Implementing a Guidelines-Based M-Health Intervention for High Risk Asthma Patients

对高危哮喘患者实施基于指南的移动健康干预措施

• 批准号: 10401897
• 负责人: Tamara Taylor Perry
• 金额: $ 60.27万
• 依托单位: ARKANSAS CHILDREN'S HOSPITAL RES INST
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-20 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10401897
• 关键词: Acute; Address; Adolescent; Age; Arkansas; Asthma; Caring; Cellular Phone; Child; Childhood; Childhood Asthma; Chronic; Chronic Disease; Cities; Client satisfaction; Communication Methods; Communities; Data; Drug Prescriptions; Eating; Education; Environment; Feedback; Future; Goals; Guidelines; Health; Health Technology; Instruction; Intervention; Investigation; Measures; Mediator; Medical; Mobile Health Application; Modeling; Monitor; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Notification; Outcome; Paper; Participant; Patients; Pediatric Hospitals; Pharmaceutical Preparations; Population; Populations at Risk; Preventive; Public Health; Randomized, Controlled Trials; Recommendation; Research Personnel; Risk; Self Efficacy; Self Management; Symptoms; Technology; Testing; Time; Translating; Translations; Visit; Work; Writing; acute symptom; adolescent health; age group; arm; asthma exacerbation; asthmatic patient; attentional control; clinical outcome assessment; clinically significant; compare effectiveness; data sharing; design; effectiveness evaluation; effectiveness testing; follow-up; fruits and vegetables; health care service utilization; health management; high risk; high risk population; improved; improved outcome; innovative technologies; mHealth; medication compliance; novel strategies; patient centered medical home; peak flow measurement; preference; primary care provider; primary outcome; prospective; pulmonary function; skills; smartphone application; social; tool; treatment as usual; trend

Project Summary Adolescents with asthma are at increased risk of adverse health outcomes related to asthma and are a group that is traditionally difficult to engage in self-management strategies for chronic illnesses. Smartphone use is prevalent and has been cited as a preferred method of communication among adolescents. The overall goal of the proposed project is to examine the effectiveness of a personalized, interactive asthma smartphone application in reducing asthma morbidity among adolescents who are at increased risk for future asthma exacerbations. Further, we will examine the impact of sharing smartphone asthma-related data with the primary care provider (PCP) on outcomes. To address this goal, we propose to conduct a 3-arm randomized, controlled trial with 432 at risk adolescents, ages 12-20 years, with uncontrolled, persistent asthma, to test the effectiveness of a mHealth Asthma Action Plan (mAAP) application that provides real-time, personalized feedback, asthma education, and data logging/tracking capabilities with and without PCP data sharing. The 3 groups will include: 1) a group utilizing the mAAP alone, 2) a group utilizing the mAAP with PCP data sharing (mAAP- DS), and 3) a usual care (UC) group that will utilize a smartphone application with daily non-asthma-related reminders (attention control). We will examine the application’s effectiveness compared to UC. The UC group will receive a simple mobile health application that will deliver daily reminders to eat fruits and vegetables via push notification. With the proposed mAAP, adolescents with asthma will have an individualized AAP readily available in a socially acceptable format (smartphone application) and will have the capability of utilizing the application at any time to guide asthma self-management. The mAAP will not only provide recommendations for steps to take during acute symptoms but will also reinforce daily medication adherence by sending medication and prescription refill reminders and reinforce asthma self-monitoring by sending prompts to record routine peak flow measurements and/or asthma symptoms. Further, data derived from the mAAP will be shared with participants in the mAAP-DS group and will allow investigators to measure the impact of data sharing on outcomes. We hypothesize that the mAAP will be an effective tool to reduce asthma-related morbidity among adolescents. This novel approach has high impact potential as it may be applicable to other age groups and patients with other chronic medical conditions.

项目摘要 青少年哮喘患者与哮喘相关的不良健康后果的风险增加， 传统上很难对慢性病采取自我管理策略。智能手机的使用很普遍， 被认为是青少年之间的首选沟通方式。拟议项目的总体目标是 研究个性化、交互式哮喘智能手机应用程序在降低哮喘发病率方面的有效性 在未来哮喘恶化风险增加的青少年中。此外，我们还将研究 与初级保健提供者（PCP）分享智能手机哮喘相关数据的结果。为了实现这一目标，我们 拟对432名12-20岁的高危青少年进行一项3组随机对照试验， 持续性哮喘，以测试mHealth哮喘行动计划（mAAP）应用程序的有效性，该应用程序提供实时， 个性化反馈、哮喘教育和数据记录/跟踪功能（有或没有PCP数据共享）。的3 组将包括：1）单独利用mAAP的组，2）利用mAAP与PCP数据共享的组（mAAP- DS），以及3）常规护理（UC）组，其将利用具有每日非哮喘相关提醒的智能手机应用程序 （注意力控制）。 我们将检查应用程序的有效性相比，UC。UC组将收到一个简单的移动的健康 应用程序将通过推送通知提供每日提醒吃水果和蔬菜。对于所提出的mAAP， 患有哮喘的青少年将以社会可接受的形式（智能手机）随时获得个性化AAP 应用程序），并且将具有在任何时间利用该应用程序来指导哮喘自我管理的能力。的 mAAP不仅提供急性症状期间采取措施的建议， 通过发送药物和处方补充提醒来坚持用药，并通过以下方式加强哮喘自我监测： 发送提示以记录常规峰值流量测量和/或哮喘症状。此外，数据来源于 mAAP将与mAAP-DS组的参与者共享，并允许研究者衡量数据的影响 分享成果。我们假设mAAP将是一种有效的工具，以减少哮喘相关的发病率， 青少年。这种新的方法具有很高的影响潜力，因为它可能适用于其他年龄组和患者， 其他慢性疾病。