Tailored Asthma Management for Urban Teens

Study Overview
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Brief Summary
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The purpose of this project is to refine and further evaluate an online asthma management and education program for urban teenagers. This project is a continuation of Puff City I, a project piloting and evaluating a tailored, school-based, computerized asthma education program for urban teenagers. In this second phase of research, a new version of software (Puff City II) will be created that will target resistance to change and relapse, and using a tested, theory-based approach to student recruitment, conduct a randomized trial to test the efficacy of this new software.

Detailed Description
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BACKGROUND: Teenagers are among an age group that has seen dramatic increases in deaths from asthma. In Detroit, asthma death rates for teenagers are high relative to younger ages, despite a higher prevalence in the latter age group. Early studies suggest that inadequate asthma management plays a significant role in these grim statistics. DESIGN NARRATIVE: The study hypothesis is that students randomized to the intervention group will have lower asthma-related morbidity as determined by fewer emergency department visits and hospitalizations at the time of the 12-month follow-up. Based on a second hypothesis of better functional status among students randomized to the intervention group, secondary outcomes include fewer symptom-days, symptom-nights, school days missed, and days of restricted activity at the time of the 12-month follow-up. In addition, it is hypothesized that students in the intervention group will have higher scores on the Juniper Pediatric Quality of Life scale at 12 months. Finally, it is hypothesized that intervention students would exhibit positive changes in adherence behavior, having a rescue inhaler nearby, and smoking at the 12-month follow-up.

Official Title
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Tailored Asthma Management for Urban Teens

Conditions
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Asthma

Intervention / Treatment
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* Behavioral: Tailored Web-based Asthma Management
* Behavioral: Generic web-based asthma education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: A physician diagnosis of asthma AND recent asthma symptoms, health care utilization for asthma, and/or use of medication (or refills of medication) to alleviate asthma symptoms OR No physician diagnosis of asthma AND positive responses to items selected from the International Study of Asthma and Allergy in Children (ISAAC) survey AND asthma symptoms similar to those used in the Expert Panel II for classification of mild intermittent asthma Exclusion Criteria: Does not meet asthma symptom criteria

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br>Receives tailored web-based program | Behavioral: Tailored Web-based Asthma Management<br>* Web-based asthma management<br>|
| Active Comparator: 2<br>Control students receive existing web-based, generic asthma education | Behavioral: Generic web-based asthma education<br>* 4 computer sessions over a period of 180 days<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Asthma-related morbidity |  | Measured at baseline, 6 months, and 12 months with the latter being the timepoint of interest | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Symptom-days |  | Measured at baseline, 6 months, and 12 months with the latter being the timepoint of interest | 
| Symptom-nights |  | Measured at baseline, 6 months, and 12 months with the latter being the timepoint of interest | 
| School days missed |  | Measured at baseline, 6 months, and 12 months with the latter being the timepoint of interest | 
| Days of restricted activity |  | Measured at baseline, 6 months, and 12 months with the latter being the timepoint of interest | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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urban, adolescents, African American, web-based, computer tailoring, school based