An asthma collaboration to reduce childhood asthma disparities on the Navajo Nation: Trial protocol for the Community Asthma Program

A. A. Lowe, B. Simmons, P. Nez, E. Begay, A. Liu, D. King, J. K. Gerald, Kobernick Aaron, Patrick Wightman, Teshia Solomon, Jim Crooks, H. Phan, W. Morgan, B. Bender, L. B. Gerald

Research output: Contribution to journalArticlepeer-review

Abstract

Navajo children disproportionately experience poor asthma outcomes. Following a one-year community engagement period with key stakeholders from the Navajo Nation, the Community Asthma Program (CAP) was created using evidenced based programs with the goal of reducing asthma disparities among Navajo children. CAP is being evaluated with a six-year, multi-site step-wedge design in three Navajo communities: Tuba City, Chinle and Fort Defiance, Arizona. The primary outcome is asthma exacerbations defined as use of systemic oral corticosteroids, asthma hospitalizations, asthma related ED visits, and ICU admissions. Asthma exacerbations will be measured using data from the electronic medical records of the three community health care centers. Secondary outcomes include will changes in asthma-related events and asthma control. The RE-AIM (Reach and representativeness, 2) Effectiveness, 3) Adoption, 4) Implementation, and 5) Maintenance) framework is being used to guide the implementation evaluation which includes iterative collection and analysis of process data to identify facilitators and barriers, describe relevant organizational contexts, and inform strategies for dissemination. The CAP intervention requires community engagement and participation, building community capacity, incorporating evidenced-based guidelines and practices while ensuring program strategies actively involve Navajo community members during all steps of the intervention. The outcome of this trial will allow us to determine the effectiveness of a multi-component, community-focused intervention to improve asthma in a tribal community.

Original languageEnglish (US)
Article number100289
JournalPublic Health in Practice
Volume4
DOIs
StatePublished - Dec 2022
Externally publishedYes

Keywords

  • Asthma
  • Asthma-management
  • Children
  • First Nations
  • Navajo Nation
  • RE-AIM

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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