Navigating Together for Equitable Asthma Management for children in families who communicate in languages other than English (Nav-TEAM): A type 2 effectiveness-implementation trial protocol.

Asthma is the most common chronic disease of childhood in the United States and disproportionately affects children in families who communicate in languages other than English (LOE), who experience worse asthma care, lower use of recommended management practices, and higher hospitalization and emergency department (ED) utilization. Navigating Together for Equitable Asthma Management (Nav-TEAM) was developed to address these asthma disparities through a culturally and linguistically responsive asthma navigation program for LOE families. This article describes the protocol for a hybrid type 2 effectiveness-implementation trial evaluating both Nav-TEAM intervention effectiveness and implementation outcomes. The study will enroll 280 parent-child dyads of children aged 4-12 years with persistent asthma whose caregivers prefer a non-English healthcare language. Using a wait-list control randomized design, participants will receive usual asthma care with or without a 9-month telehealth asthma navigation intervention delivered by trained bilingual navigators, with interpreter support for non-English, non-Spanish languages. Nav-TEAM includes asthma education, care coordination, social needs assessment, and family skill-building across scheduled and utilization-triggered visits. The primary effectiveness outcome is asthma-related ED utilization over 12 months, measured through the electronic health record. Secondary outcomes include asthma control, exacerbations, missed school and workdays, and patient-reported outcomes. Implementation will be evaluated using the Practical, Robust Implementation and Sustainability Model (PRISM) with an equity lens, applying mixed methods assessment of reach, adoption, acceptability, fidelity, adaptation, sustainability, and cost. Recruitment began in 2025. Nav-TEAM is designed to test a scalable, equity-focused model for improving asthma outcomes and reducing disparities among children in LOE families.