Adolescent Controlled Text Messaging to Improve Asthma Medication Adherence in Pr

描述（由申请人提供）：哮喘是儿童时期最常见的慢性疾病，目前影响着数百万青少年。贫困少数民族人群的发病率、严重程度和不良后果更高。造成这种情况的一个原因是这些青少年缺乏对药物的坚持。该团队开发了一种新颖的、与发育相适应的、青少年控制的、从日历到短信的干预措施，适用于初级保健，通过促进这些青少年的自主性和控制力，并促使他们使用控制者药物，来提高依从性。我们建议在四家辛辛那提儿童初级保健诊所进行一项随机对照试验，通过短信干预来提高这些贫困少数群体对预防性哮喘药物的依从性。我们将通过三个具体目标来实现这一目标：目的1：确定可行性、可接受性和低强度短信干预的使用，以提高从4个初级保健实践点招募的患有持续性哮喘的高风险青少年吸入皮质类固醇（ICS）治疗的依从性。目的2：确定改善依从性的干预措施的效应大小（通过电子监测和自我报告测量）；临床哮喘控制；青少年持续性哮喘患者与哮喘相关的生活质量。目的3：确定短信接收和ICS罐驱动之间的时间关系，以便了解短信可能增加ICS依从性的机制。这个研究小组非常适合进行这项创新试验。这两位高级研究人员以前曾合作过，包括开发这一应用程序的初步数据。我们的四个初级保健诊所在成功招募临床研究和大量患有持续性哮喘的青少年患者方面也有良好的记录。通过这项研究，我们将收集有关干预措施的可行性、可用性和有效性的数据，这些数据将导致未来的R01应用，以在全动力随机试验中检查干预措施的有效性。

DESCRIPTION (provided by applicant): Asthma, the most common chronic condition of childhood, currently affects millions of adolescents. The rates, severity and adverse outcomes for those in poor minority populations are higher. One reason for this is the lack of adherence to medication among these adolescents. This team has developed a novel, developmentally appropriate, adolescent controlled, calendar-to-text messaging intervention suitable for use in primary care to improve adherence by promoting autonomy and control and prompting use of controller medications for these adolescents. We propose to conduct a pilot randomized controlled trial, in four Cincinnati Childrens based primary care clinics, of a texting interventio to increase adherence to preventive asthma medication among this poor minority population. We will achieve this objective though three specific aims: Aim 1: To determine the feasibility, acceptability, and use of a low intensity text messaging intervention to improve adherence to inhaled corticosteroid (ICS) therapy among high risk adolescents with persistent asthma recruited from 4 primary care practice sites. Aim 2: To determine effect sizes of the intervention to improve adherence (as measured by electronic monitoring and self report); clinical asthma control; and asthma related quality of life among adolescents with persistent asthma. Aim 3: To determine the temporal relationship between text message receipt and ICS canister actuation in order to understand mechanisms by which text messaging may increase ICS adherence. This research team is ideally suited to conduct this innovative trial. The senior investigators have worked together previously, including development of the preliminary data for this application. Our four primary care clinics also have an excellent track record of successful recruitment for clinical studies and a large number of adolescent patients with persistent asthma. Through this research, we will gather data on feasibility, usability and efficacy of the intervention that will ead to a future R01 application to examine the intervention's efficacy in a fully powered randomized trial.