Feasibility of mHealth Technology for Improving Self-Management and Adherence Among Asthmatic Adolescents

移动医疗技术改善哮喘青少年自我管理和依从性的可行性

• 批准号: 10410464
• 负责人: Amy Christine Alman
• 金额: $ 21.91万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10410464
• 关键词: Address; Adherence; Adolescent; Adopted; African American; Age; Asthma; Awareness; Behavior; Cellular Phone; Childhood; Chronic; Chronic Disease; Clinic Visits; Clinical; Clinical Trials; Data; Development; Diagnosis; Disease Management; Education; Effectiveness; Emotional; Feedback; Florida; Frequencies; Future; Goals; Guidelines; Health Expenditures; Health Information System; Hispanic; Incentives; Inhalators; Intervention; Intervention Studies; Knowledge; Machine Learning; Marketing; Methods; Mission; Modeling; Monitor; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Outcome; Participant; Patients; Pharmaceutical Preparations; Pilot Projects; Population; Positioning Attribute; Prevalence; Process; Provider; Public Health; Randomized; Randomized Controlled Trials; Reporting; Research; Rewards; Risk; Risk-Taking; Sample Size; Self Management; Smoking; Social Change; Symptoms; System; Techniques; Technology; Teenagers; Telephone; Universities; Work; acceptability and feasibility; age group; aged; arm; asthma exacerbation; asthmatic; base; burden of illness; design; effectiveness trial; efficacy trial; experience; feasibility testing; implementation barriers; improved; innovation; insight; iterative design; mHealth; mobile application; mobile computing; novel; patient population; patient-clinician communication; peak flow measurement; preference; prevent; recruit; smartphone Application; standard of care; therapy development; tool; user centered design

Asthma self‐management is essential for preventing exacerbations and reducing the burden of the disease. However, poor adherence to prescribed treatment and poor recognition of symptoms leads to reduced asthma control, particularly among adolescents. Studies show that adolescents lack understanding about self‐management, and that asthma education during clinic visits is deficient, resulting in insufficient asthma management. Mobile technology, specifically, mobile applications (or apps) are an efficient way to increase patient‐provider communication, provide feedback on asthma management, and deliver asthma education. Our pilot work has demonstrated that an app can be effective at improving asthma control in adolescents aged 12‐17, and that adolescents are enthusiastic about utilizing mHealth technologies for asthma management, but that existing apps are not engaging or appealing enough to an adolescent population to sustain long‐term use. For this pilot study, we will test the feasibility, acceptability, and adherence to a smartphone app for asthma self‐management in order to obtain data necessary to complete a future large efficacy trial of the app in adolescents with persistent asthma. The objective of this project is to use an agile, iterative, user‐centered design process to tailor our existing proof of concept app to adolescent user preferences and to use a mixed‐ methods approach to test feasibility, acceptability, adherence, and preliminary efficacy. The long‐term goal is to identify mHealth technological approaches that facilitate self‐management of chronic diseases, particularly among adolescents, and to develop marketing strategies to promote long‐term support of these approaches. The rationale for this project is that adolescents are quick to adopt mobile technologies, have a high degree of smartphone use, and are at a point of transition from parental management of their chronic condition to self‐ management, making this a priority population for the development of interventions targeting asthma control. For this project, we have two specific aims: 1) To refine an asthma self‐management app for adolescents with persistent asthma; and 2) To assess feasibility, acceptability, and adherence to the app in a small randomized controlled trial. The approach is innovative because we are incorporating a user‐centered design process to integrate multiple components for facilitating asthma self‐management in a mHealth tool tailored for adolescents within the Technology Acceptance Model framework. Despite studies showing that mHealth tools can be effective, few have prioritized an adolescent audience or evaluated the tool compared to standard of care using rigorous, mixed‐method approaches. This research is significant because asthma is the most common chronic disease of childhood in the US and the prevalence of the condition continues to rise, and so innovative tools to improve self‐management of the disease are critically needed.

哮喘自我管理对于防止加重和减少疾病的燃烧至关重要。 但是，对处方治疗的依从性差，对症状的认识不佳导致降低 哮喘控制，特别是在青少年中。研究表明，青少年对 自我管理，诊所访问期间的哮喘教育缺乏，导致哮喘不足 管理。移动技术，特别是移动应用程序（或应用程序）是一种增加的方法 患者提供沟通，提供有关哮喘管理的反馈，并提供哮喘教育。 我们的试点工作表明，应用程序可以有效地改善年龄的青少年哮喘控制 12-17，青少年对使用MHealth Technologies进行哮喘管理的热情，但 现有的应用程序对青少年人群的参与或吸引力不足以维持长期 使用。对于这项试点研究，我们将测试可的可行性，可接受性和遵守智能手机应用程序的 哮喘自我管理以获取所需的数据，以完成该应用程序的未来大型效率试验 持续哮喘的青少年。该项目的目的是使用敏捷，迭代，以用户为中心的 设计过程可根据青少年用户偏好调整现有的概念验证应用程序，并使用混合 测试可行性，可接受性，依从性和初步有效性的方法。长期目标是 确定促进慢性疾病自我管理的MHealth技术方法，特别是 在青少年中，并制定营销策略来促进这些方法的长期支持。 该项目的理由是青少年很快采用移动技术，具有高度的 智能手机的使用，并且正处于从父母管理其慢性状况到自我的过渡 管理层使这成为针对哮喘控制的干预措施的优先人群。 对于这个项目，我们有两个具体的目标：1）为青少年提供一个哮喘自我管理应用程序 持续性哮喘； 2）评估小规模的可行性，可接受性和依从性 随机对照试验。这种方法具有创新性，因为我们正在融合以用户为中心的设计 在量身定制的MHealth工具中集成多个组件以支持哮喘自我管理的过程 对于技术接受模型框架中的青少年。尽管研究表明MHealth 工具可以有效，很少有人优先考虑青少年的受众或评估了该工具与标准相比 使用严格的混合方法方法的护理。这项研究很重要，因为哮喘是最大的 美国常见的童年慢性疾病以及这种病的患病率持续上升，因此 需要急需改善疾病自我管理的创新工具。