Implementing a Guidelines-Based M-Health Intervention for High Risk Asthma Patients

项目摘要 患有哮喘的青少年面临与哮喘相关的不良健康后果的风险增加，这是一个 传统上很难对慢性病采取自我管理策略。智能手机的使用很普遍，而且已经 被认为是青少年首选的沟通方式。拟议项目的总体目标是 检查个性化、交互式哮喘智能手机应用程序在降低哮喘发病率方面的有效性 在未来哮喘恶化风险增加的青少年中。此外，我们还将研究 与初级保健提供者(PCP)共享智能手机哮喘相关数据的结果。为了实现这一目标，我们 建议对432名12-20岁的高危青少年进行一项三组随机对照试验， 持续性哮喘，以测试mHealth哮喘行动计划(MAAP)应用程序的有效性，该应用程序提供实时、 个性化反馈、哮喘教育和数据记录/跟踪功能，无论是否共享PCP数据。三人组 组将包括：1)仅利用MAAP的组，2)利用具有PCP数据共享的MAAP(MAAP- DS)，以及3)普通护理(UC)小组，该小组将使用智能手机应用程序，每天提醒与哮喘无关的事情 (注意控制)。 我们将与UC进行比较，检查应用程序的有效性。UC组将获得简单的移动健康 这个应用程序将通过推送通知发送每天吃水果和蔬菜的提醒。通过建议的MAAP， 哮喘青少年将有一个个性化的AAP，以社会可接受的格式(智能手机)随时可用 应用程序)，并将具有随时使用该应用程序来指导哮喘自我管理的能力。这个 MAAP不仅将提供在急性症状期间应采取的措施的建议，而且还将每天强化 通过发送药物和处方续订提醒来遵守服药要求，并通过以下方式加强哮喘自我监测 发送提示以记录常规峰值流量测量和/或哮喘症状。此外，从 MAAP将与MAAP-DS组的参与者共享，并将允许调查人员衡量数据的影响 分享成果。我们假设MAAP将是减少哮喘相关发病率的有效工具。 青少年。这一新方法具有很高的影响潜力，因为它可能适用于其他年龄段和患者 其他慢性疾病。

Project Summary Adolescents with asthma are at increased risk of adverse health outcomes related to asthma and are a group that is traditionally difficult to engage in self-management strategies for chronic illnesses. Smartphone use is prevalent and has been cited as a preferred method of communication among adolescents. The overall goal of the proposed project is to examine the effectiveness of a personalized, interactive asthma smartphone application in reducing asthma morbidity among adolescents who are at increased risk for future asthma exacerbations. Further, we will examine the impact of sharing smartphone asthma-related data with the primary care provider (PCP) on outcomes. To address this goal, we propose to conduct a 3-arm randomized, controlled trial with 432 at risk adolescents, ages 12-20 years, with uncontrolled, persistent asthma, to test the effectiveness of a mHealth Asthma Action Plan (mAAP) application that provides real-time, personalized feedback, asthma education, and data logging/tracking capabilities with and without PCP data sharing. The 3 groups will include: 1) a group utilizing the mAAP alone, 2) a group utilizing the mAAP with PCP data sharing (mAAP- DS), and 3) a usual care (UC) group that will utilize a smartphone application with daily non-asthma-related reminders (attention control). We will examine the application’s effectiveness compared to UC. The UC group will receive a simple mobile health application that will deliver daily reminders to eat fruits and vegetables via push notification. With the proposed mAAP, adolescents with asthma will have an individualized AAP readily available in a socially acceptable format (smartphone application) and will have the capability of utilizing the application at any time to guide asthma self-management. The mAAP will not only provide recommendations for steps to take during acute symptoms but will also reinforce daily medication adherence by sending medication and prescription refill reminders and reinforce asthma self-monitoring by sending prompts to record routine peak flow measurements and/or asthma symptoms. Further, data derived from the mAAP will be shared with participants in the mAAP-DS group and will allow investigators to measure the impact of data sharing on outcomes. We hypothesize that the mAAP will be an effective tool to reduce asthma-related morbidity among adolescents. This novel approach has high impact potential as it may be applicable to other age groups and patients with other chronic medical conditions.