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Improving asthma outcomes through stress management
Investigator (PI): Teach, Stephen
Performing Organization (PO): (Current): Children's National Health System, Children's Research Institute / (202) 476-5000
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2014
Final Year: 2019
Record Source/Award ID: PCORI/AS-1307-05284
Funding: Total Award Amount: $2,287,149
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Asthma attacks, emergency department (ED) visits, and hospital admissions are much more common among African American (AA), Hispanic, and poor children living in cities than among other children with asthma. When parents are unable to follow asthma management plans, and particularly when they do not consistently give their children their daily inhaled controller medications, asthma outcomes are even worse. We have developed a unique program that follows national guidelines for asthma care and that focuses on urban youth with asthma who make frequent ED visits. While patients in the program take more daily controller medications than those not in the program, actual use remains just under 50%. The link between psychosocial stress (life's daily hassles) and poor asthma outcomes is clear. Of note, stress may lower daily use of controller medications. National experts and other stakeholders cite a pressing need to reduce parents' stress in order to increase their children's use of daily controller medications. Few studies exist of interventions to manage stress among parents of youth with asthma, however. Of note, interventions using several approaches to asthma care at once may prove crucial to such efforts. For example, cell phones are now being used to help manage chronic diseases, including pediatric asthma. No studies have examined a parental stress management program using cell phones as a means to increase medication usage. Our overall aim is therefore to work with parents and other stakeholders to develop and test a patient-centered and culturally appropriate program targeting parents of at-risk urban youth with severe asthma. It will use several approaches to reduce stress and to increase medication use including a cell phone tool that allows the research team to track home medication use and to help when that use drops off. We will do this by: stage 1: a) developing and refining a program of highly individualized stress management for the parents of urban, AA; and/or Hispanic youth with uncontrolled asthma; b) testing a cell phone tool that allows in-home tracking of controller medication use and real-time help when it falls; and stage 2 conducting a research study comparing our current program of asthma care to our current program plus parental stress management with home tracking of controller medication use in a group of 250 AA and/or Hispanic youth aged 4-12 years. We predict that the stress management program will increase the amount of daily controller medications taken. We will look at other outcomes including wheezing, cough, ED visits, hospitalizations, missed school days, parental/child stress, parental satisfaction, and parent/child quality of life. The potential for this research to determine if a stress management program plus home tracking of medication use can further improve guideline-based care in an at-risk population is very important. It will give parents and doctors more choices in caring for children.
MeSH Terms:
  • African Americans
  • Asthma /*drug therapy
  • /ethnology
  • Cell Phone
  • Child
  • Cultural Characteristics
  • Emergency Service, Hospital
  • Hispanic Americans
  • Hospitalization
  • Humans
  • * Medication Adherence
  • Outcome Assessment, Health Care
  • Parents
  • Patient Satisfaction
  • Patient-Centered Care
  • Program Development
  • Quality of Life
  • Reminder Systems
  • United States
  • Urban Population
Country: United States
State: District of Columbia
Zip Code: 20010
UI: 20143413
CTgovId: NCT02374138
Project Status: Completed
Record History: ('2018: Project extended to 2019',) (' 2017: Project extended to 2018 and changed Title. Previous Title: Parent-centered innovations to improve adherence in at-risk youth with asthma',)