Asthma is a chronic disease of the airways that afflicts 12-14 million individuals in the United States and accounts for large numbers of hospitalizations, emergency department visits, and missed school days. Alarming increases in asthma morbidity and mortality have accelerated interest in disparities between levels of increased resistance to breathing and perceived symptoms. For largely unknown reasons, some asthmatics seem more aware of symptoms than others despite similar degrees of airway obstruction. Asthmatic patients unable to detect acute fluctuations in airflow, those who underestimate the severity of airflow obstruction, and those with compromised lung function could be at increased risk for more frequent and severe attacks of asthma. We hypothesize that the control of asthma should improve when there is concordance between levels of airflow obstruction and the perception of increases in the resistance to breathing. We further hypothesize that changes in self-efficacy and changes in symptom perception serve to enable asthma self-management behaviors that result in improved health-related outcomes. Three hundred children with asthma between the ages of 9 and 12 years of age, and at least one parent or other legal guardian, will be enrolled in the project. We propose a 3 x 3 independent groups randomized trial to test the hypothesis that the control of asthma is improved differentially by the combination of self-monitoring experiences and perception training. The three levels of the first between-groups factor (self-monitoring experience) include: no PEFR (symptom diary only); PEFR (and symptom diary); and, PEFR with immediate feedback (and symptom diary). The three levels of the second between-groups factor (perception training) include: no training (resistance breathing only); discrimination training (without performance feedback); and, discrimination training with immediate performance feedback. We predict that demonstrated increases in the concordance between objective and subjective measures of asthma control, enabled by increases in the ability of patients to discriminate between the presence or absence of airflow obstruction, improves symptom management, functional status, and health-related quality of life in children with asthma. ? ?

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL068706-02
Application #
6832844
Study Section
Special Emphasis Panel (ZRG1-RPHB-3 (01))
Program Officer
Smith, Robert A
Project Start
2004-01-01
Project End
2007-12-31
Budget Start
2005-01-01
Budget End
2005-12-31
Support Year
2
Fiscal Year
2005
Total Cost
$462,329
Indirect Cost
Name
University of North Carolina Charlotte
Department
Public Health & Prev Medicine
Type
Schools of Allied Health Profes
DUNS #
066300096
City
Charlotte
State
NC
Country
United States
Zip Code
28223
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Janssens, Thomas; Harver, Andrew (2015) Effects of Symptom Perception Interventions on Trigger Identification and Quality of Life in Children with Asthma. Pulm Med 2015:825137
Harver, Andrew; Kotses, Harry; Ersek, Jennifer et al. (2013) Effects of feedback on the perception of inspiratory resistance in children with persistent asthma: a signal detection approach. Psychosom Med 75:729-36
Harver, Andrew; Schwartzstein, Richard M; Kotses, Harry et al. (2011) Descriptors of breathlessness in children with persistent asthma. Chest 139:832-838
Kotses, Harry; Harver, Andrew; Humphries, C Thomas (2006) Home monitoring in asthma self-management. J Asthma 43:649-55