Self-Management assistance for recommended treatment (SMART) IBD app randomized control trial in adolescents with IBD: Design and methodology

Caroline M. Roberts , Jill M. Plevinsky , Kaitlyn L. Gamwell , Amy E. Noser , Lee A. Denson , Kevin A. Hommel
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Abstract

Aims

Adherence to medical regimens, including medications and appointments, is a significant concern for adolescent populations that warrants behavioral interventions. Negative health behaviors during adolescence can persist into adulthood and lead to long-term negative health outcomes. Due to the limited availability and resources for behavioral self-management intervention, many youth do not receive evidence-based behavioral care and continue to struggle with managing their illness. Therefore, there is a need for easily accessible mHealth interventions targeting self-management in order to reduce health care barriers and provide more timely and effective behavioral care particularly during this developmental stage.

Methods

We provide a description of the design and methodology of the Self-Management Assistance for Recommended Treatment (SMART) IBD App randomized controlled pilot trial in pediatric inflammatory bowel disease (IBD) that aims to test the preliminary efficacy of the SMART IBD app compared to a usual care (UC) arm. Thirty participants 13–17 years of age will be recruited and randomized in the trial. Those randomized to the intervention arm will use the app for four weeks, each with one weekly challenge that focuses on self-management. Participants in both arms will complete baseline assessments, daily diaries for four weeks, and post-treatment assessments.

Conclusion

We hypothesize that participants in the intervention arm will experience clinically significant improvements in their self-management compared to those in the UC arm at the post-treatment assessment. Findings from the current study could provide initial evidence to support self-management interventions in adolescents with health conditions via mobile health apps, thereby reducing health care barriers and strains on institutional and nursing resources. Mobile health apps may also be a preferred avenue to disseminate interventions to adolescents.

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自我管理辅助推荐治疗(SMART) IBD应用程序在青少年IBD患者中的随机对照试验:设计和方法
目的坚持医疗方案,包括药物和预约,是青少年群体的一个重要问题,需要行为干预。青少年时期的负面健康行为可能持续到成年,并导致长期的负面健康后果。由于行为自我管理干预的可用性和资源有限,许多年轻人没有得到基于证据的行为护理,继续与控制他们的疾病作斗争。因此,有必要采取以自我管理为目标的易于获得的移动医疗干预措施,以减少保健障碍,并提供更及时和有效的行为护理,特别是在这一发展阶段。方法我们提供了一项针对儿童炎症性肠病(IBD)的自我管理辅助推荐治疗(SMART) IBD应用程序随机对照试验的设计和方法描述,旨在测试SMART IBD应用程序与常规护理(UC)组相比的初步疗效。将招募30名年龄在13-17岁之间的参与者并在试验中随机分组。那些被随机分配到干预组的人将使用该应用程序四周,每个人每周都有一个专注于自我管理的挑战。两组参与者将完成基线评估、为期四周的每日日记和治疗后评估。结论:我们假设在治疗后评估中,干预组的参与者在自我管理方面比UC组的参与者有显著的临床改善。本研究的结果可以为支持通过移动健康应用程序对有健康状况的青少年进行自我管理干预提供初步证据,从而减少卫生保健障碍和机构和护理资源的压力。移动健康应用程序也可能是向青少年传播干预措施的首选途径。
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