Browsing by Author "Brody, Aaron"
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- ItemThe Detroit Young Adult Asthma Project: Proposal for a Multicomponent Technology Intervention for African American Emerging Adults With Asthma.(0000-00-00) MacDonell, Karen; Naar, Sylvie; Gibson-Scipio, Wanda; Bruzzese, Jean-Marie; Wang, Bo; Brody, AaronBACKGROUND Racial and ethnic minority youth have poorer asthma status than white youth even after controlling for socioeconomic variables Proper use of asthma controller medications is critical in reducing asthma mortality and morbidity The clinical consequences of poor asthma management include increased illness complications excessive functional morbidity and fatal asthma attacks There are significant limitations in research on interventions to improve asthma management in racial minority populations particularly minority adolescents and young adults although illness management tends to deteriorate after adolescence during emerging adulthood the unique developmental period beyond adolescence but before adulthood OBJECTIVE The objective of the pilot study was to test the feasibility acceptability and signals of efficacy of an intervention targeting adherence to controller medication in African American youth ages 18 29 with asthma All elements of the protocol were piloted in a National Heart Lung and Blood Institute NHLBI funded pilot study 1R34HL107664 MacDonell Results suggested feasibility and acceptability of the protocol as well as proof of concept We are now ready to test the intervention in a larger randomized clinical trial METHODS The proposed study will include 192 African American emerging adults with moderate to severe persistent asthma and low controller medication adherence recruited from clinic emergency department and community settings Half of the sample will be randomized to receive a multicomponent technology based intervention targeting adherence to daily controller medication The multicomponent technology based intervention consists of 2 components 1 2 sessions of computer delivered motivational interviewing targeting medication adherence and 2 individualized text messaging focused on medication adherence between the sessions Text messages will be individualized based on ecological momentary assessment The remaining participants will complete a series of computer delivered asthma education modules matched for length location and method of delivery of the intervention session Control participants will also receive text messages between intervention sessions Message content will be the same for all control participants and contain general facts about asthma not tailored RESULTS It is hypothesized that youth randomized to multicomponent technology based intervention will show improvements in medication adherence primary outcome and asthma control secondary outcome compared with comparison condition at all postintervention follow ups 3 6 9 and 12 months The proposed study was funded by NHLBI from September 1 2016 through August 31 2021 CONCLUSIONS This project will test a brief technology based intervention specifically targeting adherence to asthma controller medications in an under researched population African American emerging adults If successful our multicomponent technology based intervention aimed at improving adherence to asthma medications has the potential to improve quality of life of minority emerging adults with asthma at relatively low cost It could eventually be integrated into clinical settings and practice to reach a large number of emerging adults with asthma TRIAL REGISTRATION ClinicalTrials gov NCT03121157 https clinicaltrials gov ct2 show NCT03121157 Archived by WebCite at http www webcitation org 6wq4yWHPv
- ItemImproving Blood Pressure Among African Americans With Hypertension Using a Mobile Health Approach (the MI-BP App): Protocol for a Randomized Controlled Trial.(0000-00-00) Buis, Lorraine R; Dawood, Katee; Kadri, Reema; Dawood, Rachelle; Richardson, Caroline R; Djuric, Zora; Sen, Ananda; Plegue, Melissa; Hutton, David; Brody, Aaron; McNaughton, Candace D; Brook, Robert D; Levy, PhillipBACKGROUND African Americans shoulder significant disparities related to hypertension HTN which is a serious public health problem in the city of Detroit Michigan where more than 80 of the population is African American Connectivity through smartphones use of home blood pressure BP monitoring and newly developed mobile health mHealth interventions can facilitate behavioral changes and may improve long term self care for chronic conditions but implementation of a combined approach utilizing these methods has not been tested among African American patients with uncontrolled HTN Since African Americans are more likely than other racial or ethnic subgroups to utilize the emergency department ED for ambulatory care this presents an opportunity to intervene on a population that is otherwise difficult to reach OBJECTIVE The MI BP app aims to reduce health disparities related to HTN in the community by employing a user centered intervention focused on self BP monitoring physical activity reduced sodium intake and medication adherence We seek to test the efficacy of MI BP an mHealth app for HTN self management on BP control primary aim physical activity sodium intake and medication adherence secondary aim in African Americans with HTN This study also seeks to evaluate the cost effectiveness of MI BP when compared with usual care methods METHODS This is a 1 year randomized controlled trial that will recruit individuals who have uncontrolled HTN from 2 EDs in the city of Detroit with a planned sample size of 396 randomized participants To be eligible for inclusion potential participants must be African American 25 to 70 years old previously diagnosed with HTN have a smartphone compatible with MI BP and have uncontrolled BP at triage and on repeat measurement at least 1 hour post triage vitals Once a participant is deemed eligible all study procedures and subsequent follow up visits 8 in total are conducted at the Wayne State University Clinical Research Service Center We seek to determine the effect of MI BP on BP for 1 year using BP control and mean systolic BP as coprimary outcomes and physical activity sodium intake and medication adherence as secondary outcomes compared with usual care controls RESULTS Recruitment for this study began in January 2018 The study will continue through 2021 CONCLUSIONS As the first of its kind conducted in an ED setting MI BP was designed to document the efficacy and acceptability of a multicomponent mHealth approach to help African Americans with uncontrolled BP modify their lifestyle to better manage their HTN We expect to lay the foundation to sustainably reduce HTN related health disparities through better integration of multiple behavior self monitoring and improve outcomes for those who traditionally rely on the ED for chronic disease care TRIAL REGISTRATION ClinicalTrials gov NCT02360293 http clinicaltrials gov ct2 show NCT02360293 INTERNATIONAL REGISTERED REPORT IDENTIFIER IRRID RR1 10 2196 12601