Web-based and Interactive Virtual Environments for Children with Food Allergies

描述(申请人提供)：儿童食物过敏(FA)被认为是一个严重的公共卫生问题，影响到大约4%-8%的儿童，症状影响到多个器官系统，包括皮肤、呼吸道和胃肠道。食物引起的过敏反应是一种快速的、可能危及生命的反应，在更严重的情况下可能会发生。尽管疾病管理的负担很大，相关的生活质量负面影响，但几乎没有资源来促进有效的战略来管理FA。此外，针对这一群体的大多数资源强调面对面或通过网络的信息传播和教育，通常侧重于父母，很少为受影响的儿童设计资源。这项拟议的SBIR第一阶段和第二阶段的中心目标是为患有FA的学龄儿童开发一种引人入胜的、基于网络的互动干预措施，以增加知识，提高管理疾病的自我效能，并最终降低负面结果的风险。针对儿童各种儿科疾病的基于软件的干预措施在可获得性和可获得性方面有所增加。与传统干预方法相比，虚拟现实(VR)方法在提供基于虚拟技能的实践、交互反馈和高度吸引人的心理教育形式方面具有明显优势。第一阶段SBIR将建立一种用户友好、互动和负担得起的基于网络的干预措施，具有在不同疾病情况下广泛传播、适应和商业化的巨大潜力。这种基于网络的干预包括在学校食堂的虚拟体验场景，将由三个相关的技术组件组成：(A)作为项目架构的VR软件引擎，能够创建交互式VR环境、个性化交付内容以及收集和管理数据；(B)以社交环境中的知识和行为技能实践为目标的体验场景；以及(C)虚拟游戏中使用的具有奖励的象征性经济，这将增强干预的动机、参与度和可用性。32名IgE介导的FA儿童及其父母将参加 为期4周的干预试点，在此期间，他们将被提示每周使用该系统三次。我们将通过对父母和孩子的半结构化访谈和整个软件计划的数字问卷评估来评估治疗计划的可行性、可信度和可接受性。还将评估增加FA决策和管理方面的知识和自我效能的初步临床疗效。这种干预将在互动性、易用性以及卫生保健专业人员的接受度和推广方面超过现有的以儿童为中心的软件程序。如果成功，我们预计VR项目将成为互动VR干预的模板，适用于患有其他需要自我管理的慢性病的儿童，如哮喘、糖尿病和乳糜泻。在计算机、智能手机和平板电脑技术日益普及和日常使用的时代，商机的前景意义重大。

DESCRIPTION (provided by applicant): Pediatric Food Allergy (FA) is recognized as a serious public health concern that affects approximately 4-8% of children, with symptoms affecting multiple organ systems, including skin, the respiratory tract, and the GI tract. Food-induced anaphylaxis, which is a rapid, potentially life-threatening reaction, can occur in more serious cases. Despite the substantial burden of disease management and associated negative quality of life effects, very few resources exist to promote effective strategies for managing FA. Moreover, most resources targeting this population emphasize information dissemination and education, either in-person or via the web, and typically focus on parents, with few resources designed for affected children. The central goal of Phases I & II of this proposed SBIR is to develop an engaging, interactive web- based intervention for school-aged children with FA that will increase knowledge, improve self-efficacy to manage the disease, and ultimately reduce risk of negative outcomes. Software-based interventions targeting children for various pediatric conditions have increased in availability and accessibility. Virtual Reality (VR) approaches offer distinct advantages over traditional interventions in providing virtual skills-based practice with interactive feedback and highly engaging formats of psychoeducation. This Phase I SBIR will build a user-friendly, interactive, and affordable web-based intervention, with a high potential fo broad dissemination, adaptation and commercialization across different disease conditions. The web-based intervention, which includes virtual experiential scenarios in a school cafeteria, will consist of three related technical components: (a) the VR software engine that serves as the architecture of the program, enabling the creation of interactive VR environments, individualized delivery of content, and collection and management of data, (b) the experiential scenarios that target knowledge and behavioral skills practice in social contexts, and (c) a token economy with rewards to be used in a virtual game, which will enhance motivation, engagement and usability of the intervention. Thirty-two children with IgE-mediated FA and their parents will participate in a 4-week intervention pilot, in which they will be prompted to use the system three times weekly. We will evaluate the feasibility, credibility, and acceptability of the treatment program via semi-structured interviews with parents and children, and digital questionnaire assessments throughout the software program. Preliminary clinical efficacy to increase knowledge and self-efficacy regarding FA decision-making and management will also be evaluated. This intervention will surpass existing approaches for child-focused software programs in interactivity, ease of use, and acceptance and promotion by health care professionals. If successful, we envision that the VR program will serve as a template for interactive VR interventions for children with other chronic conditions requiring self-management, such as asthma, diabetes, and celiac disease. The promise of commercial opportunity is significant in an era in which there is an increasingly widespread access to and everyday use of computers, smart phones, and tablet technologies.