with younger children and older adults, adolescent and young adult (AYA) patients with cancer receive more intensive end-of-life (EOL) care. We hypothesize that enhanced understanding of AYA preferences, increased engagement of these patients in decision-making, and improved communication of their preferences with family members and the medical team will lead to increased provision of goal-concordant care and decreased intensity of EOL care. In this study, we describe the development of a novel tool that quantifies the relative importance of numerous factors considered by AYA patients with cancer, their parents, and health care providers when choosing between treatment options. [ABSTRACT FROM AUTHOR]