Multi-component technology intervention for African American emerging adults with asthma

针对非洲裔美国新兴成人哮喘患者的多成分技术干预

基本信息

批准号：
9753332
负责人：
Karen MacDonell
金额：
$ 67.18万
依托单位：
WAYNE STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-01 至 2021-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9753332
关键词：
Accident and Emergency department Adherence Adolescence Adolescent and Young Adult Adult African American Age Asthma Behavior Therapy Behavioral Caregivers Caring Caucasians Cessation of life Childhood Chronic Disease Cities Clinic Clinical Community Health Computers Control Groups County Data Data Collection Development Devices Dose Ecological momentary assessment Elements Emergency department visit Frequencies Funding Health Incidence Intervention Knowledge Learning Module Length Literature Location Mediation Mediator of activation protein Medical center Methods Michigan Minority Modeling Monitor Morbidity - disease rate Motivation National Heart, Lung, and Blood Institute Outcome Participant Patient Self-Report Persons Pharmaceutical Preparations Pilot Projects Population Population Research Prevalence Protocols documentation Pulmonary Function Test/Forced Expiratory Volume 1 Quality of life Randomized Randomized Clinical Trials Regimen Reporting Research Respiratory physiology Risk Behaviors Sampling Self Efficacy Series Symptoms Technology Testing Text Messaging Time United States Universities Work Youth age group asthma exacerbation asthma inhaler asthma model base cost diaries eHealth efficacy testing emerging adult emerging adulthood ethnic minority population experience health care settings high risk improved inner city innovation medication compliance mortality motivational enhancement therapy post intervention primary outcome programs racial minority recruit secondary outcome skills socioeconomics treatment effect

项目摘要

Racial and ethnic minority youth 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 racial 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. All elements of the proposed study protocol were piloted in an NHLBI-funded pilot study (1R34HL107664-01A1 MacDonell). Results suggested feasibility and acceptability of the study protocol as well as proof of concept. We are now ready to test the intervention in a larger randomized clinical trial. The proposed study will include 192 African American emerging adults with moderate to severe persistent asthma and low controller medication adherence recruited from clinic and emergency department 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. It is hypothesized that youth randomized to MCTI will show improvements in adherence to medication (primary outcome) and asthma control (secondary outcome) compared to the comparison condition at all post-intervention follow ups (3, 6, 9, and 12 months).

即使在控制之后社会经济变量。正确使用哮喘控制器药物对于降低哮喘死亡率至关重要和发病率。哮喘管理差的临床后果包括增加的疾病并发症，功能性发病率过多，致命的哮喘发作。研究有重大局限性改善种族少数群体的哮喘管理的干预措施，尤其是少数民族青少年和年轻人，尽管在新兴期间青春期后疾病管理趋于恶化成年，这是青春期以外但成年之前的独特发展时期。所有元素在NHLBI资助的试点研究（1R34HL107664-01A1 MacDonell）中试用了拟议的研究方案。结果表明研究方案的可行性和可接受性以及概念证明。我们现在准备在更大的随机临床试验中测试干预措施。拟议的研究将包括192个非洲人美国新兴成年人具有中度至严重的持续性哮喘和低控制器药物的依从性从诊所和急诊科环境中招募。一半的样本将被随机分配给基于多组分技术的干预措施（MCTI）旨在遵守日常控制器药物。这 MCTI由两个组成部分组成：1）2次计算机动机访谈定位的会议药物依从性和2）个性化的文本消息传递，重点是遵守药物会议。文本消息将根据生态瞬时评估（EMA）个性化。这剩下的一半的参与者将完成一系列计算机传递的哮喘教育模块匹配为了长度，位置和干预课程的交付方法。控制参与者也将收到干预会议之间的短信。所有控制参与者的消息内容将相同，并且包含有关哮喘（未量身定制）的一般事实。青年将从底特律医疗中心招募仅在密歇根州底特律的大学附属医学中心。假设青年随机与MCTI 将显示遵守药物（主要结果）和哮喘控制的改善（次要结果）与所有干预后随访（3、6、9和12个月）的比较条件相比。