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

The study population can be viewed from the cluster (clinic), clinician, staff, or patient level.

At the cluster (clinic) level: To be eligible to participate in this study, a cluster (clinic) must meet all the following criteria:

(1) Clinics within participating health systems (Affinia Healthcare and Family Care Health Centers) will be considered eligible if they provided care to ≥100 patients aged ≥12 years with asthma (ICD-10-CM: J45.xx) during the calendar year preceding implementation (2024).

At the clinician level:

Clinicians will be considered eligible if they:

1. are physicians, nurse practitioners, or physician assistants;
2. are actively employed at a participating clinic during the implementation period; and
3. provided care to ≥10 patients aged ≥12 years with asthma (ICD-10-CM: J45.xx) during the 12 months preceding implementation.

At the staff level:

Staff will be considered eligible if they:

1. are actively employed at a participating clinic during the implementation period; and
2. directly support clinical care delivery for patients aged ≥12 years with asthma.

At the patient level:

Patients will be considered eligible if they:

1. are aged ≥12 years;
2. received care at a participating clinic during the implementation period; and (3) meet the study-defined definition of moderate-to-severe asthma based on diagnosis codes, medication use, and/or exacerbation history as defined in the study protocol.