Developing an in vivo adherence intervention for adolescents with asthma

为患有哮喘的青少年开发体内依从性干预措施

• 批准号: 7642314
• 负责人: MICHAEL SEID
• 金额: $ 23.55万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-15 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7642314
• 关键词: Address; Adherence; Adolescent; Adolescent Medicine; Adult; African American; Asthma; Behavior Therapy; Boxing; Budgets; Car Phone; Childhood; Clinic; Clinical Trials; Clinical Trials Design; Computer software; Data; Disease; Education; Effectiveness; Feedback; Focus Groups; Foundations; Goals; Health; Human Resources; Intervention; Knowledge; Language; Letters; Life; Long-Term Effects; Medical center; Methods; Morbidity - disease rate; Motivation; Not Hispanic or Latino; Outcome; Parents; Participant; Pediatric Hospitals; Population; Positioning Attribute; Primary Health Care; Principal Investigator; Problem Solving; Public Health; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Resources; Self Management; Site; Software Engineering; Symptoms; System; Technology; Teenagers; Testing; Time; Treatment Efficacy; United States; Urban Population; base; behavioral clinical trial; clinical care; efficacy testing; evidence base; follow-up; health related quality of life; improved; in vivo; innovation; innovative technologies; killings; meetings; mortality; motivational enhancement therapy; motivational intervention; post intervention; primary outcome; prototype; public health relevance; secondary outcome; skills; skills training

DESCRIPTION (provided by applicant): Asthma represents substantial morbidity and, worse, continues to kill disproportionately so for adolescents and for non-Hispanic Blacks. Adherence is key to asthma control, but is challenging, particularly for teens. While behavioral interventions to improve asthma adherence and outcomes have been studied in adult and pediatric populations, relatively few have addressed adolescents, none have explicitly combined problem- solving and motivational interviewing, and none have made use of mobile phones as a platform for bridging didactics to real life situations. There is a critical need to develop and test asthma self-management interventions incorporating efficacious components and tailored to adolescent needs in real life situations. Until this need is met, progress in reducing asthma morbidity and mortality will be slowed. The objective of this application is to develop and pilot test a tailored multimodal behavioral intervention, delivered using mobile-phone technology and incorporating motivation, knowledge, and problem-solving skills to overcome barriers to adherence in adolescents with moderate and severe persistent asthma. We will recruit participants from an academic adolescent medicine clinic serving a largely poor, urban, African-American population. Successful completion of this project will produce data that will serve as a foundation for a larger clinical trial. The application's objective will be pursued via the following three specific aims: 1) Examine the acceptability, for adolescents with moderate or severe asthma, of an intervention based on existing efficacious problem-solving and motivational interventions; 2) Develop and beta-test a mobile-phone based platform for the intervention; and 3) Feasibility test and pilot test the intervention to determine short-term efficacy in adolescents with moderate or severe asthma. This research will yield intervention materials and a feasible, field-tested mobile phone platform, pilot data on intervention acceptability, feasibility, fidelity, recruitment and retention, and potential effect sizes, and an R01 application to examine the intervention's efficacy and long-term effects through a larger clinical trial. This has great potential significance: Evidence for the efficacy and effectiveness of such an intervention could have a substantial impact on the health outcomes of adolescents with asthma throughout the United States. Moreover, as the intervention is not condition-specific, it could have broad application across populations and diseases. Public Health Relevance Paragraph: The proposed research is relevant to public health: Evidence for the efficacy of an intervention to reduce barriers to adherence and improve outcomes could have a substantial impact on the health outcomes of adolescents with asthma throughout the U.S.. Moreover, as this intervention is not condition-specific, it could have broad application across populations and diseases.

描述（由申请人提供）：哮喘代表了大量的发病率，更糟糕的是，继续不成比例地杀死青少年和非西班牙裔黑人。坚持是哮喘控制的关键，但具有挑战性，特别是对青少年。虽然已经在成人和儿童人群中研究了改善哮喘依从性和结局的行为干预措施，但相对较少针对青少年，没有人明确地将解决问题和动机访谈结合起来，也没有人利用移动的电话作为将教学与真实的生活情况联系起来的平台。迫切需要开发和测试哮喘自我管理干预措施，包括有效的成分，并适合青少年在真实的生活情况下的需求。在这一需求得到满足之前，降低哮喘发病率和死亡率的进展将放缓。本申请的目的是开发和试点测试量身定制的多模式行为干预，使用移动电话技术，并结合动机，知识和解决问题的技能，以克服中度和重度持续性哮喘青少年的依从性障碍。我们将从一个学术性的青少年医学诊所招募参与者，该诊所主要为贫困的城市非裔美国人提供服务。该项目的成功完成将产生数据，这些数据将作为更大规模临床试验的基础。该应用程序的目标将通过以下三个具体目标来实现：1）检查中度或重度哮喘青少年对基于现有有效解决问题和激励干预措施的干预措施的可接受性; 2）开发并测试基于移动电话的干预平台; 3）对中重度青少年哮喘患者进行干预的可行性试验和预试验，以确定短期疗效。这项研究将产生干预材料和一个可行的，现场测试的移动的电话平台，试点数据干预的可接受性，可行性，保真度，招聘和保留，和潜在的效果大小，和R01应用程序，以检查干预的有效性和长期影响，通过一个更大的临床试验。这具有巨大的潜在意义：这种干预措施的有效性和有效性的证据可能对美国青少年哮喘患者的健康结果产生重大影响。此外，由于干预措施不针对具体情况，因此可广泛适用于所有人群和疾病。 公共卫生相关性段落：这项拟议的研究与公共卫生有关：减少依从性障碍和改善结果的干预措施的有效性证据可能对美国青少年哮喘患者的健康结果产生重大影响。此外，由于这种干预措施不针对具体情况，因此可以广泛适用于所有人群和疾病。

项目成果

The in vivo adherence intervention for at risk adolescents with asthma: report of a randomized pilot trial.

对哮喘高危青少年的体内依从性干预：一项随机试点试验的报告。

• DOI: 10.1093/jpepsy/jsr107
• 发表时间: 2012
• 期刊: Journal of pediatric psychology
• 影响因子: 3.6
• 作者: Seid,Michael;D'Amico,ElizabethJ;Varni,JamesW;Munafo,JenniferK;Britto,MariaT;Kercsmar,CarolynM;Drotar,Dennis;King,EileenC;Darbie,Lynn
• 通讯作者: Darbie,Lynn