An Interactive Health Communication Program For Young Urban Adults With Asthma

描述（由申请人提供）：哮喘是一种疾病，在这种疾病中，观察到大量的卫生保健差异和不公平。非裔美国人的急诊就诊、住院和死亡率通常是白种人的三到五倍。虽然我们的小组和其他人已经开发了改善城市青少年（13 - 17岁）哮喘预后的项目，但还没有人开发出针对年轻的非裔美国成年人（18 - 30岁）哮喘的干预措施。不幸的是，这一人群是哮喘患病率最高的人群之一，同时哮喘控制措施也很差。部分原因是由于青年期对个人来说是一个巨大的变化，他们第一次可能要为自己的医疗、财务、教育和就业责任负责。一个基于互联网的互动健康交流项目提供了一种独特的方式来应对挑战，并为这一难以接触到的人群改善哮喘护理。它提供了一种提供哮喘教育、个性化建议、改善与卫生保健提供者沟通的机制，并在方便的时间提供给参与者。这样的方案也将以最少的人力支持提供，使其成为可能没有卫生教育工作者资源的城市环境的理想选择。我们将根据每个人面临的挑战制定并试行这样一个计划。该计划将基于行为的自我调节理论，这将增强参与者自我管理这种慢性疾病的能力。首先将利用焦点小组确保充分传达与会者的观点。焦点小组的调查结果将被纳入基于互联网的多会议干预。这种干预将包括通过视频提供的标准哮喘教育和如何克服每个人面临的具体挑战的个性化信息。我们将评估这样一个项目的能力，以吸引潜在的参与者，保留同意参与的参与者，将相关信息反馈给参与者的医疗保健提供者，并在最小的现场支持下无缝运行。我们将在整个多阶段干预中探索任何参与者的偏好、挑战和使用该计划的障碍。哮喘的具体结果也将在3个月和6个月时进行评估。这些指标包括生活质量、哮喘症状、哮喘控制、自我效能和医疗保健利用。这项探索性研究对于开发消费者健康信息干预至关重要，我们将在随后的R01应用中对其进行全面评估。

DESCRIPTION (provided by applicant): Asthma is condition in which a tremendous amount of health care disparities and inequities are observed. Emergency department visits, hospitalizations, and mortality rates are often three to five times higher in African Americans compared to Caucasians. While our group and others have developed programs to improve asthma outcomes for urban adolescents (age 13 - 17), no one has developed interventions for young African American adults (age 18 - 30) with asthma. This population unfortunately has one of the highest asthma prevalence rates, as well as very poor measures of asthma control. Part of this reason is due to the fact that young adulthood represents a dramatic change for an individual, where for the first time they may be responsible for their own health care, finances, education, and employment responsibilities. An internet-based interactive health communication program offers a unique way to address challenges and improve asthma care for this difficult-to-reach population. It provides a mechanism to deliver asthma education, personalize recommendations, improve communication with health care providers, and be delivered at a time convenient to the participant. Such a program would also be delivered with minimal human support, making it ideal for urban environments which may not have the resources for health educators. We will develop and pilot test such a program, which will be tailored to the challenges each individual faces. The program will be based on the self-regulation theory of behavior, which will enhance the participants' ability to self-manage this chronic condition. Focus groups will first be utilized to ensure that the participant's perspectiveis fully conveyed. The findings from the focus groups will be incorporated into a multi-session internet based intervention. This intervention will incorporate both standard asthma education delivered by video and personalized messages of how to overcome the specific challenges each individual faces. We will assess the ability of such a program to attract potential participants, retain participants who agree to participate, communicate relevant information back to the participant's health care provider, and operate seamlessly with minimal live support. We will explore any participant preferences, challenges, and obstacles to the use of the program over the entire multi-session intervention. Asthma specific outcomes will also be assessed at 3 and 6 months. These will include quality of life, asthma symptoms, asthma control, self-efficacy, and health care utilization. This exploratory study is critical to develop a consumer health informatics intervention, which we will fully evaluate in a subsequent R01 application. PUBLIC HEALTH RELEVANCE: The proposed research is relevant to public health because asthma is one of the most common chronic conditions in the United States, and also one which displays a tremendous amount of health care disparities. This research directly addresses the AHRQ's mission to improve the efficiency and effectiveness of health care, and to facilitate wider access to health care services.