Asthma Management Simulation for Children: Translating Theory, Methods, and Strategies to Effect Behavior Change

Shegog, Ross; Bartholomew, L. Kay; Gold, Robert S.; Pierrel, Elaine; Parcel, Guy S.; Sockrider, Marianna; Czyzewski, Danita I.; Fernández, María E.; Berlin, Nina; Abramson, Stuart L.

doi:10.1097/01.sih.0000244456.22457.e8

Cited by 6 publications

(8 citation statements)

References 56 publications

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“…The majority of the reviewed studies and interventions reported the following key targeted behaviors [ 9 - 13 ]: (1) managing environmental triggers, (2) accessing asthma services, (3) medication adherence, (4) monitoring peak flow regularly by using portable meters, (5) keeping rescue inhaler accessible, and (6) smoke reduction or cessation.…”

Section: Resultsmentioning

confidence: 99%

“…This review has shown that principles, concepts, and strategies of gamification were only applied in four studies. However, these four studies only targeted children up to 12 years old [ 13 - 16 ]. The reviewers could not cite any Internet-based asthma interventions employing gamification concepts for the adolescent or adults’ population groups.…”

Section: Resultsmentioning

confidence: 99%

“…As well, the Watch-Discover-Think-Act (WDTA) study [ 13 ] provided an applied example of how behavioral and motivation theories could be translated within the context of gamification. The WDTA program developed a game that walks through 18 real-life and four fantasy scenarios.…”

Section: Resultsmentioning

confidence: 99%

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The Use of Behavior Change Theory in Internet-Based Asthma Self-Management Interventions: A Systematic Review

Al-Durra¹,

Torio²,

Cafazzo³

2015

J Med Internet Res

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BackgroundThe high prevalence rate of asthma represents a major societal burden. Advancements in information technology continue to affect the delivery of patient care in all areas of medicine. Internet-based solutions, social media, and mobile technology could address some of the problems associated with increasing asthma prevalence.ObjectiveThis review evaluates Internet-based asthma interventions that were published between 2004 and October 2014 with respect to the use of behavioral change theoretical frameworks, applied clinical guidelines, and assessment tools.MethodsThe search term (Asthma AND [Online or Internet or Mobile or Application or eHealth or App]) was applied to six bibliographic databases (Ovid MEDLINE, PubMed, BioMed Central, ProQuest Computing, Web of Knowledge, and ACM Digital Library) including only English-language articles published between 2004 and October 2014. In total, 3932 articles matched the priori search terms and were reviewed by the primary reviewer based on their titles, index terms, and abstracts. The matching articles were then screened by the primary reviewer for inclusion or exclusion based on their abstract, study type, and intervention objectives with respect to the full set of priori inclusion and exclusion criteria; 331 duplicates were identified and removed. A total of 85 articles were included for in-depth review and the remaining 3516 articles were excluded. The primary and secondary reviewer independently reviewed the complete content of the 85 included articles to identify the applied behavioral change theories, clinical guidelines, and assessment tools. Findings and any disagreement between reviewers were resolved by in-depth discussion and through a consolidation process for each of the included articles.ResultsThe reviewers identified 17 out of 85 interventions (20%) where at least one model, framework, and/or construct of a behavioral change theory were applied. The review identified six clinical guidelines that were applied across 30 of the 85 interventions (35%) as well as a total of 21 assessment tools that were applied across 32 of the 85 interventions (38%).ConclusionsThe findings of this literature review indicate that the majority of published Internet-based interventions do not use any documented behavioral change theory, clinical guidelines, and/or assessment tools to inform their design. Further, it was found that the application of clinical guidelines and assessment tools were more salient across the reviewed interventions. A consequence, as such, is that many Internet-based asthma interventions are designed in an ad hoc manner, without the use of any notable evidence-based theoretical frameworks, clinical guidelines, and/or assessment tools.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Use of Behavior Change Theory in Internet-Based Asthma Self-Management Interventions: A Systematic Review

Al-Durra¹,

Torio²,

Cafazzo³

2015

J Med Internet Res

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“…Nurse case management can reduce asthma-related emergency care and hospitalization costs, but it is expensive [25,26]. Child-focused, Web-based asthma education and games (eHealth) have improved knowledge, asthma control, and medication adherence in the short run [27-29]. However, parents tend to overestimate their child’s medication-taking skills and actual adherence [30].…”

