[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100611479":3},{"organization":4,"armGroups":7,"interventions":19,"overallOfficials":18,"centralContacts":25,"locations":34,"responsibleParty":114,"collaborators":118,"id":129,"slug":130,"hasResults":131,"nctId":132,"briefTitle":133,"officialTitle":133,"acronym":134,"eligibilityCriteria":135,"healthyVolunteers":131,"sex":136,"minAge":137,"maxAge":18,"enrollmentInfo":138,"targetDuration":18,"studyType":141,"phases":142,"briefSummary":144,"conditions":145,"keywords":147,"overallStatus":66,"whyStopped":18,"lastUpdateSubmitDate":160,"lastUpdatePostDateStruct":161,"startDateStruct":164,"completionDateStruct":166,"leadSponsor":168,"locationsCount":169},{"fullName":5,"class":6},"Washington University School of Medicine","OTHER",[8,14],{"label":9,"type":10,"description":11,"interventionNames":12},"Active Implementation","EXPERIMENTAL","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",[13],"Behavioral: Implementation bundle",{"label":15,"type":16,"description":17,"interventionNames":18},"Control","NO_INTERVENTION","During this period, prescribing patterns and asthma outcomes will be observed without active implementation.",null,[20],{"type":21,"name":22,"description":23,"armGroupLabels":24,"otherNames":18},"BEHAVIORAL","Implementation bundle","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",[9],[26,31],{"name":27,"role":28,"phone":29,"phoneExt":18,"email":30},"James Krings, MD MSCI","CONTACT","3143769452","kringsj@wustl.edu",{"name":32,"role":28,"phone":29,"phoneExt":18,"email":33},"Krutika Chauhan, MBBS MPH","c.krutika@wustl.edu",[35,53,64,76,86,95,103],{"facility":36,"status":37,"city":38,"state":39,"zip":40,"country":41,"countryCode":42,"cosmosGeoPoint":43,"geoPoint":48,"contacts":49},"Affinia healthcare, 2220 Lemp Ave","NOT_YET_RECRUITING","St Louis","Missouri","63104","United States","US",{"type":44,"coordinates":45},"Point",[46,47],-90.19789,38.62727,{"lat":47,"lon":46},[50],{"name":51,"role":28,"phone":29,"phoneExt":18,"email":52},"Mellisa Tepe, MD","mtepe@affiniahealthcare.org",{"facility":54,"status":37,"city":38,"state":39,"zip":55,"country":41,"countryCode":42,"cosmosGeoPoint":56,"geoPoint":58,"contacts":59},"Affinia healthcare, 1717 Biddle Street","63106",{"type":44,"coordinates":57},[46,47],{"lat":47,"lon":46},[60],{"name":61,"role":28,"phone":62,"phoneExt":18,"email":63},"Patrick Schoenwalder, PA","314-814-8700","pschoenwalder@affiniahealthcare.org",{"facility":65,"status":66,"city":38,"state":39,"zip":67,"country":41,"countryCode":42,"cosmosGeoPoint":68,"geoPoint":70,"contacts":71},"Affinia healthcare, 4414 North Florissant Avenue","RECRUITING","63107",{"type":44,"coordinates":69},[46,47],{"lat":47,"lon":46},[72],{"name":73,"role":28,"phone":74,"phoneExt":18,"email":75},"Catherine Moore, DO","309-532-6707","camoore@affiniahealthcare.org",{"facility":77,"status":37,"city":38,"state":39,"zip":78,"country":41,"countryCode":42,"cosmosGeoPoint":79,"geoPoint":81,"contacts":82},"Family Care Heath Center, 4352 Manchester Ave","63110",{"type":44,"coordinates":80},[46,47],{"lat":47,"lon":46},[83],{"name":84,"role":28,"phone":29,"phoneExt":18,"email":85},"Jaime Zengotita, MD","jzengotita@fchcstl.org",{"facility":87,"status":66,"city":38,"state":39,"zip":78,"country":41,"countryCode":42,"cosmosGeoPoint":88,"geoPoint":90,"contacts":91},"Washington University in St. Louis School of Medicine",{"type":44,"coordinates":89},[46,47],{"lat":47,"lon":46},[92],{"name":93,"role":28,"phone":94,"phoneExt":18,"email":30},"James G Krings, MD","314-273-4734",{"facility":96,"status":37,"city":38,"state":39,"zip":97,"country":41,"countryCode":42,"cosmosGeoPoint":98,"geoPoint":100,"contacts":101},"Family Care Heath Center, 401 Holly Hills Ave","63111",{"type":44,"coordinates":99},[46,47],{"lat":47,"lon":46},[102],{"name":84,"role":28,"phone":29,"phoneExt":18,"email":85},{"facility":104,"status":37,"city":38,"state":39,"zip":105,"country":41,"countryCode":42,"cosmosGeoPoint":106,"geoPoint":108,"contacts":109},"Affinia healthcare, 3396 Pershall