Safer Food Allergy Management for Adolescents

为青少年提供更安全的食物过敏管理

• 批准号: 9317685
• 负责人: Carolyn Christa Cannuscio
• 金额: $ 25.85万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9317685
• 关键词: Accident and Emergency department; Address; Admission activity; Adolescence; Adolescent; Adolescent Behavior; Adverse event; Advocacy; Age; Anaphylaxis; Behavior; Behavior Control; Behavior Therapy; Body Weight decreased; Cellular Phone; Cessation of life; Child; Childhood; Conflict (Psychology); Dangerousness; Data; Data Analyses; Data Collection; Eating; Effectiveness; Emergency Situation; Emergency department visit; Ensure; Epinephrine; Event; Food; Food Hypersensitivity; Fostering; Foundations; Funding; Goals; Health; Impulsivity; Incentives; Individual; Influentials; Injectable; Intervention; Life; Longitudinal Studies; Measures; Methods; Mission; Morbidity - disease rate; National Institute of Child Health and Human Development; Pediatric Hospitals; Practice Management; Prevention strategy; Procedures; Process; Public Health; Randomized; Randomized Controlled Trials; Registries; Reminder Systems; Reporting; Research; Risk; Risk-Taking; Sampling Studies; Savings; Self Management; Social support; System; Testing; Text; Unconscious State; United States; Visit; Vulnerable Populations; Work; base; behavior change; behavior test; behavioral economics; cohort; design; evidence base; experience; experimental study; financial incentive; high risk; improved; mortality; novel; peer; primary outcome; restraint; smoking cessation; social; success; successful intervention; tailored messaging; trial design

PROJECT SUMMARY Among the 15 million people with food allergies in the United States, adolescents experience the highest risk of adverse events, including death from anaphylaxis. Visits to one pediatric emergency department for anaphylaxis doubled between 2001 and 2006, suggesting a rapidly escalating public health burden. Despite this critical concern, there are few evidence-based strategies to improve food allergy management in adolescents, who must sustain three core prevention strategies: diligent avoidance of allergenic foods, consistent carrying of potentially life-saving epinephrine auto-injectors, and prompt administration of epinephrine in the event of anaphylaxis. The objective of this proposal is to develop and test interventions to encourage safer food allergy management among adolescents. The primary outcome is consistency of epinephrine-carrying, measured using cell phone photographs at randomly-timed check-ins. This study will be among the first to longitudinally track normative food allergy management practices and one of the first to test behavior change strategies. This study is the necessary next step toward a definitive nationwide longitudinal study of food allergy management in adolescents. In a cohort multiple randomized controlled trial (n=130), the study will include two experiments to test the effectiveness of text message reminders and financial incentives, using various incentive designs that have proven effective in prior behavioral economics interventions to encourage weight loss and smoking cessation. Aim 1. Test the impact of a text-message reminder system on consistency of epinephrine carrying. Aim 2. Test the impact of modest financial incentives on consistency of epinephrine carrying. Based on promising preliminary data, the central hypothesis is that, compared to controls, adolescents who receive text message reminders plus modest financial incentives will more consistently carry their epinephrine. The proposed work is aligned with NICHD's mission to ensure “that all children have the chance to achieve their full potential for healthy and productive lives.”

项目概要 在美国有 1500 万食物过敏者中，青少年面临的风险最高 不良事件，包括因过敏反应而死亡 前往一间儿科急诊室就诊。 2001年至2006年间，过敏反应增加了一倍，表明公共卫生负担迅速加重。 对于这一关键问题，很少有基于证据的策略来改善食物过敏管理 青少年必须坚持三项核心预防策略：努力避免过敏食物， 持续携带可能挽救生命的肾上腺素自动注射器，并及时注射 发生过敏反应时使用肾上腺素。 该提案的目的是开发和测试干预措施，以鼓励更安全的食物过敏管理 主要结果是使用手机测量的肾上腺素携带一致性。 这项研究将是第一个纵向跟踪规范的研究。 这项研究是食物过敏管理实践和行为改变策略的首批测试之一。 下一步是对食物过敏管理进行明确的全国性纵向研究 青少年。 在一项队列多重随机对照试验（n=130）中，该研究将包括两个实验来测试 短信提醒和财务激励的有效性，使用各种激励设计 先前的行为经济学干预措施已证明对鼓励减肥和戒烟有效。 目标 1. 测试短信提醒系统对肾上腺素携带一致性的影响。 目标 2. 测试。 基于有希望的适度经济激励对肾上腺素携带一致性的影响。 初步数据，中心假设是，与对照组相比，收到短信的青少年 提醒加上适度的经济激励将更持续地携带他们的肾上腺素。 拟议的工作与 NICHD 的使命相一致，即确保“所有儿童都有机会实现 他们充分发挥健康和富有成效的生活的潜力。”