Asthma is condition in which a tremendous amount of health care disparities and inequities are observed. Emergency department visits, hospitalizations, and mortality rates are often three to five times higher in African Americans compared to Caucasians. While our group and others have developed programs to improve asthma outcomes for urban adolescents (age 13 - 17), no one has developed interventions for young African American adults (age 18 - 30) with asthma. This population unfortunately has one of the highest asthma prevalence rates, as well as very poor measures of asthma control. Part of this reason is due to the fact that young adulthood represents a dramatic change for an individual, where for the first time they may be responsible for their own health care, finances, education, and employment responsibilities. An internet-based interactive health communication program offers a unique way to address challenges and improve asthma care for this difficult-to-reach population. It provides a mechanism to deliver asthma education, personalize recommendations, improve communication with health care providers, and be delivered at a time convenient to the participant. Such a program would also be delivered with minimal human support, making it ideal for urban environments which may not have the resources for health educators. We will develop and pilot test such a program, which will be tailored to the challenges each individual faces. The program will be based on the self-regulation theory of behavior, which will enhance the participants'ability to self-manage this chronic condition. Focus groups will first be utilized to ensure that the participant's perspectiveis fully conveyed. The findings from the focus groups will be incorporated into a multi-session internet based intervention. This intervention will incorporate both standard asthma education delivered by video and personalized messages of how to overcome the specific challenges each individual faces. We will assess the ability of such a program to attract potential participants, retain participants who agree to participate, communicate relevant information back to the participant's health care provider, and operate seamlessly with minimal live support. We will explore any participant preferences, challenges, and obstacles to the use of the program over the entire multi-session intervention. Asthma specific outcomes will also be assessed at 3 and 6 months. These will include quality of life, asthma symptoms, asthma control, self-efficacy, and health care utilization. This exploratory study is critical to develop a consumer health informatics intervention, which we will fully evaluate in a subsequent R01 application.
The proposed research is relevant to public health because asthma is one of the most common chronic conditions in the United States, and also one which displays a tremendous amount of health care disparities. This research directly addresses the AHRQ's mission to improve the efficiency and effectiveness of health care, and to facilitate wider access to health care services.
|Speck, Aimee L; Nelson, Belinda; Jefferson, S Olivia et al. (2014) Young, African American adults with asthma: what matters to them? Ann Allergy Asthma Immunol 112:35-9|