Asthma and Technology in Emerging African American Adults (The ATHENA Project): Protocol for a Trial Using the Multiphase Optimization Strategy Framework.
Asthma and Technology in Emerging African American Adults (The ATHENA Project): Protocol for a Trial Using the Multiphase Optimization Strategy Framework.
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DOI：
10.2196/37946
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发表时间：
2022-05-10
影响因子：
1.7
通讯作者：
MacDonell, Karen Kolmodin
中科院分区：
文献类型：
--
作者：
Baptist, Alan;Gibson-Scipio, Wanda;Carcone, April Idalski;Ghosh, Samiran;Jacques-Tiura, Angela J.;Hall, Amy;MacDonell, Karen Kolmodin
关键词：
在美国，哮喘引起大量的发病率和死亡率，特别是在非洲裔美国人的新兴成人（AAEAs； 18-30岁）中，但很少有哮喘项目针对这一人群。提供教育和解决管理哮喘的潜在动机的干预措施可能是最有效的。然而，密集的面对面干预往往难以在这一人群中实施。本研究的目的是开发一种有效的流动哮喘管理干预措施，以改善对aaea的控制。我们将评估多种技术成分协助和改善传统哮喘教育的能力。第一个组成部分是哮喘管理的动机增强系统。这是一种移动的4期干预，使用支持性自我调节和动机性访谈。个性化内容基于每个参与者的活动水平、日常经验和目标。第二个组成部分是支持性问责制。它由哮喘护士使用有针对性的移动支持（Skype/语音通话）进行管理，以提供教育，提高自我效能，并通过基于动机性访谈的框架克服障碍。第三个组成部分是SMS短信。它为哮喘教育、药物依从性和身体活动提供提醒。第四个部分是身体活动跟踪。它使用可穿戴技术来帮助满足用户定义的体育活动目标。使用多阶段优化策略（MOST）框架，我们将测试干预组件和组件组合，以确定最有效的移动干预。MOST框架是一个创新的、成本和时间有效的框架，它使用工程原理来产生有效的行为干预。我们将使用析因研究设计进行成分选择实验，以构建一个已优化的最大功效的干预措施，使用哮喘的临床显着改善。参与者（N=180）将被随机分配到6个干预组中的1个。参与者将从美国肺脏协会-气道临床研究中心网络和底特律医疗中心的门诊护理诊所的多个地点招募。数据收集将在基线、3、6和12个月进行。在研究完成时，我们将有一个经验支持的优化的移动哮喘管理干预措施，以改善aaea的哮喘控制。我们假设干预后（3,6和12个月），未控制哮喘的参与者在哮喘控制方面表现出临床显着改善。我们还假设将观察到哮喘管理行为（包括身体活动）、生活质量、症状、依从性和恶化（次要结局）的改善。aaea对哮喘的影响不成比例，但在研究中代表性不足。移动哮喘管理干预措施可能有助于改善哮喘控制，使人们过上更健康的生活。在这个项目中，我们将采用一种创新策略，利用护士提供的哮喘教育、智能手机应用程序和短信的最有效组合，开发一种优化的移动哮喘管理干预措施。prr1 - 10.2196/37946
Asthma causes substantial morbidity and mortality in the United States, particularly among African American emerging adults (AAEAs; aged 18-30 years), but very few asthma programs have targeted this population. Interventions that provide education and address underlying motivation for managing asthma may be the most effective. However, intensive face-to-face interventions are often difficult to implement in this population. The purpose of this study is to develop an effective mobile asthma management intervention to improve control among AAEAs. We will assess the ability of multiple technologic components to assist and improve traditional asthma education. The first component is the Motivational Enhancement System for asthma management. It is a mobile 4-session intervention using supported self-regulation and motivational interviewing. Personalized content is based on each participant’s activity level, daily experiences, and goals. The second component is supportive accountability. It is administered by asthma nurses using targeted mobile support (Skype/voice calls) to provide education, promote self-efficacy, and overcome barriers through a motivational interviewing–based framework. The third component is SMS text messaging. It provides reminders for asthma education, medication adherence, and physical activity. The fourth component is physical activity tracking. It uses wearable technology to help meet user-defined physical activity goals. Using a multiphase optimization strategy (MOST) framework, we will test intervention components and combinations of components to identify the most effective mobile intervention. The MOST framework is an innovative, and cost- and time-effective framework that uses engineering principles to produce effective behavioral interventions. We will conduct a component selection experiment using a factorial research design to build an intervention that has been optimized for maximum efficacy, using a clinically significant improvement in asthma. Participants (N=180) will be randomized to 1 of 6 intervention arms. Participants will be recruited from multiple sites of the American Lung Association-Airway Clinical Research Centers network and ambulatory care clinics at the Detroit Medical Center. Data collections will occur at baseline, and 3, 6, and 12 months. At study completion, we will have an empirically supported optimized mobile asthma management intervention to improve asthma control for AAEAs. We hypothesize that postintervention (3, 6, and 12 months), participants with uncontrolled asthma will show a clinically significant improvement in asthma control. We also hypothesize that improvements in asthma management behaviors (including physical activity), quality of life, symptoms, adherence, and exacerbation (secondary outcomes) will be observed. AAEAs are disproportionately impacted by asthma, but have been underrepresented in research. Mobile asthma management interventions may help improve asthma control and allow people to live healthier lives. During this project, we will use an innovative strategy to develop an optimized mobile asthma management intervention using the most effective combination of nurse-delivered asthma education, a smartphone app, and text messaging. PRR1-10.2196/37946
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