Asthma is a common chronic health condition affecting about 9 million children under the age of 18, and more than 4 million children in the U.S. have suffered current asthma episodes. Despite improvement in treatments, asthma morbidity and mortality in children and adolescents continues to be a major issue due to inadequate self-management. As an essential part of asthma treatment, self-management requires individuals' active commitment to the process of overall care to minimize asthma episodes, to optimize daily functioning and to enhance overall well-being. Adolescents are at particular risk for poor self-management that has led to high asthma morbidity. Nonetheless, intervention studies addressing adolescents' poor asthma self-management are scarce. Peer relationships play an increasingly important role in adolescents' psychosocial functioning and in influencing their health-related behaviors. Using peer leaders has been found effective in improving health decisions and behaviors in both adolescent leaders and participants. Camp programs increase cognitive capability for asthma self-management and psychosocial wellbeing through interactions with peers with similar health conditions. This study is to test an asthma self- management program led by peer leaders at a day camp for adolescents. Development of the intervention and an evaluation scheme was based on Social Cognitive Theory that underscores the interactions between environments and persons, and advocates observational learning in determining behaviors.
Study aims are: (1) to determine the feasibility of implementing the intervention using a peer-assisted asthma day camp for adolescents with asthma; (2) to examine patterns of change in knowledge, attitude, self-efficacy, perception of barriers and self-management behaviors and asthma control and quality of life in peer leaders; (3) to test the hypothesis that adolescents participating in a peer-assisted asthma camp program will report improved knowledge, attitudes, self-efficacy, self-management behaviors, decreased perception of barriers and increased asthma control and quality of life over time compared with the adult-led camp group; (4) to examine the moderating effect of personal traits (e.g., age, sex, SES, race) on intervention outcomes such as self-management behaviors, asthma morbidity and quality of life in adolescents; and (5; to conduct cost analysis to examine the effect of the intervention on self-reported health care utilization by comparing baseline data with 9-months post-camp data and the peer-led camp with the adult-camp programs. Data will be collected from 116 teens ages 13-20 with mild to severe persistent asthma, living in Central Virginia. The teens will be randomly assigned to either peer-led (intervention) or adult-led camp group. Data will be collected at baseline, immediately after the camp, and 3-, 6- and 9-months post-camp. Feasibility of the intervention program will be determined using descriptive statistics of data from program evaluation instruments. General linear models will be used to examine the effectiveness of the program. ? ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21NR009837-03
Application #
7388947
Study Section
Nursing Science: Children and Families Study Section (NSCF)
Program Officer
Huss, Karen
Project Start
2006-09-29
Project End
2009-07-31
Budget Start
2007-08-01
Budget End
2009-07-31
Support Year
3
Fiscal Year
2007
Total Cost
$167,478
Indirect Cost
Name
University of Rochester
Department
Type
Schools of Nursing
DUNS #
041294109
City
Rochester
State
NY
Country
United States
Zip Code
14627
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Rhee, Hyekyun; Pesis-Katz, Irena; Xing, Jingping (2012) Cost benefits of a peer-led asthma self-management program for adolescents. J Asthma 49:606-13
Rhee, Hyekyun; Belyea, Michael J; Halterman, Jill S (2011) Adolescents' perception of asthma symptoms and health care utilization. J Pediatr Health Care 25:105-13
Rhee, Hyekyun; Belyea, Michael J; Hunt, John F et al. (2011) Effects of a peer-led asthma self-management program for adolescents. Arch Pediatr Adolesc Med 165:513-9
Rhee, Hyekyun; Belyea, Michael J; Brasch, Judith (2010) Family support and asthma outcomes in adolescents: barriers to adherence as a mediator. J Adolesc Health 47:472-8
Rhee, Hyekyun; Belyea, Michael J; Ciurzynski, Susan et al. (2009) Barriers to asthma self-management in adolescents: Relationships to psychosocial factors. Pediatr Pulmonol 44:183-91
Rhee, Hyekyun; Belyea, Michael J; Elward, Kurtis S (2008) Patterns of asthma control perception in adolescents: associations with psychosocial functioning. J Asthma 45:600-6
Rhee, Hyekyun; Ciurzynski, Susan M; Yoos, H Lorrie (2008) Pearls and pitfalls of community-based group interventions for adolescents: lessons learned from an adolescent asthma cAMP study. Issues Compr Pediatr Nurs 31:122-35