Evaluation of a web-based asthma management intervention program for urban teenagers: Reaching the hard to reach

Christine L.M. Joseph, Dennis Randall Ownby, Suzanne L. Havstad, Jacqueline Saltzgaber, Shannon Considine, Dayna Johnson, Ed Peterson, Gwen Alexander, Mei Lu, Wanda Gibson-Scipio, Christine Cole Johnson

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Purpose: Asthma interventions targeting urban adolescents are rare, despite a great need. Motivating adolescents to achieve better self-management of asthma is challenging, and the literature suggests that certain subgroups are more resistant than others. We conducted a school-based, randomized controlled trial (RCT) to evaluate Puff City, a Web-based, tailored asthma intervention, which included a referral coordinator, and incorporated theory-based strategies to target urban teens with characteristics previously found to be associated with lack of behavior change. Methods: To identify eligible teens, we administered questionnaires on asthma diagnoses and symptoms to ninth through 12th graders of participating schools during a scheduled English class. We randomized eligible, consenting students to Puff City (treatment) or generic asthma education (control). Results: We randomized 422 students (98% African-American, mean age = 15.6 years). At 12-month follow-up, adjusted odds ratios (aORs) (95% confidence intervals) indicated intervention benefit for treatment teens for symptom-days and restricted activity days (analyzed as categorical variables) as aOR =.49 (.24-.79), p =.006 and.53 (.32-.86), p =.010, respectively. Among teens meeting baseline criteria for rebelliousness, treatment teens reported fewer symptom-days, symptom-nights, school absences, and restricted activity days: aOR =.30 (.11-.80),.29 (.14-.64),.40 (.20-.78), and.23 (.10-.55); all p <.05. Among teens reporting low perceived emotional support, treatment students reported only fewer symptom-days than controls: aOR =.23 (.06-.88), p =.031. We did not observe statistically significant differences in medical care use. Conclusions: Results suggest that a theory-based, tailored approach, with a referral coordinator, can improve asthma management in urban teens. Puff City represents a viable strategy for disseminating an effective intervention to high-risk and hard-to-reach populations.

Original languageEnglish (US)
Pages (from-to)419-426
Number of pages8
JournalJournal of Adolescent Health
Volume52
Issue number4
DOIs
StatePublished - Apr 1 2013

Fingerprint

Asthma
Students
Referral and Consultation
Therapeutics
Self Care
African Americans
Randomized Controlled Trials
Odds Ratio
Confidence Intervals
Education
Population

Keywords

  • Adolescents
  • African-American
  • Asthma
  • Behavioral intervention
  • Randomized controlled trial
  • Tailored intervention
  • Web-based intervention

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

Cite this

Evaluation of a web-based asthma management intervention program for urban teenagers : Reaching the hard to reach. / Joseph, Christine L.M.; Ownby, Dennis Randall; Havstad, Suzanne L.; Saltzgaber, Jacqueline; Considine, Shannon; Johnson, Dayna; Peterson, Ed; Alexander, Gwen; Lu, Mei; Gibson-Scipio, Wanda; Johnson, Christine Cole.

In: Journal of Adolescent Health, Vol. 52, No. 4, 01.04.2013, p. 419-426.

Research output: Contribution to journalArticle

Joseph, CLM, Ownby, DR, Havstad, SL, Saltzgaber, J, Considine, S, Johnson, D, Peterson, E, Alexander, G, Lu, M, Gibson-Scipio, W & Johnson, CC 2013, 'Evaluation of a web-based asthma management intervention program for urban teenagers: Reaching the hard to reach', Journal of Adolescent Health, vol. 52, no. 4, pp. 419-426. https://doi.org/10.1016/j.jadohealth.2012.07.009
Joseph, Christine L.M. ; Ownby, Dennis Randall ; Havstad, Suzanne L. ; Saltzgaber, Jacqueline ; Considine, Shannon ; Johnson, Dayna ; Peterson, Ed ; Alexander, Gwen ; Lu, Mei ; Gibson-Scipio, Wanda ; Johnson, Christine Cole. / Evaluation of a web-based asthma management intervention program for urban teenagers : Reaching the hard to reach. In: Journal of Adolescent Health. 2013 ; Vol. 52, No. 4. pp. 419-426.
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