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. The goal of this project is to develop and evaluate a tailored, school-based, computerized asthma education program for urban teenagers. The use of computers to change behavior in teenagers is extremely promising, both in reach and in efficacy. Through pilot studies, we have identified key issues in managing asthma in urban youth; e.g., smoking is not uncommon among teenagers with asthma, yet few asthma programs address smoking cessation/reduction. Our team will incorporate asthma management issues into an existing program that was successful in decreasing smoking among teenagers in a previous study to produce a more comprehensive program. This process will be greatly facilitated as the computer software serving as the template for our project has already been developed. Our research team will work in collaboration with the Health Media Research Laboratory at University of Michigan to modify the existing program. A randomized effectiveness trial will be conducted to evaluate the program in 9th-l0th graders attending six Detroit high schools where over 90 percent of students are African American and 60 percent are eligible for free lunch. Students with uncontrolled asthma will be identified, and then randomized within school to a treatment or control group. The intervention includes the essential elements needed for success in this population: use of a theory-based approach to bringing about desired behavioral changes; use of """"""""tailoring"""""""" to address individual concerns while being delivered to large groups; identification of teen behaviors that preclude effective management of asthma; delivery of the intervention through a multi-media vehicle; and provision of assistance in the form of an asthma counselor to address health care related issues students and their families may face. The treatment group will receive four tailored computer sessions and access to an asthma counselor who will respond to requests for assistance/referral. The control group will receive four computerized general asthma informational sessions. Both groups will be followed for 1 year post-intervention. The result of this research will be an evaluated, computerized asthma management program that tailors an intervention to the specific needs, motives and barriers of teens with asthma.
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