Multi-component technology intervention for minority emerging adults with asthma

针对少数新兴成人哮喘患者的多成分技术干预

基本信息

批准号：
8399080
负责人：
Karen MacDonell
金额：
$ 21.71万
依托单位：
WAYNE STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-12-15 至 2014-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8399080
关键词：
Accident and Emergency department Adherence Adolescence Adolescent Adult African American Age Asthma Attention Behavior Belief Budgets Caregivers Caring Caucasians Caucasoid Race Censuses Cessation of life Childhood Chronic Cities Clinic Clinical Clinical Trials Color Community Health Computers Control Groups County Data Development Education Feasibility Studies Feedback Goals Health Incidence Intervention Interview Knowledge Length Life Literature Location Mediation Medical Medical center Methods Michigan Minority Morbidity - disease rate Motivation Outcome Participant Patient Self-Report Persons Pharmaceutical Preparations Pilot Projects Population Population Research Preparation Procedures Quality of life Randomized Recruitment Activity Reporting Research Risk Behaviors Sampling Self Efficacy Series Technology Testing Text Treatment Protocols United States Universities Urban Population Visit Work Youth abstracting age group asthma inhaler base brief intervention cost design emerging adult emerging adulthood follow-up high risk improved inner city medication compliance mortality motivational enhancement therapy multi-component intervention programs response satisfaction secondary outcome socioeconomics tool young adult

项目摘要

DESCRIPTION (provided by applicant): Youth of color have poorer asthma status than Caucasian youth, even after controlling for socioeconomic variables. Proper use of asthma controller medications is critical in reducing asthma mortality and morbidity. The clinical consequences of poor asthma management include increased illness complications, excessive functional morbidity, and fatal asthma attacks. There are significant limitations in research on interventions to improve asthma management in minority populations, particularly minority adolescents and young adults, though illness management tends to deteriorate after adolescence during emerging adulthood, the unique developmental period beyond adolescence but before adulthood. Because few interventions have specifically targeted this age group, we are currently conducting several small feasibility studies to inform this proposal. Building on the knowledge gained from the feasibility studies, this pilot study's goal is to develop and preliminarily test a technology-based intervention to improve asthma medication adherence in urban African American emerging adults (ages 18-25). The proposed study will collect pilot data with a sample of 80 African American emerging adults with asthma with suboptimal medication adherence recruited from clinic settings. Half of the sample will be randomized to receive a multi-component technology-based intervention (MCTI) targeting adherence to daily controller medication. The MCTI consists of two components: 1) 2 sessions of computer-delivered motivational interviewing targeting medication adherence, and 2) individualized text messaging focused on medication adherence between the sessions. Text messages will be individualized based on Ecological Momentary Assessment (EMA). The remaining half of participants will complete a series of computer-delivered asthma education modules matched for length, location, and method of delivery of the intervention session. Control participants will also receive text messages between intervention sessions. Message content will be the same for all control participants and contain general facts about asthma (not tailored). Youth will be recruited from the Detroit Medical Center, the only university affiliated medical center in Detroit, Michigan, as well as the Campus Health Center at Wayne State University also in Detroit. The goal of this project is to establish initial proof of conceptof MCTI through assessing viability, identifying technical issues, and establishing overall future research direction, as well as providing feedback for budgeting for a R01-level RCT. Although the scientific literature may provide the rationale for conducting a larger RCT, this pilot will provide critical information about the implementation of the intervention and recruitment strategies necessary to design a successful RCT. It is hypothesized that youth randomized to MCTI for adherence will show improvements in motivation to adhere to asthma medications and self-reported adherence compared to the comparison condition at 1- and 3- month follow up.

描述（由申请人提供）：即使在控制了社会经济变量之后，有色人种青少年的哮喘状况也比白人青少年更差。正确使用哮喘控制药物对于降低哮喘死亡率和发病率至关重要。哮喘管理不善的临床后果包括增加疾病并发症、过度的功能发病率和致命的哮喘发作。尽管在青春期后的成年初期（青春期之后但成年之前的独特发展时期）疾病管理往往会恶化，但改善少数群体（尤其是少数群体青少年和年轻人）哮喘管理的干预措施的研究存在重大局限性。由于很少有干预措施专门针对这个年龄段，因此我们目前正在进行几项小型可行性研究，以为本提案提供信息。基于从可行性研究中获得的知识，这项试点研究的目标是开发并初步测试基于技术的干预措施，以提高城市非裔美国新兴成年人（18-25 岁）的哮喘药物依从性。拟议的研究将从诊所招募 80 名患有哮喘且药物依从性不佳的非洲裔美国新兴成人样本，收集试点数据。一半的样本将被随机接受基于多成分技术的干预（MCTI），目标是坚持每日控制药物。 MCTI 由两个部分组成：1) 2 场计算机提供的针对药物依从性的动机性访谈，以及 2) 侧重于会议之间药物依从性的个性化短信。短信将根据生态瞬时评估 (EMA) 进行个性化。剩下的一半参与者将完成一系列由计算机提供的哮喘教育模块，这些模块与干预课程的长度、地点和提供方法相匹配。控制参与者还将在干预会话之间收到短信。所有对照参与者的消息内容都相同，并包含有关哮喘的一般事实（未定制）。将从唯一的大学底特律医学中心招募年轻人密歇根州底特律的附属医疗中心以及同样位于底特律的韦恩州立大学校园健康中心。该项目的目标是通过评估可行性、确定技术问题、确定未来总体研究方向以及为 R01 级 RCT 预算提供反馈来建立 MCTI 的初步概念证明。尽管科学文献可能为进行更大规模的随机对照试验提供了理由，但该试点项目将提供有关实施干预措施和设计成功随机对照试验所需的招募策略的关键信息。据推测，与 1 个月和 3 个月随访时的比较条件相比，随机分配到 MCTI 依从性的青少年在坚持哮喘药物治疗的动机和自我报告的依从性方面将表现出改善。