TeenMigraineConnection: Web-based self-management training for adolescents with m

描述(申请人提供)：头痛是儿童和青少年常见的健康问题(Winner&Rothner，2001)。对儿童和照顾者的影响最大的是偏头痛，这可能对残疾(Hershey等人，2001年)以及生活质量(Power，等人，2004年)产生重大影响。例如，与非偏头痛的青少年相比，患有偏头痛的青少年高中成绩较低，高中毕业和上大学的可能性也较小(Rees&Sabia，2009)。尽管偏头痛的发病率和影响很大，但儿童偏头痛受到的关注非常少，而且通常没有得到诊断或被误诊(Hershey&Winner，2005)。一些健康行为的改变可以减少偏头痛发作的频率，降低偏头痛进展的风险(Bigal，2009)，并显著提高生活质量(Cottrell等人，2007)。然而，对于这个年龄段的人来说，几乎没有什么可用的。我们建议为患有偏头痛的青少年开发一个创新的、互动的、在线的疼痛自我管理计划。这种名为TeenMigraineConnection的在线健康干预将提供有关偏头痛的诊断、治疗和管理的临床可靠信息。此外，Web 2.0技术的使用将有助于开发创新功能，例如可通过移动设备访问的头痛日记，以促进实时更新；激励性、量身定做的信息，以提高自我管理行为的自我效能；以及基于视频的证词和社交网络，以增强社会支持。在照顾者方面，文章、课程和工具将提供量身定制的信息，帮助照顾者加强青少年的自我管理行为。我们对网站的审查表明，目前还没有一家网站提供这种经验派生的自我管理功能和尖端技术的组合。我们相信，该计划将对公共卫生产生重大影响。由于偏头痛的总成本估计为每年130亿至150亿美元(斯图尔特，2003)，该计划可能会改善数百万青少年的生活质量，同时解决进入成年期的风险因素，从而降低这一可观的成本。这项在线健康干预的内容将通过以下具体目标进行开发和评估：(1)收集偏头痛青少年、照顾者和偏头痛专家对网站和移动应用程序的设计和内容的意见；(2)制定内容、设计和技术开发计划；(3)开发网站和纸的快速Flash原型-移动应用程序的原型；(4)对青少年患者和照顾者进行可用性和接受度测试，以及(5)与专家进行验收测试。 公共卫生相关性：我们建议为偏头痛青少年和他们的照顾者开发一个互动的在线疼痛自我管理计划。该计划将包括创新功能，包括可以通过移动设备访问的头痛日记，以促进实时更新；激励的、量身定做的信息，以提高自我管理行为的自我效能，以及基于视频的证词和社交网络，以增强社会支持。总体而言，TeenMigraineConnection是一项重大创新，有可能通过改善数百万青少年的生活质量，同时解决进入成年的风险因素，对公共卫生产生巨大影响。

DESCRIPTION (provided by applicant): Headache is a frequent health problem in children and adolescents (Winner & Rothner, 2001). The greatest impact on a child and caregiver is from migraine which can have a significant impact on disability (Hershey, et al., 2001), as well as quality of life (Powers, et al., 2004). For example, adolescents with migraine have lower grades at high school and are less likely to graduate from high school and attend college than adolescents without migraine (Rees & Sabia, 2009). Despite its prevalence and impact, pediatric migraine has received remarkably little attention and is commonly undiagnosed or misdiagnosed (Hershey & Winner, 2005). A number of health behavior changes can reduce migraine attack frequency, decrease the risk of migraine progression (Bigal, 2009) and significantly improve quality of life (Cottrell et al., 2007). Yet, little is available for this age group. We propose to develop an innovative, interactive, online pain self-management program for adolescents who suffer from migraines. This online health intervention, TeenMigraineConnection, will provide clinically reliable information about diagnosis, treatment, and management of migraine. Moreover, the use of Web 2.0 technology will enable the development of innovative features such as a headache diary that can be accessed through a mobile device to facilitate real-time updates; motivational, tailored information to increase self-efficacy for self-management behaviors, as well as video-based testimonies and social networking to enhance social support. On the caregiver side of the program, articles, lessons and tools will provide tailored information to help caregivers to reinforce adolescent self-management behaviors. Our review of websites suggests that no site currently offers this combination of empirically derived self-management features and cutting edge technologies. We believe the program will have a significant public health impact. With the overall total cost of migraine estimated at 13 to 15 billion dollars annually (Stewart, 2003), the program may improve quality of life for millions of adolescents while addressing risk factors for progression into adulthood, thus lowering this considerable cost. The content of this on-line health intervention will be developed and evaluated through the following specific aims: (1) Gather Input from Adolescents with Migraine, Caregivers, and Migraine Experts about Design and Content of the Website and the Mobile Application; (2) Develop Content, Design, and Technology Development Plans; (3) Develop Rapid Flash Prototype of Website and Paper-Prototyping of Mobile Application; (4) Conduct Usability and Acceptance Tests with Adolescent Patients and Caregivers, and (5) Conduct Acceptance Tests with Experts. PUBLIC HEALTH RELEVANCE: We propose to develop an interactive, online pain self-management program for adolescents with migraine and their caregivers. The program will include innovative features, including a headache diary that can be accessed through a mobile device to facilitate real-time updates; motivational, tailored information to increase self-efficacy for self-management behaviors, as well as video-based testimonies and social networking to enhance social support. Overall, TeenMigraineConnection represents a significant innovation that has the potential to have a dramatic public health impact by improving quality of life for millions of adolescents while addressing risk factors for progression into adulthood.