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：
9158851
负责人：
Karen MacDonell
金额：
$ 56.01万
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/9158851
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 Healthcare Incidence Intervention Knowledge Learning Module Length Life Life Experience 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 Recruitment Activity Regimen Reporting Research Respiratory physiology Risk Behaviors Sampling Self Efficacy Series Symptoms Technology Testing Text Time United States Universities Urban Population Work Youth age group asthma inhaler base cost diaries eHealth efficacy testing emerging adult emerging adulthood ethnic minority population high risk improved inner city innovation medication compliance mortality motivational enhancement therapy post intervention primary outcome programs racial minority 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).

即使在控制了社会经济变量。正确使用哮喘控制药物对于降低哮喘死亡率至关重要和发病率。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。研究存在重大局限性改善少数族裔人群（尤其是少数族裔青少年）哮喘管理的干预措施和年轻人，尽管青春期后的疾病管理往往会恶化成年期，青春期之后、成年之前的独特发展时期。的所有元素拟议的研究方案在 NHLBI 资助的试点研究 (1R34HL107664-01A1 MacDonell) 中进行了试点。结果表明了研究方案的可行性和可接受性以及概念验证。我们现在准备在更大规模的随机临床试验中测试干预措施。拟议的研究将包括 192 名非洲人患有中度至重度持续性哮喘且控制药物依从性较低的美国新兴成年人从诊所和急诊室招募。一半的样本将被随机分配基于多成分技术的干预（MCTI），目标是坚持每日控制药物。这 MCTI 由两个部分组成：1) 2 场计算机提供的动机性访谈目标药物依从性，以及 2) 侧重于患者之间药物依从性的个性化短信会议。短信将根据生态瞬时评估 (EMA) 进行个性化。这剩下的一半参与者将完成一系列匹配的计算机提供的哮喘教育模块了解干预课程的时长、地点和实施方法。控制参与者还将收到干预会话之间的短信。所有控制参与者的消息内容都相同，并且包含有关哮喘的一般事实（未定制）。将从底特律医疗中心招募年轻人密歇根州底特律唯一的大学附属医疗中心。假设青少年被随机分配到 MCTI 将显示药物依从性（主要结果）和哮喘控制（次要结果）方面的改善结果）与所有干预后随访（3、6、9 和 12 个月）的比较条件进行比较。