Improving Asthma Care Together (IMPACT): A Shared Management Pilot Study

项目摘要/摘要 哮喘是儿童最常见的慢性疾病，也是住院的主要原因。 以及学龄儿童的缺课问题。超过50%的儿童患有哮喘 管理养生，导致生活质量恶化，缺课，更高的医疗保健利用率，以及 永久性的呼吸道损伤。在儿童哮喘管理干预方面存在严重缺口，其中 大多数人主要关注父母，并使用规定的、自上而下的方法。未能将孩子包括在内是一种 关键的遗漏。学龄儿童离开父母的时间越来越长， 发展能力，积极参与自己的哮喘治疗。此外，现有的 干预措施没有考虑到家庭管理优先事项之间的差异。不仅缺少家庭 他们需要的工具来成功地管理哮喘，但也要逐渐将责任转移到年轻人身上 最终将为他们的终生疾病承担全部责任。 为了满足儿童和家长的哮喘管理需求，成功的干预措施需要 针对父母和孩子的管理技能，根据家庭的优先事项量身定做干预措施，并使用 一种可访问的格式。此前，我们的团队与亲子二人组合作设计了一款量身定做的哮喘共享 管理移动医疗应用程序，共同改善与父母配对的哮喘护理(IMPACT) 和孩子们一起组成一个团队来管理孩子的哮喘。对于拟议的研究，我们的目标是改进和测试 对7-11岁持续性哮喘儿童及其父母的影响。最初的可行性， IMPACT的可接受性和有效性将在一项试点随机对照试验中进行测试，比较IMPACT和 以46名持续性哮喘儿童及其父母为样本，加强了常规护理对照。父级 将测量儿童哮喘自我效能、共同管理(哮喘责任)和生活质量 两个研究组在干预前和干预后。 开发一个有效的、量身定制的共享管理健康应用程序有可能 改善哮喘儿童的健康状况，并建立终身自我管理技能。 这项研究的结果将指导未来的干预措施改进，为评估和招聘战略提供信息， 为设计一项全面的临床试验提供初步证据。Impact是一种可访问的和 可扩展的干预措施，解决关键的临床差距：在患有哮喘的儿童中共享哮喘管理 哮喘和他们的父母。

PROJECT SUMMARY/ABSTRACT Asthma is the most common chronic condition of childhood, and is the leading cause of hospitalizations and school absences among school-age children. More than 50% of children are nonadherent to asthma management regimens, leading to worsened quality of life, school absences, higher healthcare utilization, and permanent airway damage. There is a critical gap in childhood asthma management interventions wherein the majority focus primarily on parents and use a prescriptive, top-down approach. Failure to include the child is a critical omission. School-age children spend increasing time away from their parents and have the developmental capacity to be active participants in their own asthma management. Furthermore, existing interventions fail to account for the variability among family management priorities. Not only are families lacking the tools they need to manage asthma successfully, but also to gradually shift responsibility to the youth who eventually will assume sole responsibility for their lifelong condition. To meet the asthma management needs of children and parents, successful interventions need to target management skills of both parent and child, tailor the intervention to the priorities of the family, and use an accessible format. Previously, our team worked with parent-child dyads to design a tailored asthma shared management mobile health application, Improving Asthma Care Together (IMPACT) that pairs the parent and child together as a team to manage the child's asthma. For the proposed study, we aim to refine and test IMPACT with 7-11-year-old children with persistent asthma and their parents. The initial feasibility, acceptability and efficacy of IMPACT will be tested in a pilot randomized controlled trial comparing IMPACT to an enhanced usual care control with a sample of 46 children with persistent asthma and their parents. Parent and child asthma self-efficacy, shared management (asthma responsibility) and quality of life will be measured in both study groups before and after the intervention. Development of an effective, tailored shared management health application has the potential to improve health outcomes of children living with asthma, as well as establish lifelong self-management skills. Results from this study will guide future intervention refinement, inform assessment and recruitment strategies, and provide preliminary evidence for the design of a full-scale clinical trial. IMPACT is an accessible and scalable intervention that addresses a critical clinical gap: shared asthma management among children with asthma and their parents.