Telehealth Education for Asthma Connecting Hospital and Home (TEACHH)

Asthma is one of the most common chronic conditions in children and a leading cause of preventable hospitalizations, particularly among children in families from underserved communities. Effective home management is essential to prevent exacerbations and reduce repeat hospital visits. However, many caregivers face challenges in understanding asthma care and adhering to medication regimens. In-hospital education is often brief and disconnected from follow-up care, leaving caregivers, especially those with limited health literacy, underprepared to manage the condition at home.

To address this gap, researchers piloted TEACHH, a patient-centered intervention designed to be easy to understand and use. By combining clear, hospital-based asthma education with virtual follow-up visits, TEACHH offered both immediate instruction and ongoing support to engage children and caregivers in asthma self-management and help families better control the condition after leaving the hospital.

The specific aims of the research were as follows:

• Determine the feasibility and acceptability of implementing TEACHH for children with asthma throughout the hospital-to-home transition.
• Estimate the preliminary efficacy of TEACHH on patient-important outcomes and provide parameter estimates for a subsequent full-scale trial.

Building on earlier work testing a health literacy-informed asthma education toolkit in outpatient care, researchers extended the intervention to inpatient and home telehealth settings. They conducted a small randomized controlled trial (RCT) to assess feasibility and gather preliminary outcome data for a larger efficacy study. Twenty-six caregiver–child pairs with children ages 5–13 hospitalized for persistent or poorly controlled asthma were randomized to the TEACHH intervention combined with the standard care (SC) or SC alone. The TEACHH group also received tailored education before discharge, including inhaler training, a pictorial action plan, and color- and shape-coded medication labels. Designed for individuals with limited health literacy, TEACHH used simplified language, visual aids, and culturally appropriate materials. Two Zoom visits reinforced key asthma management skills. Caregivers completed follow-up surveys at 2, 4, and 6 months, while interviews and medical record data provided additional insights into outcomes and caregiver experiences.

Caregivers reported high satisfaction, particularly valuing the visual aids and telehealth follow-ups that reinforced hospital-based teaching. Preliminary findings showed that while both intervention and control groups improved asthma symptoms and caregiver quality of life, the TEACHH group had more symptom-free days within four months. The TEACHH group did have more acute care visits, potentially due to baseline health differences. The intervention proved feasible in both hospital and home settings, with 77 percent of planned educational visits completed. The research team plans to share these findings through academic and clinical networks and is preparing a larger RCT to assess TEACHH’s impact on asthma outcomes and hospital readmissions, especially in underserved populations.