An Interactive Health Communication Program For Young Urban Adults With Asthma

描述(由申请人提供)：哮喘是一种观察到巨大的卫生保健不平等和不平等的情况。与高加索人相比，非裔美国人的急诊科就诊、住院和死亡率往往高出三到五倍。虽然我们小组和其他人已经制定了改善城市青少年(13-17岁)哮喘结局的计划，但还没有人为患有哮喘的年轻非裔美国成年人(18-30岁)制定干预措施。不幸的是，这一人群的哮喘患病率是最高的之一，而且哮喘控制措施非常差。部分原因是，对于一个人来说，青壮年代表着一个戏剧性的变化，他们可能第一次对自己的医疗保健、财务、教育和就业责任负责。基于互联网的互动健康交流计划为这些难以接触到的人群提供了一种独特的方式来应对挑战和改善哮喘护理。它提供了一种机制来提供哮喘教育、个性化建议、改善与医疗保健提供者的沟通，并在参与者方便的时间提供。这样的项目也将在最少的人力支持下提供，这使其成为城市环境的理想选择，因为城市环境可能没有健康教育人员的资源。我们将开发和试行这样一个计划，该计划将根据每个人面临的挑战量身定做。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一慢性病的能力。首先将利用重点小组确保充分传达学员的观点。来自焦点小组的研究结果将被纳入基于互联网的多时段干预中。这种干预将包括通过视频提供的标准哮喘教育和关于如何克服每个人面临的具体挑战的个性化信息。我们将评估此类计划吸引潜在参与者的能力，留住同意参与的参与者，将相关信息反馈给参与者的医疗保健提供者，并在最低限度的现场支持下无缝运营。我们将探讨在整个多疗程干预过程中，任何参与者在使用该计划时的偏好、挑战和障碍。哮喘的特殊结果也将在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、自我效能和卫生保健利用。这项探索性研究对开发消费者健康信息学干预至关重要，我们将在随后的R01应用程序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.