Although most adverse outcomes due to asthma can be prevented through appropriate medical care and disease management, adolescents continue to be at high risk for negative consequences of uncontrolled asthma. Two contributing factors are 1) Failure of adolescents to understand Asthma as a chronic illness requiring scheduled medication rather than episodic responses to symptoms; 2) Failure of parents to transfer responsibility and skills for disciplined self-management when children transition into adolescence. When responsibility for decision-making and health is being turned over from parents to their children, adolescents have an opportunity to learn and practice the self-management skills necessary to maintain their health throughout their lifetime. Through the """"""""Self-Management Technology for Asthmatic Teens (STAT)"""""""" project, State of the Art, Inc. proposes the development of a coordinated multimedia resource that uses """"""""teen friendly"""""""", familiar and widely accessible video-, web-, and mobile phone-based components to provide adolescents with the knowledge and tools necessary to self-manage their asthma. Utilizing these familiar, interactive technologies enables delivery of a critical asthma self-management message into a realm of adolescent comfort, ownership and control. STAT materials will take full advantage of the stimulus of interactivity inherent and alluring to youth in these multiple and complementary technological platforms. Adolescents will be able to tailor these interactive tools to their preferences and specific needs through the resource's website, including message platform (email, SMS/text messaging, instant messaging), frequency of reminder messages, and types of information and self-management tools needed. This resource strives to increase asthma control by helping adolescents take responsibility for their health and learn to self-manage their asthma employing technologies with which they are familiar and comfortable. To accomplish this long- term objective, the STAT resource aims to increase self-management practices, improve quality of life, and decrease asthma-related symptoms and severity among adolescents ages 12-17. In Phase I, State of the Art, Inc. will conduct research with multidisciplinary professionals who work in adolescent health and asthma and respiratory conditions as well as with adolescents and parents. This research will be used to a) conceptualize the structure and content of the resource, b) develop """"""""teen friendly"""""""" sample messages and in-depth plans for materials, and c) examine the feasibility and validity of these messages and proposed features. Initially, key informant interviews with professionals, adolescents, and parents will be conducted to 1) examine the lessons learned from research- and community-based efforts, 2) determine what practical applications of research and intervention best practices can be applied to STAT, 3) learn about parents' current experience of helping an adolescent manage their asthma, 4) learn about adolescents' current experience in managing their own asthma, and 5) learn what current resources are being used to aid in adolescent asthma self-management. Sample messages and in-depth plans for materials (concept and creative plans) will be developed based on the knowledge gained from these culturally diverse key informant interviews and from advisor guidance. Once these plans are developed, focus groups with adolescents will help ensure that the planned materials and messages match the values and needs of the target audience and their caregivers. Groups will be conducted by trained moderators using standard focus group methods and cross-group comparisons will be made among groups. Concept and creative plans will be revised incorporating recommendations from the focus groups prior to submission of a Phase II application that will outline the development and evaluation of the full-scale STAT resource. Public Health Relevance: Asthma is one of the more pervasive and costly chronic childhood diseases in the United States and a major cause of childhood disability. It is also a disease that is manageable with disciplined and proper use of medications of proven efficacy. In childhood, parents provide much of this disease management discipline. In adolescence, as children spend less time under their parents' supervision, management of asthma transitions from parents to their affected children. Many adolescents are unprepared for this shift, placing a huge burden on both adolescents and their families; limiting their abilities to sleep, learn, and accomplish other undertakings. Poor self-management also may require the use of complex and expensive emergency medical treatments that result in other unnecessary direct and indirect costs from missed school and work days. While many asthma-related problems could be averted through control and self-management strategies, low rates of adherence to these techniques is common, especially among adolescents. By empowering adolescents to self- manage and control their asthma, """"""""Self-Management Technology for Asthmatic Teens (STAT)"""""""" research and resources have the potential to help adolescents take responsibility for their health and prevent potentially life- threatening asthma-related outcomes; thereby reducing the severity of asthma, related comorbidities, and associated healthcare costs throughout their lives. ? ? ?
