A Tailored Asthma Education Program for Urban Teens II

为城市青少年量身定制的哮喘教育计划 II

• 批准号: 7260421
• 负责人: Christine LM Joseph
• 金额: $ 71.15万
• 依托单位: HENRY FORD HEALTH SYSTEM
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-12-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7260421
• 关键词: Accident and Emergency department; Address; Adolescent; African American; Age; Age-Years; Asthma; Attitude; Behavior; Behavioral; Belief; Child; Cities; Communication Research; Computer software; Data; Death Rate; Depth; Education; Effectiveness; Ensure; Failure; Goals; Health; Health Communication; Health system; High Prevalence; Hospitalization; Institution; Integrated Delivery Systems; Intention; Intervention; Medical; Methods; Michigan; Modification; Morbidity - disease rate; Motivation; Numbers; Online Systems; Outcome; Participant; Persons; Phase; Play; Population; Professional counselor; Program Effectiveness; Publications; Quality of life; Race; Randomized Controlled Clinical Trials; Readiness; Recruitment Activity; Relapse; Relative (related person); Reporting; Research; Resistance; Role; Schools; Score; Self Determination; Site-Directed Mutagenesis; Staging; Students; Subgroup; Target Populations; Techniques; Teenagers; Testing; Theoretical model; Time; Universities; Visit; Youth; age group; asthma inhaler; base; behavior change; cost; design; experience; high school; improved; medication compliance; mortality; motivational enhancement therapy; programs; statistics; success; theories; tool

DESCRIPTION (provided by applicant): Asthma death rates for teenagers 15-19 years of age are higher than that of younger children, despite a higher prevalence in the latter group. The small number of publications on urban adolescents suggests that inadequate asthma management plays a significant role in these grim statistics; however, this age group has been difficult to reach, in terms of both connecting and convincing. Consequently, there are few asthma management programs targeting urban, high school students with asthma. We have developed a unique, multi-media, web-based program (Puff City I) to motivate teens to change negative behaviors related to asthma management. Puff City I software uses "tailoring" in conjunction with theoretical models of behavior change, to personalize health messages according to the beliefs, attitudes, and barriers of students with asthma. A school-based approach ensures accessibility. An asthma counselor responds to referrals generate by the software, providing assistance in addressing barriers to effective asthma management. A randomized trial to evaluate Puff City I in Detroit high schools (98% African American) is in its final stages. Results of initial analyses demonstrate short-term behavior changes, in addition to fewer Emergency Department (ED) visits (p=0.03) and hospitalizations (p=0.007), and higher scores for quality of life (p=0.02) when compared to controls. As with any research trial, not all students improved, some relapsed, and a substantial number did not participate. To maximize effectiveness of the program, we propose to use Puff City I data, including teen sociodemographics, motivation, and reported barriers, to make refinements that would target program failures resulting in a new version or Puff City II. In addition, we will test new theory- and empirically-based approaches to recruiting urban high school students into this and other randomized trials. Not only would the latter be useful to research, in terms of generalizability, but will also yield valuable information about attracting this population to health-related interventions. We will evaluate Puff City II in another randomized trial in 9 Detroit high schools. Dissemination of this unique tool will also be explored as part of this proposal. Our collaborators include the University of Michigan Center for Health Communications Research, Detroit Public Schools, and the Detroit Department of Health and Wellness Promotion (formerly Detroit Health Department). The result of this proposal will be a powerful tool for changing negative behaviors related to asthma management in a traditionally hard-to-reach population that experiences high asthma morbidity and mortality.

描述（由申请人提供）： 15-19 岁青少年的哮喘死亡率高于年龄较小的儿童，尽管后者的患病率较高。关于城市青少年的出版物数量很少，这表明哮喘管理不足在这些严峻的统计数据中发挥了重要作用；然而，无论是在联系性还是说服力方面，这个年龄段的人都很难接触到。因此，针对城市哮喘高中生的哮喘管理项目很少。我们开发了一个独特的多媒体网络计划（Puff City I）来激励青少年改变与哮喘管理相关的负面行为。 Puff City I 软件将“定制”与行为改变的理论模型相结合，根据患有哮喘的学生的信念、态度和障碍来个性化健康信息。以学校为基础的方法确保了无障碍。哮喘咨询师会对软件生成的推荐做出回应，为解决有效哮喘管理的障碍提供帮助。一项评估底特律高中（98% 非裔美国人）Puff City I 的随机试验已进入最后阶段。初步分析结果表明，与对照组相比，除了较少的急诊科 (ED) 就诊次数 (p=0.03) 和住院次数 (p=0.007) 以及较高的生活质量评分 (p=0.02) 之外，还出现了短期行为变化。与任何研究试验一样，并非所有学生都有所改善，有些学生病情复发，而且相当多的学生没有参加。为了最大限度地提高该计划的有效性，我们建议使用 Puff City I 数据（包括青少年社会人口统计数据、动机和报告的障碍）进行改进，以针对导致新版本或 Puff City II 的计划失败。此外，我们将测试新的基于理论和实证的方法来招募城市高中生参加本次随机试验和其他随机试验。后者不仅在普遍性方面对研究有用，而且还将产生关于吸引这一人群接受健康相关干预措施的有价值的信息。我们将在底特律 9 所高中的另一项随机试验中评估 Puff City II。作为该提案的一部分，还将探索这一独特工具的传播。我们的合作者包括密歇根大学健康传播研究中心、底特律公立学校和底特律健康与保健促进部（原底特律卫生局）。该提案的结果将成为一个强有力的工具，用于改变传统上难以接触到的哮喘发病率和死亡率较高的人群中与哮喘管理相关的负面行为。