A Tailored mHealth Vaping Prevention Intervention for Adolescents with Congenital Heart Defects

项目总结/摘要：先天性心脏病（CHD）影响了240多万人， 美国每年产生61亿美元的医疗费用。避免吸烟对缓解冠心病至关重要 幸存者获得心血管并发症的风险，但青年电子烟（“vaping”）危机暴露了 患有CHD的青少年（“青少年”）人口不断增长，易受潜在的vaping相关伤害， 会大大增加传统香烟使用的风险。预防青少年吸烟的干预措施 冠心病是迫切需要的，但没有现有的计划是足够的，这一风险群体。福克斯博士的TL 1 奖学金研究表明，31%的青少年CHD容易受到vaping和识别感知 压力和疾病知识不足是潜在的风险因素，但现有的计划并没有解决这些问题 注意事项。拟议的研究将产生和评估第一个vaping预防干预措施 专为青少年冠心病患者量身打造目标1：从基于证据的课堂教学中调整课程 预防干预措施，包括在移动的 健康（mHealth）格式为青少年（12-18岁）与CHD。干预调整/完善将通过以下方式进行：1） 与关键利益相关者（CHD青少年、父母、心脏病专家）组成焦点小组，了解干预措施 偏好，以及2）适应性移动健康干预的单臂试点试验（N=16），重点关注随访 小组收集信息进行改进。目标2：评估移动健康的可行性/可接受性 通过先导性随机临床试验（RCT; N=72）进行干预。探索目标3：探索初步 移动健康干预对预防电子烟指标的有效性（电子烟相关有效性，感知 vaping结果，电子烟知识）。这些目标与福克斯博士的职业目标直接一致， 独立的临床科学家，在行为RCT和可扩展的疾病自我管理方面具有专业知识 对患有CHD的过渡年龄青少年进行干预。为了实现这一目标，福克斯博士需要高级培训， 以下领域：1）行为干预科学，以设计和优化干预措施， 在公共卫生层面实施，如移动医疗模式，2）RCT方法和分析， 严格评估行为干预的功效和有效性，3）CHD疾病自我- 过渡年龄青少年的管理和医疗保健，将冠心病患者的独特因素纳入 有针对性的干预措施。职业发展计划包括教学和应用培训， 多学科（公共卫生，临床/定量心理学，心脏病学）导师从阿比盖尔 全国儿童医院的Wexner研究所是世界上发展最快的儿科医院之一。 研究中心，其学术分支机构俄亥俄州州立大学和弗雷德哈钦森癌症研究 中心该K23提案将提供R 01所需的高质量初步数据和专业知识 疗效试验，朝着在CHD的生命周期中增强健康的最终目标前进。

PROJECT SUMMARY/ABSTRACT: Congenital heart defects (CHD) affect over 2.4 million individuals in the U.S and generate $6.1 billion in annual healthcare costs. Avoidance of tobacco is vital to mitigate CHD survivors’ risk for acquired cardiovascular complications, but the youth e-cigarette (“vaping”) crisis exposes the growing and vulnerable population of adolescents (“teens”) with CHD to potential vaping-related harms and significantly increases risk for conventional cigarette use. Interventions to prevent vaping among teens with CHD are critically needed, but no existing programs are sufficient for this at-risk group. Dr. Fox’s TL1 fellowship research showed that 31% of teens with CHD are susceptible to vaping and identified perceived stress and poor disease knowledge as potential risk factors, but existing programs do not address these considerations. The proposed research will generate and evaluate the first vaping prevention intervention tailored for teens with CHD. Aim 1: Adapt curriculum from an evidence-based, classroom-delivered vaping prevention intervention to include critical stress management and disease knowledge modules in a mobile Health (mHealth) format for teens (12-18 years) with CHD. Intervention adaptation/refinement will occur via: 1) focus groups with key stakeholders (teens with CHD, parents, cardiologists) to understand intervention preferences, and 2) a single-arm pilot trial of the adapted mHealth intervention (N=16) with follow-up focus groups to gather information for refinement. Aim 2: Evaluate the feasibility/acceptability of the mHealth intervention via a pilot randomized clinical trial (RCT; N=72). Exploratory Aim 3: Explore the preliminary efficacy of the mHealth intervention for indicators of vaping prevention (vaping-related efficacy, perceived vaping outcomes, e-cigarette knowledge). These aims directly align with Dr. Fox’s career goal of becoming an independent clinician-scientist with expertise in behavioral RCTs and scalable disease self-management interventions for transition-aged teens with CHD. To achieve this goal, Dr. Fox requires advanced training in the following areas: 1) behavioral intervention science to design and optimize interventions that can be implemented on a public health level, such as mHealth modalities, 2) RCT methodology and analysis to rigorously evaluate behavioral interventions for efficacy and effectiveness, and 3) CHD disease self- management and healthcare for transition-aged teens to incorporate unique factors of living with CHD into tailored interventions. The career development plan involves didactic and applied training and leverages expert multidisciplinary (public health, clinical/quantitative psychology, cardiology) mentorship from The Abigail Wexner Research Institute at Nationwide Children’s Hospital, one of the worlds’ fastest growing pediatric research centers, its academic affiliate The Ohio State University, and the Fred Hutchinson Cancer Research Center. This K23 proposal will provide high-quality preliminary data and instill expertise needed for an R01 efficacy trial, advancing toward the ultimate goal of enhancing wellbeing across the lifespan of CHD.