Improving Asthma Care Together (IMPACT): A Shared Management Pilot Study

共同改善哮喘护理 (IMPACT)：共享管理试点研究

• 批准号: 10038119
• 负责人: Jennifer Sonney
• 金额: $ 24.67万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-09 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10038119
• 关键词: 11 year old; Address; Adoption; Affect; Age-Years; Asthma; Benchmarking; Caring; Child; Childhood; Childhood Asthma; Chronic; Clinical; Clinical Trials; Data; Development; Disease; Eligibility Determination; Enrollment; Failure; Family; Future; Health; Health Technology; Health behavior; Hospitalization; Human; Impairment; Intervention; Interview; Measures; Mobile Health Application; Monitor; Morbidity - disease rate; Outcome; Parents; Participant; Pharmaceutical Preparations; Pilot Projects; Problem Solving; Quality of life; Randomized Controlled Trials; Regimen; Reporting; Research Priority; Risk; Sampling; School-Age Population; Schools; Self Efficacy; Self Management; Social Environment; Structure; Surveys; Symptoms; Testing; Time; Treatment Efficacy; Voice; Work; Youth; airway remodeling; base; design; family management; functional disability; health application; health care service utilization; health management; improved; innovation; medication compliance; mortality; primary outcome; programs; prototype; recruit; response; secondary outcome; skills; successful intervention; symptom science; therapy design; tool; treatment as usual; trial comparing; usability

PROJECT SUMMARY/ABSTRACT Asthma is the most common chronic condition of childhood, and is the leading cause of hospitalizations and school absences among school-age children. More than 50% of children are nonadherent to asthma management regimens, leading to worsened quality of life, school absences, higher healthcare utilization, and permanent airway damage. There is a critical gap in childhood asthma management interventions wherein the majority focus primarily on parents and use a prescriptive, top-down approach. Failure to include the child is a critical omission. School-age children spend increasing time away from their parents and have the developmental capacity to be active participants in their own asthma management. Furthermore, existing interventions fail to account for the variability among family management priorities. Not only are families lacking the tools they need to manage asthma successfully, but also to gradually shift responsibility to the youth who eventually will assume sole responsibility for their lifelong condition. To meet the asthma management needs of children and parents, successful interventions need to target management skills of both parent and child, tailor the intervention to the priorities of the family, and use an accessible format. Previously, our team worked with parent-child dyads to design a tailored asthma shared management mobile health application, Improving Asthma Care Together (IMPACT) that pairs the parent and child together as a team to manage the child's asthma. For the proposed study, we aim to refine and test IMPACT with 7-11-year-old children with persistent asthma and their parents. The initial feasibility, acceptability and efficacy of IMPACT will be tested in a pilot randomized controlled trial comparing IMPACT to an enhanced usual care control with a sample of 46 children with persistent asthma and their parents. Parent and child asthma self-efficacy, shared management (asthma responsibility) and quality of life will be measured in both study groups before and after the intervention. Development of an effective, tailored shared management health application has the potential to improve health outcomes of children living with asthma, as well as establish lifelong self-management skills. Results from this study will guide future intervention refinement, inform assessment and recruitment strategies, and provide preliminary evidence for the design of a full-scale clinical trial. IMPACT is an accessible and scalable intervention that addresses a critical clinical gap: shared asthma management among children with asthma and their parents.

项目概要/摘要 哮喘是儿童期最常见的慢性疾病，也是住院的主要原因 学龄儿童缺勤。超过 50% 的儿童不患有哮喘 管理方案，导致生活质量恶化、缺课、医疗保健利用率提高，以及 永久性气道损伤。儿童哮喘管理干预措施存在严重差距，其中 大多数人主要关注父母并使用规定性的、自上而下的方法。未能将孩子包括在内是一种 关键遗漏。学龄儿童离开父母的时间越来越长， 积极参与自己的哮喘管理的发展能力。此外，现有的 干预措施未能考虑到家庭管理优先事项之间的差异。不仅家庭缺乏 成功控制哮喘所需的工具，同时也逐渐将责任转移给年轻人 最终将对他们的终身状况承担全部责任。 为了满足儿童和家长的哮喘管理需求，成功的干预措施需要 针对父母和孩子的管理技能，根据家庭的优先事项调整干预措施，并使用 一种可访问的格式。此前，我们的团队与亲子二人合作，设计了量身定制的哮喘共享 管理移动健康应用程序，与家长配对的共同改善哮喘护理 (IMPACT) 和孩子一起作为一个团队来控制孩子的哮喘。对于拟议的研究，我们的目标是完善和测试 对患有持续性哮喘的 7-11 岁儿童及其父母的影响。初步可行性， IMPACT 的可接受性和有效性将在一项随机对照试验中进行测试，该试验将 IMPACT 与 对 46 名患有持续性哮喘的儿童及其父母进行了强化的常规护理控制。家长 将衡量儿童哮喘的自我效能、共同管理（哮喘责任）和生活质量 两个研究组在干预前和干预后的情况。 开发有效的、定制的共享管理健康应用程序有可能 改善哮喘儿童的健康状况，并建立终生的自我管理技能。 这项研究的结果将指导未来的干预细化，为评估和招募策略提供信息， 并为全面临床试验的设计提供初步证据。 IMPACT 是一个易于访问且 可扩展的干预措施解决了关键的临床差距：患有哮喘的儿童之间共享哮喘管理 哮喘和他们的父母。