Peer i-Coaching for Activated Self-management Optimization in Adolescents and Young Adults with Chronic Conditions

项目摘要 几乎所有儿童期发病的慢性疾病的预期寿命增加带来了独特的 青少年和年轻人（AYA）面临的挑战，他们努力应对相关的 疾病负担，管理治疗，并随着他们发展独立的自我管理而蓬勃发展 成为积极主动的患者。影响妇女生活的挑战 AYA在很大程度上是适应性的，例如改变生活方式，坚持复杂的 药物治疗方案，以及学习如何驾驭成人健康系统。添加到这一点 复杂性是AYAs需要逐步接管更大的自我管理 父母的责任。促进积极的自我管理至关重要， 这种从父母和医疗保健提供者到AYA的医疗保健管理转变， 被认为是成功成人的关键。同伴支持干预措施非常适合于 考虑到同伴关系的重要性，解决理论上对AYA至关重要的挑战 这段时间我们提出了一个混合方法，五年随机对照试验，将 包括225名具有COCC的AYA（16-22岁），以测试激活自我的同侪i-Coaching 管理优化（PICASO）与注意力控制组。这种新颖的、移动的 健康干预利用已建立的基于电话/文本的安全界面， 从训练有素的同伴教练那里获得知识、经验和工具/情感支持 （18-26岁），已经独立，是一个积极的自我管理者。我们 将确定PICASO在自我管理/医疗保健导航、患者 活动，应对，情绪健康和健康相关的生活质量在12个月。我们将 探索年龄、性别、人种/种族、慢性疾病和/或疾病严重程度是否为中度 PICASO对自我管理、患者激活、应对、情绪 健康和与健康有关的生活质量。最后，我们将探讨PICASO的机制 通过描述AYA的干预经验的影响。

Project Summary Increases in life expectancy in almost all childhood-onset chronic conditions has brought unique challenges for adolescents and young adults (AYA) who struggle to deal with the associated disease burden, manage therapies, and thrive as they develop independent self-management skills, and become active and engaged patients. The challenges that influence the lives of AYAs are largely adaptive, such as making lifestyle modifications, adhering to complex medication regimens, and learning to navigate the adult health system. Adding to this complexity is the need for AYAs to progressively take over greater self-management responsibilities from parents. Promoting activated self-management is critically important given that this shift in health care management from parents and health care providers to the AYA is identified as key to successful adult outcomes. Peer support interventions are well-suited to address challenges theorized as critical to AYAs given the importance of peer relationships during this time. We propose a mixed-methods, five-year randomized controlled trial, that will include 225 AYAs (16-22 years) with COCCs, to test the Peer i-Coaching for Activated Self- Management Optimization (PICASO) versus an attention control group. This novel, mobile health intervention utilizes an established telephone/text based secure interface to allow AYAs access knowledge, experience, and instrumental/emotional support from a trained peer coach (18-26 years), who has already developed independence and is an active self-manager. We will determine the efficacy of the PICASO on self-management/health care navigation, patient activation, coping, emotional health and health-related quality of life across 12 months. We will explore whether age, sex, race/ethnicity, chronic condition, and/or disease severity moderate the trajectory of PICASO effects on self-management, patient activation, coping, emotional health and health-related quality of life. Lastly, we will explore mechanisms of the PICASO impact by describing AYA experiences with the intervention.