Section: Introductionmentioning

confidence: 99%

“…Interventions such as CHESS+CM, based on self-determination theory [32] and self-efficacy [33], provide information, social support, and skill-building tools for self-managing the disease. These interventions, which aim to increase confidence, competence, relatedness, and autonomous motivation, have been used successfully in asthma education programs [28,29,32,34]. However, the factors associated with these theories have not been tested for their mediational effects on adherence to controller medications or asthma control.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Combining Web-Based eHealth With Telephone Nurse Case Management for Pediatric Asthma Control: A Randomized Controlled Trial

Gustafson¹,

Wise²,

Bhattacharya³

et al. 2012

J Med Internet Res

128

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BackgroundAsthma is the most common pediatric illness in the United States, burdening low-income and minority families disproportionately and contributing to high health care costs. Clinic-based asthma education and telephone case management have had mixed results on asthma control, as have eHealth programs and online games.ObjectivesTo test the effects of (1) CHESS+CM, a system for parents and children ages 4–12 years with poorly controlled asthma, on asthma control and medication adherence, and (2) competence, self-efficacy, and social support as mediators. CHESS+CM included a fully automated eHealth component (Comprehensive Health Enhancement Support System [CHESS]) plus monthly nurse case management (CM) via phone. CHESS, based on self-determination theory, was designed to improve competence, social support, and intrinsic motivation of parents and children.MethodsWe identified eligible parent–child dyads from files of managed care organizations in Madison and Milwaukee, Wisconsin, USA, sent them recruitment letters, and randomly assigned them (unblinded) to a control group of treatment as usual plus asthma information or to CHESS+CM. Asthma control was measured by the Asthma Control Questionnaire (ACQ) and self-reported symptom-free days. Medication adherence was a composite of pharmacy refill data and medication taking. Social support, information competence, and self-efficacy were self-assessed in questionnaires. All data were collected at 0, 3, 6, 9, and 12 months. Asthma diaries kept during a 3-week run-in period before randomization provided baseline data.ResultsOf 305 parent–child dyads enrolled, 301 were randomly assigned, 153 to the control group and 148 to CHESS+CM. Most parents were female (283/301, 94%), African American (150/301, 49.8%), and had a low income as indicated by child’s Medicaid status (154/301, 51.2%); 146 (48.5%) were single and 96 of 301 (31.9%) had a high school education or less. Completion rates were 127 of 153 control group dyads (83.0%) and 132 of 148 CHESS+CM group dyads (89.2%). CHESS+CM group children had significantly better asthma control on the ACQ (d = –0.31, 95% confidence limits [CL] –0.56, –0.06, P = .011), but not as measured by symptom-free days (d = 0.18, 95% CL –0.88, 1.60, P = 1.00). The composite adherence scores did not differ significantly between groups (d = 1.48%, 95% CL –8.15, 11.11, P = .76). Social support was a significant mediator for CHESS+CM’s effect on asthma control (alpha = .200, P = .01; beta = .210, P = .03). Self-efficacy was not significant (alpha = .080, P = .14; beta = .476, P = .01); neither was information competence (alpha = .079, P = .09; beta = .063, P = .64).ConclusionsIntegrating telephone case management with eHealth benefited pediatric asthma control, though not medication adherence. Improved methods of measuring medication adherence are needed. Social support appears to be more effective than information in improving pediatric asthma control.Trial RegistrationClinicaltrials.gov NCT00214383; http://clinicaltrials.gov/ct2/show/NCT0021...

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Computer-Based Applications in the Management of Asthma

Shegog

Sockrider²

2009

Asthma, Health and Society

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Asthma Management Simulation for Children: Translating Theory, Methods, and Strategies to Effect Behavior Change

Cited by 6 publications

References 56 publications

The Use of Behavior Change Theory in Internet-Based Asthma Self-Management Interventions: A Systematic Review

The Use of Behavior Change Theory in Internet-Based Asthma Self-Management Interventions: A Systematic Review

The Effects of Combining Web-Based eHealth With Telephone Nurse Case Management for Pediatric Asthma Control: A Randomized Controlled Trial

Computer-Based Applications in the Management of Asthma

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