R01HL151854
Project Grant
Overview
Grant Description
Primary Care Implementation and Evaluation of Coach McLungssm: An Asthma Shared Decision-Making Intervention, Across a Large Healthcare System - Project Summary / Abstract (30 lines)
Changing behavior of health providers can be challenging, and significant gaps exist in our knowledge of how to best implement new medical evidence into everyday practice. Numerous individual- and system-level factors contribute to poor asthma outcomes which persist due to the lack of a comprehensive approach for asthma care that is scalable, sustainable, and widely disseminated.
Improved asthma outcomes are associated with effective communication strategies between the patient and provider. Shared Decision Making (SDM) is a patient-centered process in which patients and providers work together to make decisions and select tests, treatments, and care plans based on evidence that balances risks with patient preferences and values. Previous studies, including our PCORI-funded dissemination study, have shown that SDM is associated with improved outcomes for asthma patients in primary care.
Here we will evaluate the implementation of Coach McLungssm, a virtual evidence-based asthma SDM intervention with built-in asthma education and clinical decision support, into primary care practices across a large healthcare system. Atrium Health, the 2nd largest virtually integrated healthcare system in the nation, with over 14 million patient visits per year and the region's largest primary care network, provides an ideal venue to evaluate implementation into primary care.
Coach McLungssm will be fully integrated into the electronic medical record at all primary care practices. All asthma patients aged 5-17 who attend these practices will be assessed for uncontrolled asthma. The goal of this study will be to evaluate the implementation of the Coach McLungssm SDM intervention into primary care. Implementation will be guided using the Expert Recommendations for Implementing Change (ERIC), a compilation of implementation strategies, and evaluated using the RE-AIM (Reach Effectiveness, Adoption, Implementation, Maintenance) framework.
Research questions are: How best can we implement the Coach McLungssm SDM asthma intervention into primary care? Will use of Coach McLungssm in primary care improve outcomes for patients with uncontrolled asthma?
After convening a Stakeholder Advisory Committee (SAC) composed of providers, researchers, patients, stakeholders with expertise in implementation science, asthma research, and advocacy, we will implement the Coach McLungssm SDM intervention into primary care practices using a stepped wedge randomized control study design. Providers and staff will be trained in SDM communication and use of the Coach McLungssm tool.
We will measure changes in emergency department visits, hospitalizations, and oral steroid use, which serve as surrogate measures for patient-centered asthma outcomes. The SAC will use an iterative process improvement method and give best practice recommendations back to the practices for implementation improvement.
We will disseminate findings through local stakeholders, practice-based research networks, asthma advocacy national organizations, and academic research meetings for healthcare, primary care, and asthma.
Changing behavior of health providers can be challenging, and significant gaps exist in our knowledge of how to best implement new medical evidence into everyday practice. Numerous individual- and system-level factors contribute to poor asthma outcomes which persist due to the lack of a comprehensive approach for asthma care that is scalable, sustainable, and widely disseminated.
Improved asthma outcomes are associated with effective communication strategies between the patient and provider. Shared Decision Making (SDM) is a patient-centered process in which patients and providers work together to make decisions and select tests, treatments, and care plans based on evidence that balances risks with patient preferences and values. Previous studies, including our PCORI-funded dissemination study, have shown that SDM is associated with improved outcomes for asthma patients in primary care.
Here we will evaluate the implementation of Coach McLungssm, a virtual evidence-based asthma SDM intervention with built-in asthma education and clinical decision support, into primary care practices across a large healthcare system. Atrium Health, the 2nd largest virtually integrated healthcare system in the nation, with over 14 million patient visits per year and the region's largest primary care network, provides an ideal venue to evaluate implementation into primary care.
Coach McLungssm will be fully integrated into the electronic medical record at all primary care practices. All asthma patients aged 5-17 who attend these practices will be assessed for uncontrolled asthma. The goal of this study will be to evaluate the implementation of the Coach McLungssm SDM intervention into primary care. Implementation will be guided using the Expert Recommendations for Implementing Change (ERIC), a compilation of implementation strategies, and evaluated using the RE-AIM (Reach Effectiveness, Adoption, Implementation, Maintenance) framework.
Research questions are: How best can we implement the Coach McLungssm SDM asthma intervention into primary care? Will use of Coach McLungssm in primary care improve outcomes for patients with uncontrolled asthma?
After convening a Stakeholder Advisory Committee (SAC) composed of providers, researchers, patients, stakeholders with expertise in implementation science, asthma research, and advocacy, we will implement the Coach McLungssm SDM intervention into primary care practices using a stepped wedge randomized control study design. Providers and staff will be trained in SDM communication and use of the Coach McLungssm tool.
We will measure changes in emergency department visits, hospitalizations, and oral steroid use, which serve as surrogate measures for patient-centered asthma outcomes. The SAC will use an iterative process improvement method and give best practice recommendations back to the practices for implementation improvement.
We will disseminate findings through local stakeholders, practice-based research networks, asthma advocacy national organizations, and academic research meetings for healthcare, primary care, and asthma.
Funding Goals
NOT APPLICABLE
Grant Program (CFDA)
Awarding / Funding Agency
Place of Performance
Winston Salem,
North Carolina
27157
United States
Geographic Scope
Single Zip Code
Related Opportunity
Analysis Notes
Amendment Since initial award the total obligations have increased 394% from $694,138 to $3,428,676.
Wake Forest University Health Sciences was awarded
Coach McLungssm: Asthma SDM Implementation in Primary Care
Project Grant R01HL151854
worth $3,428,676
from National Heart Lung and Blood Institute in September 2021 with work to be completed primarily in Winston Salem North Carolina United States.
The grant
has a duration of 4 years 10 months and
was awarded through assistance program 93.837 Cardiovascular Diseases Research.
The Project Grant was awarded through grant opportunity Implementation of shared decision making for HLBS diseases and conditions (R01 Clinical Trial Optional).
Status
(Ongoing)
Last Modified 8/20/25
Period of Performance
9/1/21
Start Date
7/31/26
End Date
Funding Split
$3.4M
Federal Obligation
$0.0
Non-Federal Obligation
$3.4M
Total Obligated
Activity Timeline
Transaction History
Modifications to R01HL151854
Additional Detail
Award ID FAIN
R01HL151854
SAI Number
R01HL151854-3134597711
Award ID URI
SAI UNAVAILABLE
Awardee Classifications
Private Institution Of Higher Education
Awarding Office
75NH00 NIH National Heart, Lung, and Blood Institute
Funding Office
75NH00 NIH National Heart, Lung, and Blood Institute
Awardee UEI
SN7KD2UK7GC5
Awardee CAGE
1WEZ6
Performance District
NC-10
Senators
Thom Tillis
Ted Budd
Ted Budd
Budget Funding
Federal Account | Budget Subfunction | Object Class | Total | Percentage |
---|---|---|---|---|
National Heart, Lung, and Blood Institute, National Institutes of Health, Health and Human Services (075-0872) | Health research and training | Grants, subsidies, and contributions (41.0) | $1,434,066 | 100% |
Modified: 8/20/25