Peer i-Coaching for Activated Self-management Optimization in Adolescents and Young Adults with Chronic Conditions

同伴在线辅导可促进患有慢性病的青少年和年轻人的主动自我管理优化

基本信息

批准号：
10362624
负责人：
Sharron L Docherty
金额：
$ 60.64万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-26 至 2024-02-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10362624
关键词：
Address Adolescence Adolescent and Young Adult Adult Advocacy Age Agreement Behavior Caring Characteristics Childhood Chronic Chronic Disease Clinic Collaborations Complex Control Groups Data Development Emotional Ethnic Origin Future Goals Health Health Personnel Health system Healthcare Home Individual Intervention Interview Knowledge Lead Learning Life Life Expectancy Life Style Modification Maintenance Mediator of activation protein Medical Medication Management Methods Modeling Mood Disorders Multi-Institutional Clinical Trial Outcome Parents Participant Patients Pharmaceutical Preparations Preparation Program Reviews Provider Quality of life Race Randomized Controlled Trials Readiness Regimen Reporting Schools Secure Self Care Self Management Severity of illness Site Symptoms Testing Text Telephone Time Training Work attentional control base burden of illness care systems coping critical period design experience health management health related quality of life improved interest interoperability intrinsic motivation mHealth novel patient oriented peer peer coaching peer support pilot test primary outcome psychosocial secondary outcome sex skills systematic review

项目摘要

Project Summary Increases in life expectancy in almost all childhood-onset chronic conditions has brought unique challenges for adolescents and young adults (AYA) who struggle to deal with the associated disease burden, manage therapies, and thrive as they develop independent self-management skills, and become active and engaged patients. The challenges that influence the lives of AYAs are largely adaptive, such as making lifestyle modifications, adhering to complex medication regimens, and learning to navigate the adult health system. Adding to this complexity is the need for AYAs to progressively take over greater self-management responsibilities from parents. Promoting activated self-management is critically important given that this shift in health care management from parents and health care providers to the AYA is identified as key to successful adult outcomes. Peer support interventions are well-suited to address challenges theorized as critical to AYAs given the importance of peer relationships during this time. We propose a mixed-methods, five-year randomized controlled trial, that will include 225 AYAs (16-22 years) with COCCs, to test the Peer i-Coaching for Activated Self- Management Optimization (PICASO) versus an attention control group. This novel, mobile health intervention utilizes an established telephone/text based secure interface to allow AYAs access knowledge, experience, and instrumental/emotional support from a trained peer coach (18-26 years), who has already developed independence and is an active self-manager. We will determine the efficacy of the PICASO on self-management/health care navigation, patient activation, coping, emotional health and health-related quality of life across 12 months. We will explore whether age, sex, race/ethnicity, chronic condition, and/or disease severity moderate the trajectory of PICASO effects on self-management, patient activation, coping, emotional health and health-related quality of life. Lastly, we will explore mechanisms of the PICASO impact by describing AYA experiences with the intervention.

项目概要几乎所有儿童期发病的慢性疾病的预期寿命的增加都带来了独特的结果努力应对相关问题的青少年和年轻人 (AYA) 面临的挑战疾病负担、管理治疗并随着他们发展独立的自我管理而蓬勃发展技能，并成为积极主动的患者。影响人们生活的挑战 AYA 在很大程度上具有适应性，例如改变生活方式、遵守复杂的规则药物治疗方案，以及学习如何驾驭成人健康系统。添加到此复杂性是 AYA 需要逐步接管更大的自我管理来自父母的责任。鉴于以下情况，促进积极的自我管理至关重要医疗保健管理从父母和医疗保健提供者向 AYA 的转变被认为是成人成功的关键。同伴支持干预非常适合鉴于同伴关系的重要性，解决理论上对 AY 至关重要的挑战这段时间。我们提出了一项混合方法、为期五年的随机对照试验，该试验将包括 225 个具有 COCC 的 AYA（16-22 岁），以测试同伴 i-Coaching 的激活自我训练管理优化（PICASO）与注意力对照组。这本小说，手机健康干预利用已建立的基于电话/文本的安全界面来允许 AYA 从训练有素的同伴教练那里获得知识、经验和工具/情感支持（18-26岁），已经发展出独立性，是一位积极的自我管理者。我们将决定 PICASO 在自我管理/医疗保健导航、患者 12 个月内的激活、应对、情绪健康和健康相关的生活质量。我们将探讨年龄、性别、种族/民族、慢性病和/或疾病严重程度是否为中等毕加索对自我管理、患者激活、应对、情绪的影响轨迹健康和与健康相关的生活质量。最后，我们将探讨PICASO的机制通过描述 AYA 的干预经历来影响。