Using Mobile Health to Improve Asthma Self-Management in Early Adolescence: A Pilot Randomized Controlled Trial

David A Fedele; J Graham Thomas; Andrew McConville; Elizabeth L McQuaid; Sara Voorhees; David M Janicke; Mutasim Abu-Hasan; Xiaofei Chi; Matthew J Gurka

doi:10.1016/j.jadohealth.2021.06.011

Using Mobile Health to Improve Asthma Self-Management in Early Adolescence: A Pilot Randomized Controlled Trial

J Adolesc Health. 2021 Dec;69(6):1032-1040. doi: 10.1016/j.jadohealth.2021.06.011. Epub 2021 Jul 15.

Authors

David A Fedele¹, J Graham Thomas², Andrew McConville³, Elizabeth L McQuaid⁴, Sara Voorhees⁵, David M Janicke⁵, Mutasim Abu-Hasan⁶, Xiaofei Chi⁷, Matthew J Gurka⁷

Affiliations

¹ Department of Clinical & Health Psychology, University of Florida, Gainesville, Florida. Electronic address: dfedele@phhp.ufl.edu.
² Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, Alpert Medical School, Brown University, Providence, Rhode Island.
³ Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas.
⁴ Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island; Department of Pediatrics, Alpert Medical School, Brown University, Providence, Rhode Island.
⁵ Department of Clinical & Health Psychology, University of Florida, Gainesville, Florida.
⁶ Pediatric Pulmonary Division, Department of Pediatrics, Sidra Medicine, Doha, Qatar.
⁷ Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida.

PMID: 34274211
DOI: 10.1016/j.jadohealth.2021.06.011

Abstract

Purpose: Early adolescence is an important developmental period where youth take primary responsibility for asthma self-management. Helpful caregiver support during this time is pivotal in determining whether early adolescents successfully develop asthma self-management behaviors. AIM2ACT is a dyadic mobile health intervention designed to increase helpful caregiver support as early adolescents engage in asthma self-management behaviors. We conducted a pilot randomized controlled trial to determine the feasibility and acceptability of AIM2ACT and conduct preliminary tests of efficacy.

Methods: We randomized adolescents (12-15 years old) and a caregiver to receive AIM2ACT (n = 17) or a self-guided attention control condition (n = 16) for 20 weeks. We conducted assessment visits at baseline, postintervention, and 4-month follow-up. Outcomes included family asthma management (primary outcome), adolescent asthma control, lung function (forced expiratory volume in 1 second), asthma-related quality of life, asthma management self-efficacy, and family communication.

Results: We randomized 33 dyads and had 100% retention in the trial among AIM2ACT participants. Dyads frequently engaged with AIM2ACT (M = 21 days for adolescents, 32.65 days for caregivers) and reported very high satisfaction with content, functionality, and helpfulness. Participants randomized to AIM2ACT had significant improvements in asthma control scores (p = .04) compared to control that surpassed the minimally clinically important difference threshold. Although not statistically significant, the magnitude of improvements in family asthma management, asthma-related quality of life, and family communication was larger in the AIM2ACT group.

Conclusions: AIM2ACT is a feasible and acceptable dyadic mobile health asthma self-management intervention that improves asthma control.

Trial registration: ClinicalTrials.gov NCT02302040.

Keywords: Applications; Apps; Asthma; Self-management; mHealth.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Asthma* / therapy
Child
Humans
Pilot Projects
Quality of Life
Self-Management*
Telemedicine*

Associated data

ClinicalTrials.gov/NCT02302040

Grants and funding

R21 HD083830/HD/NICHD NIH HHS/United States