mHealth Approach to Collaborative Asthma Management for Teens & Parents

 描述(申请人提供)：儿童哮喘影响9.6%的青年，是青年发病率的主要原因。培养和掌握哮喘自我管理行为对控制哮喘、降低青少年发病率具有重要意义。青少年通常不能进行哮喘的自我管理行为，以防止并发症和提高生活质量。哮喘自我管理困难出现在青春期早期，因为年轻人开始转向更多地控制他们的治疗方案，使其成为关键的干预期。有没有有帮助的照顾者支持往往决定早期青少年是否最终发展并掌握哮喘自我管理行为。该应用程序的目标是开发和测试Team Speech，这是一种通过智能手机实施的移动健康(MHealth)工具，可在患有持续性哮喘的早期青少年发展并掌握哮喘自我管理行为时培养有用的照顾者支持。为了促进有益的照顾者支持，团队发言使用研究团队开发的现有mHealth技术来阐明为每个家庭量身定做的干预目标。然后，Team Talk通过一个结构化的过程自动指导DYAD，从而促进协作式照顾者/青少年哮喘管理，该过程包括目标设置、应急管理和问题解决沟通等支持性行为管理策略。为青少年和照顾者提供的技能培训视频提供了如何完成每个协作性哮喘管理组成部分的指导。我们建议通过来自咨询委员会的迭代反馈来开发团队发言，该咨询委员会由来自目标用户群体的十个青少年-照顾者二人组和一名儿科肺病专家组成。根据咨询委员会的反馈，我们将对50名早期哮喘控制不佳的青少年和一名照顾者进行小组谈话的先导性随机对照试验。家庭将被随机分配接受团队演讲或自我指导控制条件，为期4个月的干预期。在自我引导控制条件下的参与者将获得关于支持性行为管理技术的一般信息，他们可以使用这些技术来针对哮喘自我管理行为的改善。控制条件将作为注意力控制，旨在优化招募和保持兴趣，同时对哮喘管理产生最小的影响。在整个试验过程中，将收集可行性、可接受性和利用率数据。疗效结果包括家庭哮喘治疗的变化(主要结果)、处方补充史、肺功能、哮喘控制、哮喘相关的生活质量以及哮喘治疗的疗效。评估疗效结果的数据将在基线、治疗后和4个月随访时间点收集。团队演讲的可行性、可接受性和利用率将通过检查注册和流失率、使用统计数据以及参与者对团队演讲工具的满意度来确定。如果成功，这种干预 为广泛传播提供了极好的潜力，以解决紧迫的公共卫生问题。

 DESCRIPTION (provided by applicant): Pediatric asthma affects 9.6% of youth and is a leading cause of youth morbidity. Developing and mastering asthma self-management behaviors is imperative to control asthma and reduce morbidity among youth. Adolescents typically fail to perform the asthma self-management behaviors that prevent complications and enhance quality of life. Asthma self-management difficulties emerge in early adolescence as youth begin to transition towards taking more control of their treatment regimen, making it a critical intervention period. The presence or absence of helpful caregiver support often determines whether early adolescents ultimately develop and master asthma self-management behaviors. The aims of this application are to develop and test Team Speak, a mobile health (mHealth) tool, implemented via smartphones, that fosters helpful caregiver support as early adolescents with persistent asthma develop and master asthma self-management behaviors. To facilitate helpful caregiver support, Team Speak uses existing mHealth technology developed by the study team to elucidate tailored intervention targets for each family. Team Speak then facilitates collaborative caregiver/adolescent asthma management by automatically guiding dyads through a structured process that includes the supportive behavioral management strategies of goal setting, contingency management, and problem solving communication. Skills-training videos for adolescents and caregivers provide guidance on how to complete each collaborative asthma management component. We propose to develop Team Speak through iterative feedback from an advisory board composed of ten adolescent-caregiver dyads from the target user population and a pediatric pulmonologist. Following advisory board feedback, we will conduct a pilot randomized controlled trial of Team Speak with 50 early adolescents with poorly controlled asthma, ages 12-15 years, and a caregiver. Families will be randomly assigned to receive Team Speak or a self-guided control condition for a 4 month intervention period. Participants in the self-guided control condition will be given general information on supportive behavioral management techniques they can use to target improvement in asthma self-management behaviors. The control condition will serve as an attention control and is designed to optimize recruitment and sustain interest while concurrently having a minimal impact on asthma management. Feasibility, acceptability, and utilization data will be collected throughout the trial. Efficacy outcomes include changes in family asthma management (primary outcome), prescription refill history, lung function, asthma control, asthma-related quality of life, and sel-efficacy for asthma management. Data to evaluate efficacy outcomes will be collected at baseline, post-treatment, and 4 month follow-up time points. Feasibility, acceptability, and utilization of Team Speak will be determined by examining enrollment and attrition rates, usage statistics, and participant satisfaction with the Team Speak tool. If successful, this intervention offers excellent potential for wide spread dissemination to address a pressing public health problem.