Road,","63135",{"type":44,"coordinates":107},[46,47],{"lat":47,"lon":46},[110],{"name":111,"role":28,"phone":112,"phoneExt":18,"email":113},"Iesha Draper, MD","314-793-7214","idraper@affiniahealthcare.org",{"type":115,"investigatorFullName":116,"investigatorTitle":117,"investigatorAffiliation":5,"oldNameTitle":18,"oldOrganization":18},"PRINCIPAL_INVESTIGATOR","James Krings","Assistant Professor of Medicine",[119,122,124,127],{"name":120,"class":121},"National Heart, Lung, and Blood Institute (NHLBI)","NIH",{"name":123,"class":6},"Doris Duke Charitable Foundation",{"name":125,"class":126},"Affinia Healthcare","UNKNOWN",{"name":128,"class":126},"Family Care Health Centers","100611479","phase-4-chest-a-collaboration-with-community-health-centers-to-implement-smart-for-asthma-100611479",false,"NCT07241117","CHEST: A Collaboration With Community HEalth Centers to Implement SmarT for Asthma","CHEST","The study population can be viewed from the cluster (clinic), clinician, staff, or patient level.\n\nAt the cluster (clinic) level: To be eligible to participate in this study, a cluster (clinic) must meet all the following criteria:\n\n1. Active participation in the St. Louis Integrated Health Center Network for Community Academic Partnerships.\n2. Employment of at least 3 clinicians who commonly manage adult asthma (defined as managing asthma for at least one adult asthma patient, on average, on a weekly basis).\n3. Data provided to Azara for data queries, and\n4. Willing and able to receive all components of the SMART implementation bundle (i.e., initial educational outreach visit, ongoing practice facilitation\u002Fsupervision, audit \\& feedback, and provision of education of patient-level education aides and SMART asthma action plans and monthly operations committee meetings).\n\nAt the clinician\u002Fclinical staff level:\n\nTo be eligible to participate in this study, a clinician\u002Fclinical staff member must meet all of the following criteria:\n\n1. Provision of a signed and dated informed consent form.\n2. Current state licenses of physician, assistant physician, nurse practitioner, or physician assistant.\n3. Regularly cares for adults with asthma (which may include those trained in family medicine, internal medicine, obstetrics\u002Fgynecology, and\u002For specialty medicine).\n4. Willing and able to integrate the SMART implementation bundle into their practice.\n5. Willing and able to participate for the entire duration of the study, including the pre-implementation, active implementation, and post-implementation periods.\n6. Willing to provide data on prescribing patterns and asthma patient outcomes for the duration of the study.\n\nAt the patient level:\n\nTo be eligible to participate in this study, a patient must meet all of the following criteria:\n\n1. Age ≥12 years old\n2. Diagnosis of asthma, of any severity, coded (i.e., International Classification of Diseases \\[ICD\\]-10-CM: J45\\*\\*).\n3. The patient has had ≥2 asthma exacerbations in the last year during which systemic corticosteroids were prescribed, and\u002For the encounter contains an active prescription for an inhaler that is congruent with medium-dose (or higher) maintenance inhaled corticosteroids (ICS) inhalers or low-dose (or higher) ICS-long-acting β-agonist (LABA) inhalers with concomitant reliever short-acting β-agonist inhalers.","ALL","12 Years",{"count":139,"type":140},2000,"ESTIMATED","INTERVENTIONAL",[143],"PHASE4","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).\n\nThe 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.",[146],"Moderate to Severe Asthma",[148,149,150,134,151,152,153,154,155,156,157,158,159],"asthma","SMART","moderate to severe asthma","CHEST asthma study","asthma study","asthma action plan","implementation science","hybrid cluster","community health centers","MART","single maintenance and reliever therapy","maintenance and reliever therapy","2026-01-15",{"date":162,"type":163},"2026-01-16","ACTUAL",{"date":165,"type":163},"2026-01-06",{"date":167,"type":140},"2028-11-15",{"name":5,"class":6},7]