Developing an in vivo adherence intervention for adolescents with asthma

为患有哮喘的青少年开发体内依从性干预措施

• 批准号: 7470914
• 负责人: MICHAEL SEID
• 金额: $ 21.4万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-15 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7470914
• 关键词: Address; Adherence; Adolescent; Adolescent Medicine; Adult; African American; Asthma; Behavior Therapy; Boxing; Budgets; Car Phone; Caring; Childhood; Clinic; Clinical; Clinical Trials; Computer software; Condition; Daily; Data; Disease; Education; Effectiveness; Feedback; Focus Groups; Foundations; Goals; Health; Human Resources; Intervention; Knowledge; Language; Letters; Life; Long-Term Effects; Medical center; Methods; Morbidity - disease rate; Motivation; Not Hispanic or Latino; Outcome; Parents; Participant; Pediatric Hospitals; Population; Positioning Attribute; Primary Health Care; Principal Investigator; Problem Solving; Public Health; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Resources; Self Management; Site; Software Engineering; Standards of Weights and Measures; Symptoms; System; Technology; Teenagers; Testing; Time; Treatment Efficacy; United States; Urban Population; base; behavioral clinical trial; design; follow-up; health related quality of life; improved; in vivo; innovation; innovative technologies; killings; mortality; motivational enhancement therapy; motivational intervention; prototype; size; skills; skills training

DESCRIPTION (provided by applicant): Asthma represents substantial morbidity and, worse, continues to kill disproportionately so for adolescents and for non-Hispanic Blacks. Adherence is key to asthma control, but is challenging, particularly for teens. While behavioral interventions to improve asthma adherence and outcomes have been studied in adult and pediatric populations, relatively few have addressed adolescents, none have explicitly combined problem- solving and motivational interviewing, and none have made use of mobile phones as a platform for bridging didactics to real life situations. There is a critical need to develop and test asthma self-management interventions incorporating efficacious components and tailored to adolescent needs in real life situations. Until this need is met, progress in reducing asthma morbidity and mortality will be slowed. The objective of this application is to develop and pilot test a tailored multimodal behavioral intervention, delivered using mobile-phone technology and incorporating motivation, knowledge, and problem-solving skills to overcome barriers to adherence in adolescents with moderate and severe persistent asthma. We will recruit participants from an academic adolescent medicine clinic serving a largely poor, urban, African-American population. Successful completion of this project will produce data that will serve as a foundation for a larger clinical trial. The application's objective will be pursued via the following three specific aims: 1) Examine the acceptability, for adolescents with moderate or severe asthma, of an intervention based on existing efficacious problem-solving and motivational interventions; 2) Develop and beta-test a mobile-phone based platform for the intervention; and 3) Feasibility test and pilot test the intervention to determine short-term efficacy in adolescents with moderate or severe asthma. This research will yield intervention materials and a feasible, field-tested mobile phone platform, pilot data on intervention acceptability, feasibility, fidelity, recruitment and retention, and potential effect sizes, and an R01 application to examine the intervention's efficacy and long-term effects through a larger clinical trial. This has great potential significance: Evidence for the efficacy and effectiveness of such an intervention could have a substantial impact on the health outcomes of adolescents with asthma throughout the United States. Moreover, as the intervention is not condition-specific, it could have broad application across populations and diseases. Public Health Relevance Paragraph: The proposed research is relevant to public health: Evidence for the efficacy of an intervention to reduce barriers to adherence and improve outcomes could have a substantial impact on the health outcomes of adolescents with asthma throughout the U.S.. Moreover, as this intervention is not condition-specific, it could have broad application across populations and diseases.

描述(由申请人提供)：哮喘代表着相当高的发病率，更糟糕的是，对青少年和非西班牙裔黑人来说，哮喘继续不成比例地导致死亡。坚持是控制哮喘的关键，但也是具有挑战性的，特别是对青少年来说。虽然在成人和儿童人群中研究了改善哮喘依从性和预后的行为干预措施，但针对青少年的行为干预相对较少，没有人明确地将解决问题和动机访谈结合起来，也没有人利用手机作为教学人员与现实生活情景联系的平台。迫切需要开发和测试哮喘自我管理干预措施，包括有效的组成部分，并针对现实生活中青少年的需要量身定做。在满足这一需求之前，降低哮喘发病率和死亡率方面的进展将会放缓。该应用程序的目标是开发和试点测试一种量身定制的多模式行为干预，使用移动电话技术并结合动机、知识和解决问题的技能，以克服中重度持续性哮喘青少年的坚持障碍。我们将从一家学术青少年医学诊所招募参与者，该诊所主要服务于贫穷的城市非裔美国人。该项目的成功完成将产生数据，为更大规模的临床试验奠定基础。该应用程序的目标将通过以下三个具体目标实现：1)检查基于现有有效的解决问题和激励干预措施的干预措施对中度或重度哮喘青少年的可接受性；2)开发和Beta测试基于手机的干预平台；以及3)可行性测试和初步测试干预措施，以确定对中度或重度哮喘青少年的短期疗效。这项研究将产生干预材料和一个可行的、经过现场测试的手机平台，关于干预的可接受性、可行性、保真度、招募和保留以及潜在效果大小的试点数据，以及通过更大的临床试验检验干预效果和长期效果的R01应用程序。这具有巨大的潜在意义：这种干预的有效性和有效性的证据可能会对全美哮喘青少年的健康结果产生重大影响。此外，由于这种干预不是针对具体情况的，它可能会在人群和疾病中得到广泛应用。 公共卫生相关性段落：拟议的研究与公共健康相关：减少坚持障碍和改善结果的干预有效的证据可能会对全美哮喘青少年的健康结果产生重大影响。此外，由于这种干预不是特定条件的，它可能会在人群和疾病中得到广泛应用。