CHEST: A Collaboration With Community HEalth Centers to Implement SmarT for Asthma

Conditions

• Moderate to Severe Asthma

Eligibility Criteria

Sex

ALL

Age

12 Years - N/A

Healthy Volunteers

Not accepted

Interventions

• Implementation bundle — BEHAVIORAL
  The intervention is a SMART implementation bundle delivered in Federally Qualified Health Centers. Unlike drug trials, no medication is supplied; providers prescribe according to guidelines. The bundle includes three components: (1) clinician education with practice facilitation, (2) audit and feedback on prescribing, (3) patient education tools such as a SMART-aligned asthma action plan and videos tailored for low health literacy, and (4) operations committee meetings during the implementation period

Study Details

Purpose: This study aims to improve asthma care by helping clinicians at community health centers prescribe a guideline-recommended treatment called SMART (Single Maintenance and Reliever Therapy). The investigators will provide training and resources to clinicians, give feedback on prescribing patterns, and offer educational tools for patients and providers. The investigators will roll out these resources in stages across clinics. The study will measure how well the program helps clinicians prescribe SMART therapy and whether it reduces asthma exacerbations in patients.

Key Dates

Start date

Jan 6, 2026

Status verified

Jan 2026

Primary completion

Nov 15, 2027

Completion

Nov 15, 2028

Study Design

Enrollment

2,000 participants (estimated)

Allocation

RANDOMIZED

Intervention model

CROSSOVER

Primary purpose

TREATMENT

Arms

• Experimental: Active Implementation
  The intervention is a SMART implementation bundle delivered at community health centers. It includes (1) clinician education with practice facilitation to support guideline-concordant prescribing and (2) regular audit and feedback on inhaler prescribing patterns (3) patient-centered education tools such as instructional videos and a SMART-congruent asthma action plan designed for low health literacy, and (4) operations committee meetings during the implementation period. Educational outreach is co-led by the PI and a certified asthma educator, with quarterly practice facilitation and feedback visits during the active implementation period. All materials are available in paper and digital formats, with continued access to patient tools beyond the intervention. Providers retain full autonomy over prescribing decisions
• No Intervention: Control
  During this period, prescribing patterns and asthma outcomes will be observed without active implementation.

Primary Outcome Measure

Patient-level Effectiveness (of the SMART implementation bundle) [ Time Frame: Through study completion, up to 24 months ]

Central Contacts

• James Krings, MD MSCI
  3143769452
  [email protected]
• Krutika Chauhan, MBBS MPH
  3143769452
  [email protected]

Locations (7)

Find similar trials in St Louis, MO

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