Project Overview +

Puff City is a successful asthma management program for urban teenagers in Detroit high schools. This iteration of Puff City uses a pilot approach to test if Puff City was accessible and feasible in an ED setting.

Aims +

Create a version of Puff City that is accessible to students who present in the ED with symptoms of asthma.

Participants +

Adolescents who present in the ED with symptoms of asthma

Intervention +

For this non-school oriented use of Puff City, the login process allows students to enter an email address and password (instead of a school ID and a random security question in past versions of this project). When students present in the ED with symptoms of asthma, a hospital employee allows them access to the Puff City website. They are then able to access the Puff City program in its entirety.

Two recruiters were stationed in the HFHS Fairlane ED and the Children's Hospital of Michigan adolescent health clinic. The recruitment protocol was tailored to each site. Our interest was in testing the recruitment protocol, not the intervention, so we enrolled any teen that met age criteria and had a physician diagnosis of asthma (regardless of reason for visit). Teens could earn up to $40 in cash ($20) and gift cards ($20).

Findings +

We were able to conduct a small pilot to test the feasibility of initiating Puff City in a clinical setting, facilitated by Dr. Usamah Mossollum (HFHS) and Dr. Prashant Mahajan (Children's Hospital of Michigan), site Investigators for PC 24/7.

A total of 10 students (6 from the ED) were consecutively recruited through this pilot from 9/16/08 - 10/07/08, of which 50% (n=5) were Medicaid enrollees. Eight of the 10 teens completed 4 sessions; all completed > 2 sessions. The average number of reminders was 7.0 for persons completing all 4 sessions. A satisfaction survey was administered 4 weeks after baseline with responses from 9/10 students and caregivers. Six participants accessed the program from a home computer, 2 from a school computer, and 1 used some other computer (library, friend or relative). Problems that arose during our pilot were handled by the University of Michigan CHCR team at a remote office.

Conclusion +

Our pilot helped to test our recruitment protocol (at HFHS Fairlane), and also suggest that: (1) teens are willing to participate; (2) teens will complete sessions on their own, (3) teens are able to find computers to complete the sessions, (4) the program works well on a variety of computers in community-based settings, and (5) trouble-shooting from a remote location remains feasible.

Puff City - OPD Recruitment Trial

07/01/2008 - 09/30/2008

Principal Investigator:

Christine L. M. Joseph, PhD, MPH


Alan P. Baptist, MD, MPH