Protocol for the Development of a Behavioral Family Lifestyle Intervention Supported by Mobile Health to Improve Weight Self-Management in Children With Asthma and Obesity
Protocol for the Development of a Behavioral Family Lifestyle Intervention Supported by Mobile Health to Improve Weight Self-Management in Children With Asthma and Obesity
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DOI：
10.2196/13549
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发表时间：
2019-06-01
影响因子：
1.7
通讯作者：
Lindberg, David
中科院分区：
文献类型：
--
作者：
Fedele, David;Lucero, Robert;Lindberg, David
背景：哮喘是最常见的儿童慢性疾病，也是美国急诊科就诊的主要原因。在患有哮喘的青少年中，肥胖会增加健康状况不佳、生活质量下降和医疗保健支出增加的风险。减肥对于改善肥胖儿童的哮喘预后至关重要。我们的研究团队开发了儿童健康和哮喘管理计划(CHAMP)，这是一种针对患有哮喘和肥胖症的学龄儿童的16节行为家庭生活方式干预(BFI)，并在随机对照试验中与注意力控制进行了比较。对于体重指数z分数、哮喘控制和肺功能的变化，在完成者(即，参加16个疗程中的9个疗程的患者)中，CHAMP有中等效应。尽管家庭报告的满意率很高，但出勤率和试验自然减员情况并不理想，这引发了人们对CHAMP可行性的担忧。参与者的定性反馈指出了3个需要改进的领域：(1)负担较轻的干预模式，(2)更个性化的干预体验，以及(3)干预者可以更好地回答与健康相关的问题。目的：我们建议通过开发移动儿童健康和哮喘管理计划(MCHAMP)来改进我们的试点干预，这是一个护士提供的BFI，提供给单个家庭，并由移动健康(MHealth)应用程序支持。本研究的目的是(1)确定mCHAMP的结构成分，(2)开发和测试我们的mCHAMP应用程序的可用性。我们将与哮喘和肥胖症儿童的父母一起进行需求评估，以确定mCHAMP的结构组成部分。随后，我们将使用迭代过程开发和测试我们的mCHAMP应用程序，其中包括与目标用户和儿科护士进行可用性测试。结果：本研究于2018年获得资助；13名哮喘和肥胖儿童的父母参与了需求评估。来自焦点小组和个人会议的初步主题包括参与促进健康行为的障碍、哮喘和肥胖之间的感知关系、行为改变的促进者以及干预偏好。参与式设计会议和可用性测试预计将于2019年底结束。结论：这项研究的结果预计将包括由目标受众直接参与设计的mHealth应用程序，以及来自利益相关者和潜在最终用户的可用性数据。
Background: Asthma is the most common chronic childhood illness and is a leading cause of emergency department visits in the United States. Obesity increases the risk of poor health outcomes, reduced quality of life, and increased health care expenditures among youth with asthma. Weight loss is crucial for improving asthma outcomes in children with obesity. Our study team developed the Childhood Health and Asthma Management Program (CHAMP), a 16-session behavioral family lifestyle intervention (BFI) for school-age children with asthma and obesity and evaluated CHAMP in a randomized controlled trial compared with attention control. There were medium effect sizes favoring CHAMP for changes in body mass index z-scores, asthma control, and lung function among completers (ie, those who attended >= 9 of 16 sessions). Despite high rates of satisfaction reported by families, attendance and trial attrition were suboptimal, which raised concerns regarding the feasibility of CHAMP. Qualitative feedback from participants indicated 3 areas for refinement: (1) a less burdensome intervention modality, (2) a more individually tailored intervention experience, and (3) that interventionists can better answer health-related questions.Objective: We propose to improve upon our pilot intervention by developing the Mobile Childhood Health and Asthma Management Program (mCHAMP), a nurse-delivered BFI, delivered to individual families, and supported by a mobile health (mHealth) app. This study aims to (1) identify structural components of mCHAMP and (2) develop and test the usability of our mCHAMP app.Methods: Participants will be recruited from an outpatient pediatric pulmonary clinic. We will identify the structural components of mCHAMP by conducting a needs assessment with parents of children with asthma and obesity. Subsequently, we will develop and test our mCHAMP app using an iterative process that includes usability testing with target users and pediatric nurses.Results: This study was funded in 2018; 13 parents of children with asthma and obesity participated in the needs assessment. Preliminary themes from focus groups and individual meetings included barriers to engaging in health-promoting behaviors, perceived relationships between asthma and obesity, facilitators to behavior change, and intervention preferences. Participatory design sessions and usability testing are expected to conclude in late 2019.Conclusions: Outcomes from this study are expected to include an mHealth app designed with direct participation from the target audience and usability data from stakeholders as well as potential end users.