TESTING INTERVENTIONS IN PEDIATRIC ASTHMA

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DESCRIPTION (Adapted from applicant's description): This project seeks preliminary funding to compare two interventions to increase adherence and reduce morbidity for children with persistent asthma. Recent studies demonstrate that children with asthma typically take less than half of their prescribed doses of preventive medications. Targeting this problem specifically has the potential to improve symptoms, decrease morbidity, and decrease health care utilization in pediatric asthma. Focus groups will first be conducted to provide feedback regarding preliminary intervention materials. Then, 110 families with a child with persistent asthma (between 8-14) will be recruited into a month's baseline, including electronic adherence assessment, and evaluation of asthma know1edge, self-efficacy, and morbidity. At the end of baseline, families whose children exhibit less than 70% adherence (expected n equals 60) will be randomized to one of two treatment conditions, either Behavioral Feedback (BF) or Asthma Education (AE). Each treatment consists of three individualized one-hour sessions over a month's time. The BF condition includes feedback regarding medication use, problem-solving regarding adherence barriers, and behavioral contracting. The AE condition provides education regarding asthma biology and medications, environmental control, and symptom assessment and management. Adherence and asthma morbidity will be assessed during the intervention month, and one month post-treatment. It is expected that: 1) Participants in the EF condition will demonstrate greater increases in adherence than participants in the AE condition and 2) Participants in the BF condition will have decreased functional morbidity due to asthma relative to participants receiving AE. Preliminary analyses will determine relevant covariates; key analyses will determine intervention effects within and across groups. Exploratory analyses will investigate mediators of behavior change. Results will be used to design a larger, randomized controlled trial comparing behavioral feedback to asthma education.