Adolescent Controlled Text Messaging to Improve Asthma Medication Adherence in Pr

描述(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。贫困少数群体的发病率、严重性和不良后果更高。其中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、适合发育的、青少年控制的、日历到文本的消息干预，适合在初级保健中使用，通过促进自主性和控制性，并促使这些青少年使用控制性药物来提高依从性。我们建议在四家以辛辛那提儿童为基础的初级保健诊所进行一项试点随机对照试验，对这一贫困少数民族人群进行短信干预，以提高他们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：目标1：确定从4个初级保健实践站点招募的患有持续性哮喘的高危青少年使用低强度短信干预来提高对吸入性皮质类固醇(ICS)治疗的依从性的可行性、可接受性和使用。目的：确定改善持续性哮喘青少年的依从性(通过电子监测和自我报告进行测量)、临床哮喘控制和哮喘相关生活质量的干预措施的效果大小。目的3：确定短信接收与ICS罐启动之间的时间关系，以了解短信可能增加ICS依从性的机制。这个研究团队非常适合进行这项创新的试验。高级调查人员以前曾合作过，包括为这一申请开发初步数据。此外，我们的四间基层医疗诊所亦有良好的纪录，成功招募临床研究人员，并收治了大量持续哮喘的青少年病人。通过这项研究，我们将收集关于干预的可行性、可用性和有效性的数据，这将有助于未来的R01应用，以在完全有效的随机试验中检查干预的有效性。

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.