Project on TRAC: Improving Asthma Control in Children

TRAC 项目：改善儿童哮喘控制

• 批准号: 7822351
• 负责人: ANDREW R HARVER
• 金额: $ 0.6万
• 依托单位: UNIVERSITY OF NORTH CAROLINA CHARLOTTE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-01 至 2009-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7822351
• 关键词: 12 year old; Accident and Emergency department; Accounting; Acute; Affect; Age; Asthma; Awareness; Behavior; Behavior Therapy; Behavioral; Behavioral Model; Breathing; Child; Chronic Disease; Clinical; Discrimination; Disease Management; Educational Intervention; Elements; Enrollment; Environment; Esthesia; Feedback; Health; Health behavior; Health care facility; Hospitalization; Human; Individual; Intervention; Knowledge; Legal Guardians; Maintenance; Measures; Modeling; Monitor; Morbidity - disease rate; Motivation; Obstruction; Outcome; Parents; Patients; Pattern; Peak Expiratory Flow Rate; Perception; Performance; Persons; Positioning Attribute; Process; Psychology; Randomized; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Research; Research Personnel; Resistance; Respiratory physiology; Risk; Schools; Scientist; Self Efficacy; Self Management; Self Perception; Severities; Symptoms; Testing; Training; United States; Visceral; Visit; Vulnerable Populations; Work; airway obstruction; asthmatic patient; base; behavior change; clinically significant; diaries; experience; functional status; health related quality of life; improved; information processing; interest; meter; mortality; programs; strength training; symptom management; theories; therapy design; young adult

DESCRIPTION (provided by applicant): Asthma is a chronic disease of the airways that afflicts 12-14 million individuals in the United States and accounts for large numbers of hospitalizations, emergency department visits, and missed school days. Alarming increases in asthma morbidity and mortality have accelerated interest in disparities between levels of increased resistance to breathing and perceived symptoms. For largely unknown reasons, some asthmatics seem more aware of symptoms than others despite similar degrees of airway obstruction. Asthmatic patients unable to detect acute fluctuations in airflow, those who underestimate the severity of airflow obstruction, and those with compromised lung function could be at increased risk for more frequent and severe attacks of asthma. We hypothesize that the control of asthma should improve when there is concordance between levels of airflow obstruction and the perception of increases in the resistance to breathing. We further hypothesize that changes in self-efficacy and changes in symptom perception serve to enable asthma self-management behaviors that result in improved health-related outcomes. Three hundred children with asthma between the ages of 9 and 12 years of age, and at least one parent or other legal guardian, will be enrolled in the project. We propose a 3 x 3 independent groups randomized trial to test the hypothesis that the control of asthma is improved differentially by the combination of self-monitoring experiences and perception training. The three levels of the first between-groups factor (self-monitoring experience) include: no PEFR (symptom diary only); PEFR (and symptom diary); and, PEFR with immediate feedback (and symptom diary). The three levels of the second between-groups factor (perception training) include: no training (resistance breathing only); discrimination training (without performance feedback); and, discrimination training with immediate performance feedback. We predict that demonstrated increases in the concordance between objective and subjective measures of asthma control, enabled by increases in the ability of patients to discriminate between the presence or absence of airflow obstruction, improves symptom management, functional status, and health-related quality of life in children with asthma.

描述（由申请人提供）：哮喘是一种慢性呼吸道疾病，在美国有 12-1400 万人患有哮喘，导致大量患者住院、急诊就诊和旷课。哮喘发病率和死亡率的惊人增加，加速了人们对呼吸阻力增加水平与感知症状之间差异的兴趣。由于很大程度上未知的原因，尽管气道阻塞程度相似，但一些哮喘患者似乎比其他人更能意识到症状。无法察觉气流剧烈波动的哮喘患者、低估气流阻塞严重程度的患者以及肺功能受损的患者，哮喘更频繁、更严重发作的风险可能会增加。我们假设，当气流阻塞程度与呼吸阻力增加的感知之间存在一致性时，哮喘的控制应该会得到改善。我们进一步假设自我效能的变化和症状感知的变化有助于实现哮喘自我管理行为，从而改善健康相关的结果。该项目将招募 300 名年龄在 9 至 12 岁之间的哮喘儿童，以及至少一名家长或其他法定监护人。我们提出了一项 3 x 3 独立组随机试验来检验这样的假设：通过自我监控经验和感知训练的结合，哮喘的控制得到了不同程度的改善。第一个组间因素（自我监测经验）的三个级别包括： 无 PEFR（仅症状日记）； PEFR（和症状日记）；并且，PEFR 具有即时反馈（和症状日记）。第二个组间因素（感知训练）的三个级别包括： 无训练（仅阻力呼吸）；歧视培训（无绩效反馈）；以及具有即时绩效反馈的歧视培训。我们预测，通过提高患者区分是否存在气流阻塞的能力，哮喘控制的客观和主观测量之间的一致性会增加，从而改善哮喘儿童的症状管理、功能状态和健康相关的生活质量。

项目成果

Effects of Symptom Perception Interventions on Trigger Identification and Quality of Life in Children with Asthma.

• DOI: 10.1155/2015/825137
• 发表时间: 2015
• 期刊: Pulmonary medicine
• 影响因子: 4.3
• 作者: Janssens T;Harver A
• 通讯作者: Harver A

Effects of feedback on the perception of inspiratory resistance in children with persistent asthma: a signal detection approach.

• DOI: 10.1097/psy.0b013e3182a8bcde
• 发表时间: 2013-10
• 期刊: Psychosomatic medicine
• 影响因子: 3.3
• 作者: Harver A;Kotses H;Ersek J;Humphries CT;Ashe WS Jr;Black HR 2nd
• 通讯作者: Black HR 2nd

Reliability and predictors of resistive load detection in children with persistent asthma: a multivariate approach.

• DOI: 10.3109/02770903.2014.955188
• 发表时间: 2015-03
• 期刊: The Journal of asthma : official journal of the Association for the Care of Asthma
• 作者: Harver A;Dyer A;Ersek JL;Kotses H;Humphries CT
• 通讯作者: Humphries CT

Descriptors of breathlessness in children with persistent asthma.

持续性哮喘儿童呼吸困难的描述。

• DOI: 10.1378/chest.10-2388
• 发表时间: 2011
• 期刊: Chest
• 影响因子: 9.6
• 作者: Harver,Andrew;Schwartzstein,RichardM;Kotses,Harry;Humphries,CThomas;Schmaling,KarenB;Mullin,MelanieLee
• 通讯作者: Mullin,MelanieLee