The Efficacy of CAMP Air, a Web-based Asthma Intervention, Among Urban Adolescents with Uncontrolled Asthma

CAMP Air（一种基于网络的哮喘干预措施）对哮喘不受控制的城市青少年的疗效

基本信息

批准号：
10677621
负责人：
Jean-Marie Bruzzese
金额：
$ 77.96万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-07 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10677621
关键词：
Address Administrator Adolescence Adolescent Adopted Adoption Affect African American Aftercare Age Air Asthma Black race Caregivers Characteristics Child Childhood Chronic Disease Collection Consolidated Framework for Implementation Research Cost Analysis Cost Effectiveness Analysis Data Development Dissemination and Implementation Education Educational process of instructing Enrollment Future Goals Growth Health Health behavior Health education High Prevalence Hispanic Hispanic Americans Intervention Intervention Studies Interview Latino Learning Maintenance Measures Methodology Methods Modeling Morbidity - disease rate Online Systems Outcome Participant Pattern Pharmaceutical Preparations Pilot Projects Play Population Public Health Quality Control Quality of life Quality-Adjusted Life Years Randomized Randomized, Controlled Trials Reach, Effectiveness, Adoption, Implementation, and Maintenance Recommendation Reduce health disparities Research Resources Risk Role Schools Science Self Care Self Management Spirometry Steroids Students Symptoms Technology Teenagers Testing Translation Process Visit Youth age group clinical efficacy clinical implementation comparison control cost cost effectiveness cost per quality-adjusted life year cost-effectiveness ratio disparity reduction eHealth economic value efficacy evaluation efficacy testing ethnic minority experience follow-up graduate school health disparity populations high school implementation determinants implementation research implementation science implementation study incremental cost incremental cost-effectiveness intervention cost intervention delivery intervention effect markov model minority children mortality motivational enhancement therapy online intervention pilot trial post intervention primary outcome process evaluation programs public health relevance pulmonary function randomized trial scale up secondary outcome skills social cognitive theory success urgent care

项目摘要

PROJECT SUMMARY / ABSTRACT Background and Rationale: Asthma has high prevalence and morbidity among minority adolescents. Yet, few interventions are tested in adolescents, with only one being web-based. Given asthma's significant impact on this group, and the important role technology plays in their lives, this oversight is a significant public health concern. There is a dearth of cost-effectiveness analyses and implementation studies in asthma intervention research. This study addresses these treatment and methodological gaps. We developed and established the preliminary impact of the Controlling Asthma Program for Adolescents (CAMP Air), a seven-module personalized, e-health intervention for adolescents with uncontrolled asthma. Objective: We aim to: (1) systematically evaluate CAMP Air's efficacy in 370 urban adolescents with uncontrolled asthma; (2) assess its cost-effectiveness; and (3) identify multi-level factors associated with successful implementation of CAMP Air to inform its future scale-up. Hypotheses: Relative to controls, over 1-year CAMP Air participants will have significantly better asthma control as indicated by (a) higher scores on the Asthma Control Test (ACT) and (b) fewer asthma-related urgent care visits (primary outcomes). CAMP Air participants will also have significantly better (a) asthma self-care skills, (b) controller medication use, (c) lung function (measured by spirometry), and (d) quality of life; and significantly lower rates of (e) steroid bursts, (f) symptoms days, (g) nights woken, (h) activity limitations, and (i) school absences. We hypothesize that compared to the control, CAMP Air will have favorable value (incremental cost-effectiveness ratio<$100,000/ quality adjusted life years [QALYs]). Methods: We will enroll 370 9th – 11th graders with uncontrolled asthma from up to 19 NYC high schools. We will randomize participants to CAMP Air or an asthma education control intervention and follow them for 12 months post-treatment. Using a decision-analytic Markov model, we will estimate CAMP Air's incremental cost per QALY gained and cost per symptom free days, from both the societal and payer perspectives. For the process evaluation, which is built on the RE-AIM and Consolidated Framework for Implementation Research (CFIR) models, we will collect qualitative and quantitative data from students, caregivers, and school administrators. Together with stakeholders we will develop strategies for widespread implementation of CAMP Air, informed by our clinical efficacy, cost-effectiveness, and implementation results. Significance: The study has high public health significance because it (1) targets an understudied population impacted greatly by asthma, (2) leverages technology in a health disparate population to promote self-care, (3) assesses CAMP Air's economic value using QALYs and symptom-free days, and (4) bridges a gap between research and practice by identifying implementation factors to inform strategies for widespread implementation of CAMP Air.

项目摘要 /摘要背景和基本原理：哮喘在少数青少年的患病率和发病率很高。然而，在青少年中，很少有人测试干预措施，只有一个是基于网络的。考虑到哮喘的重大影响在这个小组中，技术在他们的生活中起着重要的作用，这种监督是重要的公共卫生忧虑。哮喘干预中的成本效益分析和实施研究死亡研究。这项研究解决了这些治疗方法和方法论差距。我们开发并建立了对青少年控制哮喘计划的初步影响（CAMP AIR），七模块针对不受控制的哮喘的青少年的个性化，电子健康干预。目的：我们的目标是：（1）系统地评估了370名城市青少年营地的效率，哮喘是不受控制的；（2）评估成本效益；（3）确定与成功实施营地有关的多层次因素告知其未来的规模。假设：相对于对照组，超过1年的营地参与者将拥有如（a）在哮喘控制测试（ACT）和（b）上表明的哮喘控制明显更好与哮喘相关的紧急护理就诊（主要结果）较少。营地参与者也将有明显的更好（a）哮喘自我护理技能，（b）控制器药物使用，（c）肺功能（通过肺活量测定法），（d）生活质量；（e）类固醇爆发的发生率明显降低，（f）症状天，（g）夜晚，（h）活动限制，以及（i）学校虐待。我们假设与对照相比，营地将具有良好的价值（增量成本效益比<$ 100,000/质量调整后的寿命[QALYS]）。方法：我们将注册370年9至11年级的学生，其哮喘从最高到19个纽约高中。我们将随机将参与者随机露营或哮喘教育控制干预措施，并跟随他们进行12 治疗后的月份。使用决策分析的马尔可夫模型，我们将估计营地的增量成本从社会和付款人的角度来看，QALY获得了QALY和每个无症状的成本。为了流程评估是建立在实施研究的重新AIM和合并框架上的（CFIR）模型，我们将从学生，看护人和学校收集定性和定量数据管理员。与利益相关者一起，我们将制定策略以扩大营地的实施空气，以我们的临床效率，成本效益和实施结果得出。意义：研究具有很高的公共卫生意义哮喘，（2）利用健康人群中的技术来促进自我保健，（3）评估营地空气使用QALY和无症状的日子的经济价值，以及（4）在研究与通过确定实施因素来练习策略，以实施营地空中的宽度。