Asthma and Technology in Emerging African American Adults (The ATHENA Project)

新兴非洲裔美国成年人的哮喘与技术（雅典娜项目）

• 批准号: 10296991
• 负责人: ALAN P. BAPTIST
• 金额: $ 46.35万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10296991
• 关键词: Accountability; Address; Adherence; Adolescence; Adult; African American; Age; Algorithms; Ambulatory Care; American Lung Association; Asthma; Attitude; Behavior; Behavior Therapy; Behavioral; Blinded; Cellular Phone; Child Care; Clinic; Clinical Research; Computational algorithm; Computers; Data Collection; Decision Making; Education; Educational Intervention; Engineering; Experimental Designs; Goals; Guidelines; Human; Individual; Informal Social Control; International; Intervention; Knowledge; Mediator of activation protein; Medical center; Modeling; Morbidity - disease rate; Motivation; Multicenter Trials; Nurses; Participant; Persons; Physical activity; Play; Population; Quality of life; Randomized; Randomized Clinical Trials; Regimen; Research; Research Design; Resources; Risk-Taking; Role; Sample Size; Schools; Self Efficacy; Self Management; Site; Symptoms; System; Target Populations; Technology; Testing; Text Messaging; Time; Universities; Voice; Work; base; behavior test; clinically significant; cost; design; efficacy evaluation; emerging adult; emerging adulthood; experience; experimental study; improved; innovation; mHealth; medication compliance; meetings; mortality; motivational enhancement therapy; multiphase optimization strategy; post intervention; programs; recruit; secondary outcome; skills; smartphone Application; theories; treatment arm; virtual; wearable device

Asthma causes substantial morbidity and mortality in the U.S., particularly among African American emerging adults (AAEA; ages 18-30), but very few asthma programs have targeted this population. Interventions that provide education and address underlying motivation for managing asthma may be most effective. However, intensive, face-to-face interventions are often difficult to implement, especially among emerging adults. The purpose of this proposal is to develop an effective mobile asthma management intervention to improve control in AAEA. We will assess the ability of multiple technologic components to assist and improve traditional asthma education: 1) MES. The Motivational Enhancement System (MES) for Asthma Management is a mobile 4-session intervention utilizing supported self-regulation and Motivational Interviewing (MI). Personalized content is based on each participant’s activity level, daily experiences, and goals. 2) SA. Supportive accountability (SA) is administered by asthma nurses utilizing targeted mobile support (Skype/voice calls) to provide education, promote self-efficacy, and overcome barriers through an MI-based framework. 3) SMS. Text messaging (SMS) provides reminders for asthma education, medication adherence, and physical activity. 4) PAT. Physical activity tracking (PAT) uses wearable technology to help meet user-defined physical activity goals. Using a multiphase optimization strategy (MOST) framework, we will test these 4 intervention components and combination of components to identify the most effective mobile intervention. MOST is an innovative, cost- and time-effective framework that utilizes engineering principles to produce effective behavioral interventions. We will conduct a component selection experiment using a factorial research design to build an intervention that has been optimized for maximum efficacy. We will use a clinically significant improvement in asthma control as the criterion for determining which components should be kept in the optimized intervention. Participants (N=180) will be randomized to 1 of 6 intervention arms consisting of various combinations of the intervention components. This experimental design is equivalent to conducting multiple pilot randomized clinical trials to evaluate the efficacy of each component, yet uses only a fraction of the sample size and resources. At the completion of the study, we will have an empirically-supported, optimized mobile asthma management intervention to improve asthma control for AAEA. Participants will be recruited from multiple sites of the American Lung Association Airway Clinical Research Center network and ambulatory care clinics at the Detroit Medical Center. Data collections will occur at baseline, 3, 6, and 12 months. We hypothesize that post-intervention (3, 6, and 12 months), participants with uncontrolled asthma will show clinically-significant improvement in asthma control. We hypothesize that improvements in asthma management behaviors (including physical activity), quality of life, symptoms, adherence, and exacerbations (secondary outcomes) will also be observed.

在美国，哮喘引起了大量的发病率和死亡率，特别是在非洲裔美国人中