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: 10730212
• 负责人: ALAN P. BAPTIST
• 金额: $ 53.9万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 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/10730212
• 关键词: Asthma; Technology; Emerging; African; American

Asthma causes substantial morbidity and mortality in the United States, 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, 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. The intervention includes 4 potential components: 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 management education, medication adherence, and physical activity. 4) PAT. Physical activity tracking (PAT) uses wearable technology to encourage asthma control in order to meet user-defined physical activity goals. Using a multiphase optimization strategy (MOST), we will refine and test these 4 intervention components and combination of components to identify the most effective mobile intervention. MOST is an innovative, cost- and time-effective experimental design that utilizes engineering principles to test behavioral interventions. Participants (N=180) will be randomized to 1 of 6 intervention arms consisting of various combinations of the intervention components. Using factorial design, this experiment is equivalent to conducting multiple pilot randomized clinical trials to evaluate the efficacy of each of the intervention components, yet uses only a fraction of the sample size and resources. At the completion of the study, we will have an empirically- supported 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, 4, and 6 months. We hypothesize that post-intervention (4 and 6 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.

哮喘在美国，特别是在非裔美国人中引起大量的发病率和死亡率 新兴的成年人（AAEA； 18-30岁），但很少有哮喘计划针对这一人群。 提供教育和解决哮喘的基本动机的干预措施可能是大多数 有效的。但是，面对面的干预通常很难实施，尤其是在新兴 成年人。该建议的目的是开发有效的移动哮喘管理干预措施 改善AAEA的控制。我们将评估多个技术组件协助和改进的能力 传统的哮喘教育。干预措施包括4个潜在组成部分：1）MES。激励性 用于哮喘管理的增强系统（MES）是使用支持的移动4节干预措施 自我调节和动机访谈（MI）。个性化内容基于每个参与的活动 水平，日常经验和目标。 2）SA。支持责任（SA）由哮喘护士管理 利用有针对性的移动支持（Skype/语音通话）来提供教育，促进自我效能和克服 通过基于MI的框架的障碍。 3）短信。短信（SMS）提供了哮喘的提醒 管理教育，依从性和体育锻炼。 4）帕特。体育活动跟踪（PAT） 使用可穿戴技术来鼓励哮喘控制以实现用户定义的体育活动目标。 使用多相优化策略（大多数），我们将完善并测试这4种干预组件，以及 组件的组合以识别最有效的移动干预。大多数是创新的，成本和 具有时间效率的实验设计，利用工程原理来测试行为干预措施。 参与者（n = 180）将被随机分为由各种组合组成的6个干预组中的1个 干预组件。使用阶乘设计，该实验等于进行多个飞行员 随机临床试验评估每个干预组件的效率，但仅使用 样本量和资源的一部分。研究完成后，我们将有一个经验上的 支持移动哮喘管理干预措施，以改善AAEA的哮喘控制。参与者会 从美国肺协会临床研究中心网络的多个地点招募 底特律医疗中心的门诊护理诊所。数据收集将在基线，4和6个月发生。 我们假设干预后（4个月和6个月），哮喘不受控制的参与者将显示 哮喘控制的临床明显改善。我们假设哮喘的改善 管理行为（包括体育锻炼），生活质量，症状，依从性和恶化 （次要结果）也将观察到。