Applying Interactive Mobile Health to Asthma Care in Teens (AIM2ACT)
| Status: | Completed |
|---|---|
| Conditions: | Asthma |
| Therapuetic Areas: | Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 12 - 15 |
| Updated: | 3/16/2019 |
| Start Date: | December 2015 |
| End Date: | February 22, 2019 |
mHealth Approach to Collaborative Asthma Management for Teens & Parents
The aims of this application are to develop and test AIM2ACT, a mobile health (mHealth) tool,
delivered via smartphones, that fosters helpful caregiver support as early adolescents (ages
12-15) with persistent asthma develop and master asthma self-management behaviors. To
facilitate helpful caregiver support, AIM2ACT uses mHealth technology to determine tailored
intervention targets for each family. AIM2ACT then helps caregiver/adolescent dyads set
asthma management goals by automatically guiding families through a structured process that
includes the supportive behavioral management strategies of goal setting, contingency
management, and problem solving communication. Skills-training videos for adolescents and
caregivers provide guidance on how to complete each collaborative asthma management
component.
AIM2ACT will be developed through feedback from an advisory board of adolescent-caregiver
dyads from the target user population and a pediatric pulmonologist. Following advisory board
feedback, the investigators will conduct a pilot randomized controlled trial of AIM2ACT with
50 early adolescents with poorly controlled asthma, ages 12-15 years, and a caregiver.
Families will be randomly assigned to receive AIM2ACT or a self-guided condition for a 4
month intervention period. Participants in the self-guided condition will be given general
information on supportive behavioral management techniques they can use to target improvement
in asthma self-management behaviors. Outcomes include whether participants prefer AIM2ACT or
the self-guided condition. Additionally, AIM2ACT and the self-guided condition will be
compared to see if there are differences in changes in family asthma management (primary
outcome), lung function, asthma control, asthma-related quality of life, and self-efficacy
for asthma management. Data will be collected before participants are assigned to AIM2ACT or
the self-guided control, post-treatment, and 4 month follow-up time points.
delivered via smartphones, that fosters helpful caregiver support as early adolescents (ages
12-15) with persistent asthma develop and master asthma self-management behaviors. To
facilitate helpful caregiver support, AIM2ACT uses mHealth technology to determine tailored
intervention targets for each family. AIM2ACT then helps caregiver/adolescent dyads set
asthma management goals by automatically guiding families through a structured process that
includes the supportive behavioral management strategies of goal setting, contingency
management, and problem solving communication. Skills-training videos for adolescents and
caregivers provide guidance on how to complete each collaborative asthma management
component.
AIM2ACT will be developed through feedback from an advisory board of adolescent-caregiver
dyads from the target user population and a pediatric pulmonologist. Following advisory board
feedback, the investigators will conduct a pilot randomized controlled trial of AIM2ACT with
50 early adolescents with poorly controlled asthma, ages 12-15 years, and a caregiver.
Families will be randomly assigned to receive AIM2ACT or a self-guided condition for a 4
month intervention period. Participants in the self-guided condition will be given general
information on supportive behavioral management techniques they can use to target improvement
in asthma self-management behaviors. Outcomes include whether participants prefer AIM2ACT or
the self-guided condition. Additionally, AIM2ACT and the self-guided condition will be
compared to see if there are differences in changes in family asthma management (primary
outcome), lung function, asthma control, asthma-related quality of life, and self-efficacy
for asthma management. Data will be collected before participants are assigned to AIM2ACT or
the self-guided control, post-treatment, and 4 month follow-up time points.
As a participant in the study the following will take place:
Questionnaires will be filled out which will include medical history, including asthma
symptoms and control, and questions related to quality of life. In addition, an interview
will be completed which assesses the participants asthma management.
During this visit a brief training on how to complete lung function testing with a portable
device will be demonstrated. The participant will breathe into twice per day for 14 days and
then the device will be collected at the end of the 14 day period.
Randomization A computer will randomly chose one of the two programs; Program A or Program B.
Random assignment is like rolling a dice to decide which group a person is assigned to. Both
Program A and B are 4 months in length.
Program A the participant will answer questions about asthma management for a one-week period
on a smartphone program. A smartphone can be provided for the duration of the study. After
the one-week period, a report will be received on the smartphone about areas of asthma
management that are going well and areas that may be in need of improvement. Next, brief
meetings with study personnel to help determine things that will help improve asthma
management. This information will be entered into a smartphone program. The participant will
continue to use the smartphone program for a four month period.
Program B the participant answer questions about asthma for a one-week period on a paper and
pencil diary. The participant will receive a paper copy of feedback from study personnel
related to areas of asthma management that are going well and areas that may be in need of
improvement. The participant will then be given information on techniques they can use to
target identified areas for improvement. The participant will be encouraged to use these
strategies to for a 4 month period.
Questionnaires will be filled out which will include medical history, including asthma
symptoms and control, and questions related to quality of life. In addition, an interview
will be completed which assesses the participants asthma management.
During this visit a brief training on how to complete lung function testing with a portable
device will be demonstrated. The participant will breathe into twice per day for 14 days and
then the device will be collected at the end of the 14 day period.
Randomization A computer will randomly chose one of the two programs; Program A or Program B.
Random assignment is like rolling a dice to decide which group a person is assigned to. Both
Program A and B are 4 months in length.
Program A the participant will answer questions about asthma management for a one-week period
on a smartphone program. A smartphone can be provided for the duration of the study. After
the one-week period, a report will be received on the smartphone about areas of asthma
management that are going well and areas that may be in need of improvement. Next, brief
meetings with study personnel to help determine things that will help improve asthma
management. This information will be entered into a smartphone program. The participant will
continue to use the smartphone program for a four month period.
Program B the participant answer questions about asthma for a one-week period on a paper and
pencil diary. The participant will receive a paper copy of feedback from study personnel
related to areas of asthma management that are going well and areas that may be in need of
improvement. The participant will then be given information on techniques they can use to
target identified areas for improvement. The participant will be encouraged to use these
strategies to for a 4 month period.
Inclusion Criteria:
- Lives in residence of caregiver,
- adolescent meets screening criteria for current persistent asthma,
- adolescent has uncontrolled asthma as indicated by a score of ≤ 19 on the Asthma
Control Test,
- poorly controlled asthma according to National Heart, Lung, and Blood Institute
(NHLBI) guidelines
- adolescent-caregiver dyad speak and read English
Exclusion Criteria:
- family is currently involved in an asthma management intervention, or
- adolescent has well controlled asthma as indicated by a score of ≥ 20 on the Asthma
Control Test.
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