Improving Asthma Care Together (IMPACT): A Shared Management Pilot Study

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PROJECT SUMMARY/ABSTRACT Asthma is the most common chronic condition of childhood, and is the leading cause of hospitalizations and school absences among school-age children. More than 50% of children are nonadherent to asthma management regimens, leading to worsened quality of life, school absences, higher healthcare utilization, and permanent airway damage. There is a critical gap in childhood asthma management interventions wherein the majority focus primarily on parents and use a prescriptive, top-down approach. Failure to include the child is a critical omission. School-age children spend increasing time away from their parents and have the developmental capacity to be active participants in their own asthma management. Furthermore, existing interventions fail to account for the variability among family management priorities. Not only are families lacking the tools they need to manage asthma successfully, but also to gradually shift responsibility to the youth who eventually will assume sole responsibility for their lifelong condition. To meet the asthma management needs of children and parents, successful interventions need to target management skills of both parent and child, tailor the intervention to the priorities of the family, and use an accessible format. Previously, our team worked with parent-child dyads to design a tailored asthma shared management mobile health application, Improving Asthma Care Together (IMPACT) that pairs the parent and child together as a team to manage the child's asthma. For the proposed study, we aim to refine and test IMPACT with 7-11-year-old children with persistent asthma and their parents. The initial feasibility, acceptability and efficacy of IMPACT will be tested in a pilot randomized controlled trial comparing IMPACT to an enhanced usual care control with a sample of 46 children with persistent asthma and their parents. Parent and child asthma self-efficacy, shared management (asthma responsibility) and quality of life will be measured in both study groups before and after the intervention. Development of an effective, tailored shared management health application has the potential to improve health outcomes of children living with asthma, as well as establish lifelong self-management skills. Results from this study will guide future intervention refinement, inform assessment and recruitment strategies, and provide preliminary evidence for the design of a full-scale clinical trial. IMPACT is an accessible and scalable intervention that addresses a critical clinical gap: shared asthma management among children with asthma and their parents.