TESTING INTERVENTIONS IN PEDIATRIC ASTHMA

描述(根据申请者的描述改编)：本项目寻求 初步资金用于比较两种干预措施以增加依从性和 减少持续性哮喘儿童的发病率。最新研究 证明患有哮喘的儿童通常服用不到一半的 处方剂量的预防性药物。瞄准这个问题 特别是有可能改善症状，降低发病率，以及 降低儿童哮喘患者的医疗保健利用率。 将首先开展焦点小组，就初步情况提供反馈 干预材料。然后，110个家庭有一个患有持续性哮喘的孩子 (8-14岁)将被招募到一个月的基线中，包括电子 依从性评估，以及哮喘知识、自我效能和 发病率。在基线结束时，子女表现不到 70%的忠诚度(预计n等于60)将随机分配到两个选项中的一个 治疗条件，行为反馈(BF)或哮喘教育 (AE)。 每种治疗包括三次个体化治疗，每次一小时，每次治疗 一个月的时间。BF状况包括关于药物使用的反馈， 解决关于遵守障碍和行为契约的问题。 这种情况提供了关于哮喘生物学和药物的教育， 环境控制，以及症状评估和管理。遵守和 哮喘发病率将在干预一个月和一个月期间进行评估 后处理。预计：1)EF条件下的参与者将 表现出比AE参与者更高的遵从性 条件和2)高炉条件下的参与者将减少 与接受AE治疗的参与者相比，哮喘导致的功能性发病率。 初步分析将确定相关协变量；关键分析将 确定组内和组间的干预效果。探索性分析 将调查行为改变的调解人。结果将用于设计 一项比较行为反馈与哮喘的更大规模的随机对照试验 教育。

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.