Asthma and Technology in Emerging African American Adults (The ATHENA Project)

新兴非洲裔美国成年人的哮喘与技术（雅典娜项目）

• 批准号: 10478271
• 负责人: ALAN P. BAPTIST
• 金额: $ 5.73万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2022-08-25
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10478271
• 关键词: Accountability; Address; Adherence; Adolescence; Adult; African American; Age; Algorithms; Ambulatory Care; American Lung Association; Asthma; Attitude; Behavior; Behavior Therapy; Behavioral; Blinded; Cellular Phone; Child Care; Clinic; Clinical Research; Computational algorithm; Computers; Data Collection; Decision Making; Education; Educational Intervention; Engineering; Experimental Designs; Goals; Guidelines; Human; Individual; Informal Social Control; International; Intervention; Knowledge; Mediator of activation protein; Medical center; Modeling; Morbidity - disease rate; Motivation; Multicenter Trials; Nurses; Participant; Persons; Physical activity; Play; Population; Quality of life; Randomized; Randomized Clinical Trials; Regimen; Research; Research Design; Resources; Risk-Taking; Role; Sample Size; Schools; Self Efficacy; Self Management; Site; Symptoms; System; Target Populations; Technology; Testing; Text Messaging; Time; Universities; Voice; Work; base; behavior test; clinically significant; cost; design; efficacy evaluation; emerging adult; emerging adulthood; experience; experimental study; improved; innovation; intervention delivery; mHealth; medication compliance; meetings; mortality; motivational enhancement therapy; multiphase optimization strategy; post intervention; programs; recruit; secondary outcome; skills; smartphone Application; theories; treatment arm; virtual; wearable device

Asthma causes substantial morbidity and mortality in the U.S., particularly among African American emerging adults (AAEA; ages 18-30), but very few asthma programs have targeted this population. Interventions that provide education and address underlying motivation for managing asthma may be most effective. However, intensive, face-to-face interventions are often difficult to implement, especially among emerging adults. The purpose of this proposal is to develop an effective mobile asthma management intervention to improve control in AAEA. We will assess the ability of multiple technologic components to assist and improve traditional asthma education: 1) MES. The Motivational Enhancement System (MES) for Asthma Management is a mobile 4-session intervention utilizing supported self-regulation and Motivational Interviewing (MI). Personalized content is based on each participant’s activity level, daily experiences, and goals. 2) SA. Supportive accountability (SA) is administered by asthma nurses utilizing targeted mobile support (Skype/voice calls) to provide education, promote self-efficacy, and overcome barriers through an MI-based framework. 3) SMS. Text messaging (SMS) provides reminders for asthma education, medication adherence, and physical activity. 4) PAT. Physical activity tracking (PAT) uses wearable technology to help meet user-defined physical activity goals. Using a multiphase optimization strategy (MOST) framework, we will test these 4 intervention components and combination of components to identify the most effective mobile intervention. MOST is an innovative, cost- and time-effective framework that utilizes engineering principles to produce effective behavioral interventions. We will conduct a component selection experiment using a factorial research design to build an intervention that has been optimized for maximum efficacy. We will use a clinically significant improvement in asthma control as the criterion for determining which components should be kept in the optimized intervention. Participants (N=180) will be randomized to 1 of 6 intervention arms consisting of various combinations of the intervention components. This experimental design is equivalent to conducting multiple pilot randomized clinical trials to evaluate the efficacy of each component, yet uses only a fraction of the sample size and resources. At the completion of the study, we will have an empirically-supported, optimized mobile asthma management intervention to improve asthma control for AAEA. Participants will be recruited from multiple sites of the American Lung Association Airway Clinical Research Center network and ambulatory care clinics at the Detroit Medical Center. Data collections will occur at baseline, 3, 6, and 12 months. We hypothesize that post-intervention (3, 6, and 12 months), participants with uncontrolled asthma will show clinically-significant improvement in asthma control. We hypothesize that improvements in asthma management behaviors (including physical activity), quality of life, symptoms, adherence, and exacerbations (secondary outcomes) will also be observed.

哮喘在美国引起大量的发病率和死亡率，尤其是在非裔美国人的新兴中 成人（AAEA； 18-30岁），但很少有哮喘计划针对这一人群。干预措施 提供管理哮喘的教育和地址可能是最有效的。然而， 密集，面对面的干预通常很难实施，尤其是在新兴的成年人中。 该建议的目的是开发有效的移动哮喘管理干预措施以改善控制 在AAEA。我们将评估多个技术组件协助和改善传统的能力 哮喘教育：1）Mes。哮喘管理的动机增强系统（MES）是 使用支持的自我调节和动机访谈（MI）的移动4条干预措施。 个性化内容基于每个参与者的活动水平，日常体验和目标。 2）SA。 支持性问责制（SA）由哮喘护士使用针对性的移动支持（Skype/Voice）管理 呼叫）通过基于MI的框架提供教育，促进自我效能感并克服障碍。 3） 短信。文本消息传递（SMS）提供了哮喘教育，药物依从性和身体的提醒 活动。 4）帕特。体育活动跟踪（PAT）使用可穿戴技术来帮助满足用户定义的物理 活动目标。使用多相优化策略（大多数）框架，我们将测试这4个干预措施 组件和组件组合以识别最有效的移动干预。大多数是一个 创新，成本和时间效率的框架，利用工程原则来产生有效 行为干预。我们将使用阶乘研究设计进行组件选择实验 建立已对最大效率进行优化的干预措施。我们将使用临床意义 改善哮喘控制作为确定应保留哪些组件的标准 优化的干预措施。参与者（n = 180）将被随机分为6个干预臂中的1个 干预组件的各种组合。这种实验设计等同于进行 多个飞行员随机临床试验以评估每个组件的效率，但仅使用一小部分 样本量和资源。研究完成时，我们将有一个经验支持的， 优化的移动哮喘管理干预措施以改善AAEA的哮喘控制。参与者会 从美国肺协会临床研究中心网络的多个地点招募 底特律医疗中心的门诊护理诊所。数据收集将在基线，3、6和12发生。 月份。我们假设干预后（3、6和12个月），患有不受控制的哮喘的参与者将 在哮喘控制中显示出临床上显着的改善。我们假设哮喘的改善 管理行为（包括体育锻炼），生活质量，症状，依从性和恶化 （次要结果）也将观察到。