A Self-Regulation Intervention for Older Adults with Asthma

描述（由申请人提供）：老年人哮喘一直被忽视，研究不足，治疗不足。虽然针对儿童、青少年、妇女、少数民族和其他人群的哮喘项目已经成功开发，但目前还没有针对老年人的项目。这是特别令人痛心的，因为与其他年龄组相比，老年人的哮喘住院率、死亡率、生活质量和控制明显更差。很明显，需要新的方法来改善这一人群的护理。 我们小组一直积极从事老年人哮喘的研究。我们分析了全国哮喘数据集以寻找老年人的差异，进行了定性研究以确定与老年人控制不良相关的因素，并进行了一项能够改善结果的自我调节干预的试点研究。我们还拥有超过20年的经验，在哮喘自我调节干预和医生沟通增强多个人群的哮喘患者。我们将把这些优势联合收割机结合到我们目前的协议中。 干预计划将基于行为的自我调节理论，这将增强参与者的自我管理能力 这种慢性病，积极参与自己的健康护理管理的参与者，并产生持续的结果。在本申请中，我们将评估一种自我调节哮喘干预在不同人群的老年人。干预措施将针对每个人面临的挑战和目标进行个性化，这将增强其在不同人群中的适用性。这种干预将包括标准的哮喘教育，老年人表达强烈兴趣的补充技术，以及加强与每位参与者医生的沟通。将在1个月、6个月和12个月时评估哮喘特定结局。这种干预的主要目标是减少老年哮喘患者的医疗保健利用率（急诊室，紧急护理，医院和计划外就诊）。我们还将评估改善生活质量、哮喘症状、哮喘控制、肺功能参数、自我效能和成本效益的能力。

DESCRIPTION (provided by applicant): Asthma in older adults has been overlooked, understudied, and inadequately treated. While asthma programs targeting the unique needs of children, teenagers, women, minorities, and other populations have been successfully developed, there are currently none for older adults. This is particularly distressing as the asthma hospitalization rates, mortality rates, quality of life, and control are significantly worsein the elderly as compared to other age groups. It is clear that novel approaches are needed to improve the care in this population. Our group has been active in the research of asthma in the elderly. We have analyzed national asthma data sets to look for disparities in older adults, have conducted qualitative research to determine factors associated with poor control in the elderly, and have performed a pilot study of a self- regulation intervention which was able to improve outcomes. We also have over 20 years of experience in asthma self-regulation interventions and physician communication enhancement for multiple populations of asthma patients. We will combine these strengths into our current protocol. The intervention program will be based on the self-regulation theory of behavior, which will enhance the participants' ability to self-manage this chronic condition, actively involve the participant in their own health care management, and produce sustained results. In this application, we will evaluate a self-regulation asthma intervention in a diverse population of older adults. The intervention will be personalized to the challenges and goals each individual faces, which will enhance its applicability in different populations. This intervention will incorporate standard asthma education, complementary techniques for which older adults have expressed a strong interest, and enhanced communication with each participant's physician. Asthma specific outcomes will be assessed at one, six, and 12 months. The primary goal of this intervention is to decrease health care utilization (emergency department, urgent care, hospital, and unscheduled visits) for older adults with asthma. We will also assess the ability to improve quality of life, asthma symptoms, asthma control, lung function parameters, self-efficacy, and cost effectiveness.