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

项目摘要 几乎所有儿童慢性病患者预期寿命的增加都带来了独特的 青少年和年轻人(Aya)面临的挑战，他们正在努力应对相关的 疾病负担，管理治疗，并在发展独立自我管理的过程中茁壮成长 技能，并成为积极和积极参与的患者。影响中国人民生活的挑战 AYA在很大程度上是适应性的，比如改变生活方式，坚持复杂的 药物治疗方案，以及学习如何在成人健康系统中导航。再加上这一点 复杂性是AYA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，因为 医疗保健管理从父母和医疗保健提供者向Aya的转变是 被认为是成人成功结局的关键。同伴支持干预非常适合于 鉴于同伴关系的重要性，应对理论上对AYA至关重要的挑战 在这段时间里。我们提出一项混合方法、为期五年的随机对照试验，该试验将 包括225名具有COCC的AYA(16-22岁)，以测试同伴I-辅导的激活自我 管理优化(毕加索)与注意力控制组。这部小说，手机 健康干预利用已建立的基于电话/文本的安全接口来允许AYA 从训练有素的同行教练那里获得知识、经验和工具/情感支持 (18-26岁)，已经发展出独立性，是一名积极的自我管理人员。我们 将决定毕加索对自我管理/医疗保健导航的疗效，患者 12个月的激活度、应对、情绪健康和与健康相关的生活质量。我们会 探讨年龄、性别、种族/民族、慢性病和/或疾病严重程度是否为中等 毕加索对自我管理、患者激活度、应对方式、情绪的影响轨迹 健康和与健康相关的生活质量。最后，我们将探讨毕加索的创作机制 通过描述阿亚在干预中的经验来说明影响。

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.