Pogge Gabrielle, Fedele David A, Waters Erika A, Maki Julia, Hunleth Jean M, Prabhakaran Sreekala, Bowen Deborah J, Shepperd James A
Department of Psychology, University of Florida, Gainesville, FL, United States.
Division of Public Health Sciences, Washington University in St Louis, St Louis, MO, United States.
JMIR Form Res. 2023 Aug 2;7:e46341. doi: 10.2196/46341.
Maintaining control of asthma symptoms is the cornerstone of asthma treatment guidelines in the United States. However, suboptimal asthma control and asthma exacerbations among young people are common and are associated with many negative outcomes. Interventions to improve asthma control are needed. For such interventions to be successful, it is necessary to understand the types of interventions that are appealing to caregivers of children with different levels of risk of exacerbation.
This study aimed to evaluate whether caregivers of children with high (vs low) risk of asthma exacerbation show different levels of interest in and preferences for potential intervention programs and delivery methods.
We contracted with Ipsos to administer a web-based survey to caregivers of children with asthma who were residing in the United States. Caregivers (N=394) reported their interest (1=not at all; 3=a lot) in 9 possible intervention programs and 8 possible intervention delivery methods. Caregivers also indicated their preferences by selecting the 3 intervention programs and 3 delivery methods that "most" interested them. Finally, caregivers completed 2 open-ended questions asking what other resources might be useful for managing their children's asthma. We classified children as having a high risk of exacerbation if they had an exacerbation in the past 3 months (n=116) and a low risk of exacerbation if otherwise (n=278).
Caregivers reported higher levels of interest in all intervention programs and delivery methods if they cared for a child with a high risk rather than a low risk of exacerbation. However, regardless of the child's risk status, caregivers expressed the highest levels of interest in programs to increase their child's self-management skills, to help pay for asthma care, and to work with the school to manage asthma. Caregivers expressed the highest levels of interest in delivery methods that maintained personal control over accessing information (websites, videos, printed materials, and smartphone apps). Caregivers' preferences were consistent with their interests; programs and delivery methods that were rated as high in interest were also selected as one of the 3 that "most" interested them. Although most caregivers did not provide additional suggestions for the open-ended questions, a few caregivers suggested intervention programs and delivery methods that we had not included (eg, education about avoiding triggers and medication reminders).
Similar interests and preferences among caregivers of children with high and low risk of exacerbation suggest a broad need for support in managing childhood asthma. Providers could help caregivers by directing them toward resources that make asthma care more affordable and by helping their children with asthma self-management. Interventions that accommodate caregivers' concerns about having personal control over access to asthma information are likely to be more successful than interventions that do not.
在美国,维持哮喘症状的控制是哮喘治疗指南的基石。然而,青少年哮喘控制不佳和哮喘发作很常见,且与许多负面后果相关。需要采取干预措施来改善哮喘控制。为使此类干预措施取得成功,有必要了解对不同发作风险水平儿童的照料者有吸引力的干预措施类型。
本研究旨在评估哮喘发作高风险(与低风险相比)儿童的照料者对潜在干预项目和实施方式是否表现出不同程度的兴趣和偏好。
我们与益普索公司签约,对居住在美国的哮喘儿童照料者进行一项基于网络的调查。照料者(N = 394)报告了他们对9种可能的干预项目和8种可能的干预实施方式的兴趣程度(1 = 完全不感兴趣;3 = 非常感兴趣)。照料者还通过选择“最”感兴趣的3种干预项目和3种实施方式来表明他们的偏好。最后,照料者完成了2个开放式问题,询问还有哪些其他资源可能有助于管理孩子的哮喘。如果孩子在过去3个月内有过发作(n = 116),我们将其归类为发作高风险;否则(n = 278)归类为发作低风险。
如果照料的是发作高风险而非低风险的儿童,他们对所有干预项目和实施方式的兴趣程度更高。然而,无论孩子的风险状况如何,照料者对旨在提高孩子自我管理技能、帮助支付哮喘治疗费用以及与学校合作管理哮喘的项目表现出最高的兴趣。照料者对能让他们个人控制获取信息的实施方式(网站、视频、印刷材料和智能手机应用程序)表现出最高的兴趣。照料者的偏好与他们的兴趣一致;被评为兴趣高的项目和实施方式也被选为“最”感兴趣的3种之一。尽管大多数照料者没有对开放式问题提供额外建议,但有少数照料者提出了我们未纳入的干预项目和实施方式(例如,关于避免触发因素的教育和用药提醒)。
哮喘发作高风险和低风险儿童的照料者有相似的兴趣和偏好,这表明在管理儿童哮喘方面广泛需要支持。医疗服务提供者可以通过引导照料者获取使哮喘治疗更经济实惠的资源以及帮助患有哮喘的孩子进行自我管理来提供帮助。能顾及照料者对个人控制获取哮喘信息的担忧的干预措施可能比不考虑这些的干预措施更成功。