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

项目总结/摘要 哮喘是儿童最常见的慢性疾病，也是住院的主要原因 以及学龄儿童的缺课问题。超过50%的儿童对哮喘不依从 管理方案，导致生活质量恶化，缺课，更高的医疗保健利用率， 永久性气道损伤在儿童哮喘管理干预方面存在着一个关键的差距， 大多数主要侧重于父母，并采用自上而下的规定性方法。不把孩子包括在内是一种 关键性遗漏学龄儿童离开父母的时间越来越长， 积极参与自己的哮喘管理。此外，现有 干预措施未能考虑到家庭管理优先事项的差异。不仅家庭缺乏 他们需要成功地管理哮喘的工具，但也要逐渐将责任转移到年轻人身上， 最终将对他们的终身状况承担全部责任。 为了满足儿童和家长的哮喘管理需求，成功的干预措施需要 以父母和子女的管理技能为目标，根据家庭的优先事项调整干预措施， 无障碍格式。此前，我们的团队与亲子二人组合作，设计了一个量身定制的哮喘共享 管理移动的健康应用程序，共同改善哮喘护理（IMPACT）， 和孩子一起作为一个团队来管理孩子的哮喘。对于拟议的研究，我们的目标是完善和测试 对7-11岁持续性哮喘儿童及其父母的影响。最初的可行性， IMPACT的可接受性和有效性将在一项初步随机对照试验中进行测试， 一个增强的常规护理控制与样本的46名儿童持续哮喘和他们的父母。母 和儿童哮喘自我效能，共同管理（哮喘责任）和生活质量将被测量 在干预之前和之后的两个研究组中。 开发一个有效的、量身定制的共享管理健康应用程序有可能 改善哮喘儿童的健康状况，并建立终身自我管理技能。 这项研究的结果将指导未来的干预措施的改进，为评估和招募策略提供信息， 并为全面临床试验的设计提供初步证据。IMPACT是一个可访问的， 可扩展的干预措施，解决了一个关键的临床差距：儿童哮喘管理共享 哮喘和父母

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.