Mobile Technology and Online Tools to Improve Asthma Control in Adolescents

 简介(申请人提供)：背景和理由：哮喘是影响青少年的最常见的慢性疾病，在青少年中发病率和患病率很高。基于学校和基于网络的哮喘干预措施已被证明对年幼的儿童有效。然而，很少有干预措施被开发出来并在高中生中进行测试，目前只有一种干预措施部署在网上。青少年哮喘自我管理(ASMA)的有效性已经确立，这是一种以面对面的循证高中为基础的干预措施；我们还成功地将基于3C的动态电子学习平台(DELP)的面向青少年的技术产品商业化。目的：这个直接到第二阶段的SBIR项目将全面开发并初步验证ASMA 2.0，这是一种基于经验的动态电子健康干预措施，旨在帮助患有无法控制的哮喘的青少年学习如何管理他们的疾病和改善他们的哮喘控制。我们将应用我们演示的Delp平台来部署这种演示的哮喘干预。在ASMA成功的基础上，ASMA 2.0将以社会认知理论、激励性访谈和用户界面设计的最佳实践为基础，创建一种可以向广大用户传播的产品。我们将实现三个具体目标：(1)全面开发ASMA 2.0，包括核心教学主题、定制课程和嵌入互动活动的8个模块；(2)对纽约市两所公立高中的70名9-12年级哮喘失控学生进行两组随机先导试验，以评估ASMA 2.0的初步干预效果，并评估ASMA 2.0的可行性和可接受性；以及(3)根据参与ASMA 2.0试点测试的青少年以及治疗和/或教育患有哮喘的青少年或可能的付款人的利益相关者的反馈，最终确定并准备将ASMA 2.0商业化。我们还将评估ASMA 2.0产品的覆盖范围、可接受性、可行性和可持续性。假设：在干预两个月后，相对于对照组，ASMA 2.0参与者将在哮喘相关结局方面表现出显著的改善。我们还假设，评级和软件使用指数将证明ASMA 2.0是一种可行的、可用的和可接受的青少年干预措施。我们还将探索剂量反应的证据，在这种情况下，花更多时间参与电子培训材料的参与者表现出更大的积极变化。意义：ASMA 2.0将是第一个动态适应的、个性化的、互动的软件产品，专门为改善哮喘管理和哮喘青少年的哮喘控制而设计。正如商业化计划中详细描述的那样，ASMA 2.0将是一个巨大潜在市场中独特的商业产品，通过向学校、诊所、急诊科、健康保险公司和专业健康组织(例如，当地ALA分会、哮喘联盟)销售来产生收入。

 DESCRIPTION (provided by applicant): Background and Rationale: Asthma is the most common chronic illness affecting youth, with prevalence and morbidity being significant among adolescents. School-based and web-based asthma interventions have been shown to be effective with younger children. Yet, few interventions have been developed and tested with high school students, with only one currently deployed online. The efficacy of Asthma Self-Management for Adolescents (ASMA), an in-person evidence-based high school based intervention, has been established; we have also successfully commercialized technology products for youth that are built on 3C's dynamic e-learning platform (DELP). Objective: This Direct to Phase II SBIR project will fully develop and preliminarily validate ASMA 2.0, an empirically-based dynamic e-health intervention to assist adolescents with uncontrolled asthma to learn how to manage their illness and improve their asthma control. We will apply our demonstrated DELP platform to deploy this demonstrated asthma intervention. Building on ASMA's success, ASMA 2.0 will be grounded in social cognitive theory, motivational interviewing, and best practices for user interface design to create a product that can be disseminated to a broad audience of users. We will accomplish three specific aims: (1) to fully develop ASMA 2.0, including eight modules with core instructional topics, tailored sessions, and embedded interactive activities; (2) to conduct a two group randomized pilot trial with 70, 9th - 12th graders with uncontrolled asthma from two NYC public high schools in order to assess the preliminary intervention effects of ASMA 2.0, and to evaluate the feasibility and acceptability of ASMA 2.0; and (3) to finalize and prepare ASMA 2.0 for commercialization based on feedback from adolescents who participated in the pilot test of ASMA 2.0 and stakeholders who treat and/or educate adolescents with asthma or who are likely payers. We will also evaluate the reach, acceptability, feasibility, and sustainability of the ASMA 2.0 product. Hypotheses: Over two months post-intervention, relative to controls, ASMA 2.0 participants will show significantly greater improvement in asthma-related outcomes. We also hypothesize that ratings and software usage indices will demonstrate that ASMA 2.0 is a feasible, usable, and acceptable intervention for use with adolescents. We will also explore evidence of a dose-response in which participants who spend more time engaged with the e- training materials show greater positive change. Significance: ASMA 2.0 will be the first dynamically adaptive, personalized, interactive software product specifically designed for improving management of asthma and asthma control in adolescents with uncontrolled asthma. As detailed in the Commercialization Plan, ASMA 2.0 will be a unique commercial offering within a large potential market, with revenue being generated through sales to schools, clinics, emergency departments, health insurance companies, and professional health organizations (e.g., local ALA chapters, asthma coalitions).