mHealth Approach to Collaborative Asthma Management for Teens & Parents

青少年哮喘协作管理的移动健康方法

• 批准号: 9198574
• 负责人: DAVID A FEDELE
• 金额: $ 18.65万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-01-01 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9198574
• 关键词: Address; Adherence; Adolescence; Adolescent; Adult; Affect; Aftercare; Age; Asthma; Attention; Behavior; Behavioral; Caregiver support; Caregivers; Cellular Phone; Child; Childhood; Childhood Asthma; Communication; Conflict (Psychology); Data; Development; Devices; Disease; Disease Management; Enrollment; Environment; Family; Feedback; Fostering; Goals; Guidelines; Health; Health Technology; Impaired health; Individual; Intervention; Literature; Modeling; Morbidity - disease rate; Outcome; Parents; Participant; Pharmaceutical Preparations; Population; Problem Solving; Process; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Recording of previous events; Recruitment Activity; Respiratory physiology; Risk; Self Efficacy; Self Management; Structure; System; Techniques; Teenagers; Testing; Time; Treatment Protocols; Youth; attentional control; base; contingency management; critical period; design; early adolescence; experience; family support; follow-up; high risk; improved; innovation; interest; mHealth; mobile computing; novel; prevent; primary outcome; programs; public health relevance; satisfaction; skills training; statistics; successful intervention; tool

 DESCRIPTION (provided by applicant): Pediatric asthma affects 9.6% of youth and is a leading cause of youth morbidity. Developing and mastering asthma self-management behaviors is imperative to control asthma and reduce morbidity among youth. Adolescents typically fail to perform the asthma self-management behaviors that prevent complications and enhance quality of life. Asthma self-management difficulties emerge in early adolescence as youth begin to transition towards taking more control of their treatment regimen, making it a critical intervention period. The presence or absence of helpful caregiver support often determines whether early adolescents ultimately develop and master asthma self-management behaviors. The aims of this application are to develop and test Team Speak, a mobile health (mHealth) tool, implemented via smartphones, that fosters helpful caregiver support as early adolescents with persistent asthma develop and master asthma self-management behaviors. To facilitate helpful caregiver support, Team Speak uses existing mHealth technology developed by the study team to elucidate tailored intervention targets for each family. Team Speak then facilitates collaborative caregiver/adolescent asthma management by automatically guiding dyads through a structured process that includes the supportive behavioral management strategies of goal setting, contingency management, and problem solving communication. Skills-training videos for adolescents and caregivers provide guidance on how to complete each collaborative asthma management component. We propose to develop Team Speak through iterative feedback from an advisory board composed of ten adolescent-caregiver dyads from the target user population and a pediatric pulmonologist. Following advisory board feedback, we will conduct a pilot randomized controlled trial of Team Speak with 50 early adolescents with poorly controlled asthma, ages 12-15 years, and a caregiver. Families will be randomly assigned to receive Team Speak or a self-guided control condition for a 4 month intervention period. Participants in the self-guided control condition will be given general information on supportive behavioral management techniques they can use to target improvement in asthma self-management behaviors. The control condition will serve as an attention control and is designed to optimize recruitment and sustain interest while concurrently having a minimal impact on asthma management. Feasibility, acceptability, and utilization data will be collected throughout the trial. Efficacy outcomes include changes in family asthma management (primary outcome), prescription refill history, lung function, asthma control, asthma-related quality of life, and sel-efficacy for asthma management. Data to evaluate efficacy outcomes will be collected at baseline, post-treatment, and 4 month follow-up time points. Feasibility, acceptability, and utilization of Team Speak will be determined by examining enrollment and attrition rates, usage statistics, and participant satisfaction with the Team Speak tool. If successful, this intervention offers excellent potential for wide spread dissemination to address a pressing public health problem.

 描述（由适用提供）：小儿哮喘影响9.6％的青年，是青年发病率的主要原因。发展和掌握哮喘的自我管理行为必须控制哮喘并降低青年的发病率。青少年通常无法执行哮喘自我管理行为，以防止并发症并提高生活质量。随着年轻人开始过渡到更多地控制其治疗方案，哮喘的自我管理难以在青少年早期出现，这使其成为关键的干预期。有用的护理人员的存在或不存在通常决定早期青少年是否最终发展并掌握哮喘自我管理行为。该应用程序的目的是开发和测试通过智能手机实施的移动健康（MHealth）工具的发展和测试团队，促进了有用的护理人员支持，因为早期的青少年具有持续的哮喘发展和主人哮喘的自我管理行为。为了促进有用的护理人员支持，Team Speak使用研究团队开发的现有MHealth技术来阐明每个家庭的量身定制干预目标。团队讲话然后通过自动指导二元组通过结构化过程来促进协作护理人员/青少年哮喘管理，该过程包括支持目标设定，应急管理和解决问题的沟通的支持行为管理策略。针对青少年和看护者的技能培训视频提供了有关如何完成每个协作哮喘管理组件的指导。我们建议通过迭代反馈从目标用户群体和一名儿科肺科医生组成的顾问委员会的迭代反馈来发展团队。顾问委员会的反馈后，我们将与50名早期青少年交谈的飞行员随机对照试验，患有哮喘，年龄较差，年龄在12-15岁和看护者。在4个月的干预期内，将随机分配家庭以接受团队说话或自我指导的控制条件。在自我引导的控制条件下的参与者将获得有关他们可以用来针对哮喘自我管理行为改善的支持行为管理技术的一般信息。控制条件将作为注意力控制，旨在优化招聘和维持兴趣，同时对哮喘管理产生最小的影响。在整个试验过程中，将收集可行性，可接受性和利用数据。功效结果包括家庭哮喘管理（主要结果），处方补充病史，肺功能，哮喘控制，与哮喘相关的生活质量以及对哮喘管理有效的SEL。评估效率结果的数据将在基线，处理后和4个月的随访时间点收集。团队说话的可行性，可接受性和利用将通过检查入学率和属性率，用法统计数据以及对团队说话工具的参与满意来确定。如果成功，这项干预 为广泛传播提供了极大的潜力，以解决紧迫的公共卫生问题。

项目成果

Using Mobile Health to Improve Asthma Self-Management in Early Adolescence: A Pilot Randomized Controlled Trial.

使用移动健康改善青春期早期哮喘的自我管理：一项随机对照试验。

• DOI: 10.1016/j.jadohealth.2021.06.011
• 发表时间: 2021
• 期刊: The Journal of adolescent health : official publication of the Society for Adolescent Medicine
• 作者: Fedele,DavidA;Thomas,JGraham;McConville,Andrew;McQuaid,ElizabethL;Voorhees,Sara;Janicke,DavidM;Abu-Hasan,Mutasim;Chi,Xiaofei;Gurka,MatthewJ
• 通讯作者: Gurka,MatthewJ

Sleep and asthma management in youth with poorly-controlled asthma and their caregivers: a qualitative approach.

• DOI: 10.1080/02770903.2021.1914650
• 发表时间: 2022-06
• 期刊: The Journal of asthma : official journal of the Association for the Care of Asthma