TeenMigraineConnection: Web-based self-management training for adolescents with m

描述（由申请人提供）：头痛是儿童和青少年中常见的健康问题（Winner & Rothner, 2001）。对儿童和照顾者影响最大的是偏头痛，它会对残疾产生重大影响（Hershey, et al., 2001），以及生活质量（Powers, et al., 2004）。例如，与没有偏头痛的青少年相比，患有偏头痛的青少年在高中学习成绩较低，高中毕业和上大学的可能性较小（Rees & Sabia, 2009）。尽管儿童偏头痛的发病率和影响很大，但它得到的关注却很少，而且通常未被诊断或误诊（Hershey & Winner, 2005）。一些健康行为的改变可以减少偏头痛发作频率，降低偏头痛进展的风险（Bigal, 2009），并显著提高生活质量（Cottrell等人，2007）。然而，这个年龄段的人几乎没有机会。我们建议为患有偏头痛的青少年开发一个创新的、互动的、在线的疼痛自我管理程序。这个在线健康干预，TeenMigraineConnection，将提供关于偏头痛的诊断、治疗和管理的临床可靠信息。此外，利用Web 2.0技术，可开发创新功能，例如可透过流动装置存取的头痛日记，以方便即时更新；激励，量身定制的信息，以提高自我管理行为的自我效能感，以及基于视频的证词和社交网络，以增强社会支持。在项目的照顾者方面，文章、课程和工具将提供量身定制的信息，帮助照顾者加强青少年的自我管理行为。我们对网站的回顾表明，目前还没有网站提供这种经验衍生的自我管理功能和尖端技术的结合。我们相信该项目将对公共卫生产生重大影响。据估计，偏头痛每年的总成本为130亿至150亿美元（Stewart, 2003），该项目可以改善数百万青少年的生活质量，同时解决他们进入成年期的风险因素，从而降低这一可观的成本。这一在线健康干预的内容将通过以下具体目标进行开发和评估：(1)收集偏头痛青少年、护理人员和偏头痛专家对网站和移动应用程序的设计和内容的意见；(2)制定内容、设计和技术开发计划；(3)开发网站快速Flash原型和移动应用的纸质原型；(4)对青少年患者和护理人员进行可用性和验收测试，(5)对专家进行验收测试。

DESCRIPTION (provided by applicant): Headache is a frequent health problem in children and adolescents (Winner & Rothner, 2001). The greatest impact on a child and caregiver is from migraine which can have a significant impact on disability (Hershey, et al., 2001), as well as quality of life (Powers, et al., 2004). For example, adolescents with migraine have lower grades at high school and are less likely to graduate from high school and attend college than adolescents without migraine (Rees & Sabia, 2009). Despite its prevalence and impact, pediatric migraine has received remarkably little attention and is commonly undiagnosed or misdiagnosed (Hershey & Winner, 2005). A number of health behavior changes can reduce migraine attack frequency, decrease the risk of migraine progression (Bigal, 2009) and significantly improve quality of life (Cottrell et al., 2007). Yet, little is available for this age group. We propose to develop an innovative, interactive, online pain self-management program for adolescents who suffer from migraines. This online health intervention, TeenMigraineConnection, will provide clinically reliable information about diagnosis, treatment, and management of migraine. Moreover, the use of Web 2.0 technology will enable the development of innovative features such as a headache diary that can be accessed through a mobile device to facilitate real-time updates; motivational, tailored information to increase self-efficacy for self-management behaviors, as well as video-based testimonies and social networking to enhance social support. On the caregiver side of the program, articles, lessons and tools will provide tailored information to help caregivers to reinforce adolescent self-management behaviors. Our review of websites suggests that no site currently offers this combination of empirically derived self-management features and cutting edge technologies. We believe the program will have a significant public health impact. With the overall total cost of migraine estimated at 13 to 15 billion dollars annually (Stewart, 2003), the program may improve quality of life for millions of adolescents while addressing risk factors for progression into adulthood, thus lowering this considerable cost. The content of this on-line health intervention will be developed and evaluated through the following specific aims: (1) Gather Input from Adolescents with Migraine, Caregivers, and Migraine Experts about Design and Content of the Website and the Mobile Application; (2) Develop Content, Design, and Technology Development Plans; (3) Develop Rapid Flash Prototype of Website and Paper-Prototyping of Mobile Application; (4) Conduct Usability and Acceptance Tests with Adolescent Patients and Caregivers, and (5) Conduct Acceptance Tests with Experts. PUBLIC HEALTH RELEVANCE: We propose to develop an interactive, online pain self-management program for adolescents with migraine and their caregivers. The program will include innovative features, including a headache diary that can be accessed through a mobile device to facilitate real-time updates; motivational, tailored information to increase self-efficacy for self-management behaviors, as well as video-based testimonies and social networking to enhance social support. Overall, TeenMigraineConnection represents a significant innovation that has the potential to have a dramatic public health impact by improving quality of life for millions of adolescents while addressing risk factors for progression into adulthood.